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Carolyn B. Coulam - One of the best experts on this subject based on the ideXlab platform.

  • Is superfertility associated with Recurrent Pregnancy Loss
    American journal of reproductive immunology (New York N.Y. : 1989), 2014
    Co-Authors: Jennie Orlando, Carolyn B. Coulam
    Abstract:

    Problem A recent hypothesis has implicated superfertility as a cause of Recurrent Pregnancy Loss. Clinical support for the concept comes from one report that 40% of women experiencing Recurrent miscarriages had monthly fecundity rates of 60% or greater and thus were designated as superfertile. Methods of study To confirm or refute this finding, clinical histories of 201 women with a history of Recurrent Pregnancy Loss were reviewed and months to desired Pregnancy, karyotypes of their products of conception as well as results of laboratory tests including antiphospholipid antibodies and circulating natural killer cells were recorded. Results The prevalence of superfertility was 32% (64/201) among Recurrently aborting women compared with 3% of the general population according to the model of Tietze (P 

  • ORIGINAL ARTICLE: The Association of Apoprotien E Polymorphisms with Recurrent Pregnancy Loss
    American journal of reproductive immunology (New York N.Y. : 1989), 2008
    Co-Authors: Chelsi Goodman, Cyle S Goodman, Jee Hur, R.s. Jeyendran, Carolyn B. Coulam
    Abstract:

    Problem  We have previously reported the role of polymorphisms of thrombogenic genes involved in coagulation and fibrinolysis as risk factors for Recurrent Pregnancy Loss. Thrombophilia has been viewed as a multigenic disorder rather than a monogenetic clinical phenotype and Apo E has been shown to play an important role in lipid metabolism in Pregnancy. As individuals carrying the E4 allele of the ApoE gene have the highest risk for thrombosis, we evaluated the frequency of the Apo E4 genotype among women suffering from Recurrent Pregnancy Loss. Method of study  Buccal swabs were obtained from 69 women with a history of two or more consecutive spontaneous abortions and 37 women with at least two live births and not more than one miscarriage. DNA was extracted from the buccal swabs and PCR amplification of Apo E2, E3, and E4 was performed. Results  Women experiencing Recurrent Pregnancy Loss had a significantly higher prevalence of Apo E3/4, E4/4 genotypes (21.7%) compared with control women (5.4%) (P = 0.036). Conclusion  Apo E4 polymorphism may contribute to the thrombophilic risk factors contributing to Recurrent Pregnancy Loss.

  • which thrombophilic gene mutations are risk factors for Recurrent Pregnancy Loss
    American Journal of Reproductive Immunology, 2006
    Co-Authors: Cyle S Goodman, Carolyn B. Coulam, Rajasingam S Jeyendran, Vida A Acosta, Roumen G Roussev
    Abstract:

    Problem  Thrombophilia has been associated with poor obstetrical outcomes. To determine the association of specific inherited thrombophilias and Recurrent Pregnancy Loss, 10 thrombophilic genes were investigated. Method of study  A total of 550 women with a history of Recurrent Pregnancy Loss had buccal swabs taken for DNA analyses of the following gene mutations: factor V G1691A, factor V H1299R (R2), factor V Y1702C, factor II prothrombin G20210A, factor XIII V34L, β-fibrinogen -455G>A, PAI-1 4G/5G, HPA1 a/b(L33P), methylenetetrahydrofolate reductase (MTHFR) C677T, MTHFR A1298C. The frequencies of these mutations were compared with controls published in the literature. Results  When examined individually, PAI-1 4G/5G (P = 0.009), factor XIII V34L (P < 0.0001), and homozygous MTHFR C667T (P < 0.0001) correlated significantly with Recurrent Pregnancy Loss compared with controls. The frequency of the factor V Y1702C mutation was extremely low in patients and controls; thus, this gene was removed from further calculations. The remaining six mutated genes, when analyzed cumulatively, also corresponded with Recurrent Pregnancy Loss (P < 0.0001). Conclusion  A panel of thrombogenic gene mutations consisting of factor V G1691A, factor V H1299R (R2), factor II prothrombin G20210A, factor XIII V34L, β-fibrinogen -455G>A, PAI-1 4G/5G, HPA1 a/b(L33P), MTHFR C677T, and MTHFR A1298C can identify individuals at risk for Recurrent Pregnancy Loss.

  • Which thrombophilic gene mutations are risk factors for Recurrent Pregnancy Loss
    American journal of reproductive immunology (New York N.Y. : 1989), 2006
    Co-Authors: Cyle S Goodman, Carolyn B. Coulam, Rajasingam S Jeyendran, Vida A Acosta, Roumen G Roussev
    Abstract:

    Problem  Thrombophilia has been associated with poor obstetrical outcomes. To determine the association of specific inherited thrombophilias and Recurrent Pregnancy Loss, 10 thrombophilic genes were investigated. Method of study  A total of 550 women with a history of Recurrent Pregnancy Loss had buccal swabs taken for DNA analyses of the following gene mutations: factor V G1691A, factor V H1299R (R2), factor V Y1702C, factor II prothrombin G20210A, factor XIII V34L, β-fibrinogen -455G>A, PAI-1 4G/5G, HPA1 a/b(L33P), methylenetetrahydrofolate reductase (MTHFR) C677T, MTHFR A1298C. The frequencies of these mutations were compared with controls published in the literature. Results  When examined individually, PAI-1 4G/5G (P = 0.009), factor XIII V34L (P 

  • Current status of immunologic Recurrent Pregnancy Loss.
    Current opinion in obstetrics & gynecology, 1993
    Co-Authors: J. Jaroslav Stern, Carolyn B. Coulam
    Abstract:

    Normal mammalian Pregnancy is confronted with a great number of self (autoimmune) and foreign (alloimmune) antigens that modulate the immune system of the mother. When maternal immune response is affected, Recurrent Pregnancy Loss can result. Recurrent Pregnancy Loss affects 2% to 5% of reproducing couples. Half of these failures can be explained by genetic, hormonal, infectious, and anatomic factors. Eighty percent of the unexplained failures are proposed to have an immunologic cause. HLA typing, mixed lymphocytotoxic antibody tests, mixed lymphocyte culture reactions, lupus anticoagulant tests, and antiphospholipid antibody determination are methods used to study and differentiate between auto- and alloimmune response. Experimental therapies, including leukocyte immunization, seminal plasma suppositories, intravenous immunoglobulin, aspirin and prednisone, and heparin, have been tried to manage this condition. Results of randomized placebo-controlled clinical trials will aid in the choice of treatment for Recurrent Pregnancy Loss. New assays to diagnose auto- and alloimmune factors in Recurrent Pregnancy Loss are being investigated.

Roumen G Roussev - One of the best experts on this subject based on the ideXlab platform.

  • which thrombophilic gene mutations are risk factors for Recurrent Pregnancy Loss
    American Journal of Reproductive Immunology, 2006
    Co-Authors: Cyle S Goodman, Carolyn B. Coulam, Rajasingam S Jeyendran, Vida A Acosta, Roumen G Roussev
    Abstract:

    Problem  Thrombophilia has been associated with poor obstetrical outcomes. To determine the association of specific inherited thrombophilias and Recurrent Pregnancy Loss, 10 thrombophilic genes were investigated. Method of study  A total of 550 women with a history of Recurrent Pregnancy Loss had buccal swabs taken for DNA analyses of the following gene mutations: factor V G1691A, factor V H1299R (R2), factor V Y1702C, factor II prothrombin G20210A, factor XIII V34L, β-fibrinogen -455G>A, PAI-1 4G/5G, HPA1 a/b(L33P), methylenetetrahydrofolate reductase (MTHFR) C677T, MTHFR A1298C. The frequencies of these mutations were compared with controls published in the literature. Results  When examined individually, PAI-1 4G/5G (P = 0.009), factor XIII V34L (P < 0.0001), and homozygous MTHFR C667T (P < 0.0001) correlated significantly with Recurrent Pregnancy Loss compared with controls. The frequency of the factor V Y1702C mutation was extremely low in patients and controls; thus, this gene was removed from further calculations. The remaining six mutated genes, when analyzed cumulatively, also corresponded with Recurrent Pregnancy Loss (P < 0.0001). Conclusion  A panel of thrombogenic gene mutations consisting of factor V G1691A, factor V H1299R (R2), factor II prothrombin G20210A, factor XIII V34L, β-fibrinogen -455G>A, PAI-1 4G/5G, HPA1 a/b(L33P), MTHFR C677T, and MTHFR A1298C can identify individuals at risk for Recurrent Pregnancy Loss.

  • Which thrombophilic gene mutations are risk factors for Recurrent Pregnancy Loss
    American journal of reproductive immunology (New York N.Y. : 1989), 2006
    Co-Authors: Cyle S Goodman, Carolyn B. Coulam, Rajasingam S Jeyendran, Vida A Acosta, Roumen G Roussev
    Abstract:

    Problem  Thrombophilia has been associated with poor obstetrical outcomes. To determine the association of specific inherited thrombophilias and Recurrent Pregnancy Loss, 10 thrombophilic genes were investigated. Method of study  A total of 550 women with a history of Recurrent Pregnancy Loss had buccal swabs taken for DNA analyses of the following gene mutations: factor V G1691A, factor V H1299R (R2), factor V Y1702C, factor II prothrombin G20210A, factor XIII V34L, β-fibrinogen -455G>A, PAI-1 4G/5G, HPA1 a/b(L33P), methylenetetrahydrofolate reductase (MTHFR) C677T, MTHFR A1298C. The frequencies of these mutations were compared with controls published in the literature. Results  When examined individually, PAI-1 4G/5G (P = 0.009), factor XIII V34L (P 

Jared C. Robins - One of the best experts on this subject based on the ideXlab platform.

  • Sperm DNA fragmentation and Recurrent Pregnancy Loss: a systematic review and meta-analysis
    Fertility and sterility, 2019
    Co-Authors: Dana B. Mcqueen, J. Zhang, Jared C. Robins
    Abstract:

    Objective To investigate the rate of sperm DNA fragmentation in male partners of women with Recurrent Pregnancy Loss and fertile control women. Design Systematic review and meta-analysis. Setting Not applicable. Patient(s) A total of 579 male partners of women with Recurrent Pregnancy Loss and 434 male partners fertile control women. Intervention(s) Prospective studies were identified through a Pubmed search. Recurrent Pregnancy Loss was defined as two or more previous Pregnancy Losses. Fertile control women had a history of a live birth or ongoing Pregnancy. Main Outcome Measure(s) The primary outcome was the rate of sperm DNA fragmentation. The summary measures were reported as mean difference with 95% confidence interval (CI). Result(s) Fifteen prospective studies were included in a qualitative review. Pooled data from 13 studies with sufficient data for meta-analysis suggest that male partners of women with a history of Recurrent Pregnancy Loss have a significantly higher rate of sperm DNA fragmentation compared to the partners of fertile control women: mean difference 11.91, 95% CI 4.97–18.86. Conclusion(s) These findings support an association between sperm DNA fragmentation and Recurrent Pregnancy Loss. However, given the significant heterogeneity between studies and lack of prospective Pregnancy outcome data, further large prospective studies are needed.

A Stagnaro-green - One of the best experts on this subject based on the ideXlab platform.

  • Thyroid autoantibodies are not associated with Recurrent Pregnancy Loss.
    American journal of obstetrics and gynecology, 1998
    Co-Authors: M S Esplin, D W Branch, R Silver, A Stagnaro-green
    Abstract:

    Approximately 1% of all women have Recurrent Pregnancy Loss, defined as >/=3 spontaneous Losses of Pregnancy; however, a cause is determined in only 50% of cases. Recent studies have associated the presence of thyroid autoantibodies during the first trimester of Pregnancy with spontaneous abortion in the current Pregnancy among women without a history of Recurrent abortion. The objective of this study was to determine whether circulating thyroid autoantibodies were associated with Recurrent Pregnancy Loss. Sera from 74 nonpregnant women with a history of Recurrent Pregnancy Loss and from 75 healthy, fertile control subjects of similar gravidity were tested for thyroglobulin and thyroid peroxidase antibodies by means of radioimmunoassay kits. All women had a third-generation thyroid-stimulating hormone assay performed. Samples were obtained >/=6 months after a Pregnancy. Twenty-two of the women with a history of Recurrent Pregnancy Loss (29.3%) and twenty-eight of the control subjects (37%) had positive results for either one or both of the thyroid autoantibodies (P >. 05). Mean thyroid-stimulating hormone levels and the proportion of women with abnormal thyroid-stimulating hormone values did not differ between the 2 groups. Women with a history of Recurrent Pregnancy Loss are no more likely than are fertile control subjects to have circulating thyroid autoantibodies. Testing for antithyroid antibodies is not clinically useful in the evaluation of patients with a history of Recurrent Pregnancy Loss.

  • Thyroid autoantibodies are not associated with Recurrent Pregnancy Loss.
    American Journal of Obstetrics and Gynecology, 1998
    Co-Authors: M S Esplin, D W Branch, Robert M. Silver, A Stagnaro-green
    Abstract:

    Abstract Objective: Approximately 1% of all women have Recurrent Pregnancy Loss, defined as ≥3 spontaneous Losses of Pregnancy; however, a cause is determined in only 50% of cases. Recent studies have associated the presence of thyroid autoantibodies during the first trimester of Pregnancy with spontaneous abortion in the current Pregnancy among women without a history of Recurrent abortion. The objective of this study was to determine whether circulating thyroid autoantibodies were associated with Recurrent Pregnancy Loss. Study Design: Sera from 74 nonpregnant women with a history of Recurrent Pregnancy Loss and from 75 healthy, fertile control subjects of similar gravidity were tested for thyroglobulin and thyroid peroxidase antibodies by means of radioimmunoassay kits. All women had a third-generation thyroid-stimulating hormone assay performed. Samples were obtained ≥6 months after a Pregnancy. Results: Twenty-two of the women with a history of Recurrent Pregnancy Loss (29.3%) and twenty-eight of the control subjects (37%) had positive results for either one or both of the thyroid autoantibodies ( P > .05). Mean thyroid-stimulating hormone levels and the proportion of women with abnormal thyroid-stimulating hormone values did not differ between the 2 groups. Conclusion: Women with a history of Recurrent Pregnancy Loss are no more likely than are fertile control subjects to have circulating thyroid autoantibodies. Testing for antithyroid antibodies is not clinically useful in the evaluation of patients with a history of Recurrent Pregnancy Loss. (Am J Obstet Gynecol 1998;179:1583-6.)

Cyle S Goodman - One of the best experts on this subject based on the ideXlab platform.

  • ORIGINAL ARTICLE: The Association of Apoprotien E Polymorphisms with Recurrent Pregnancy Loss
    American journal of reproductive immunology (New York N.Y. : 1989), 2008
    Co-Authors: Chelsi Goodman, Cyle S Goodman, Jee Hur, R.s. Jeyendran, Carolyn B. Coulam
    Abstract:

    Problem  We have previously reported the role of polymorphisms of thrombogenic genes involved in coagulation and fibrinolysis as risk factors for Recurrent Pregnancy Loss. Thrombophilia has been viewed as a multigenic disorder rather than a monogenetic clinical phenotype and Apo E has been shown to play an important role in lipid metabolism in Pregnancy. As individuals carrying the E4 allele of the ApoE gene have the highest risk for thrombosis, we evaluated the frequency of the Apo E4 genotype among women suffering from Recurrent Pregnancy Loss. Method of study  Buccal swabs were obtained from 69 women with a history of two or more consecutive spontaneous abortions and 37 women with at least two live births and not more than one miscarriage. DNA was extracted from the buccal swabs and PCR amplification of Apo E2, E3, and E4 was performed. Results  Women experiencing Recurrent Pregnancy Loss had a significantly higher prevalence of Apo E3/4, E4/4 genotypes (21.7%) compared with control women (5.4%) (P = 0.036). Conclusion  Apo E4 polymorphism may contribute to the thrombophilic risk factors contributing to Recurrent Pregnancy Loss.

  • which thrombophilic gene mutations are risk factors for Recurrent Pregnancy Loss
    American Journal of Reproductive Immunology, 2006
    Co-Authors: Cyle S Goodman, Carolyn B. Coulam, Rajasingam S Jeyendran, Vida A Acosta, Roumen G Roussev
    Abstract:

    Problem  Thrombophilia has been associated with poor obstetrical outcomes. To determine the association of specific inherited thrombophilias and Recurrent Pregnancy Loss, 10 thrombophilic genes were investigated. Method of study  A total of 550 women with a history of Recurrent Pregnancy Loss had buccal swabs taken for DNA analyses of the following gene mutations: factor V G1691A, factor V H1299R (R2), factor V Y1702C, factor II prothrombin G20210A, factor XIII V34L, β-fibrinogen -455G>A, PAI-1 4G/5G, HPA1 a/b(L33P), methylenetetrahydrofolate reductase (MTHFR) C677T, MTHFR A1298C. The frequencies of these mutations were compared with controls published in the literature. Results  When examined individually, PAI-1 4G/5G (P = 0.009), factor XIII V34L (P < 0.0001), and homozygous MTHFR C667T (P < 0.0001) correlated significantly with Recurrent Pregnancy Loss compared with controls. The frequency of the factor V Y1702C mutation was extremely low in patients and controls; thus, this gene was removed from further calculations. The remaining six mutated genes, when analyzed cumulatively, also corresponded with Recurrent Pregnancy Loss (P < 0.0001). Conclusion  A panel of thrombogenic gene mutations consisting of factor V G1691A, factor V H1299R (R2), factor II prothrombin G20210A, factor XIII V34L, β-fibrinogen -455G>A, PAI-1 4G/5G, HPA1 a/b(L33P), MTHFR C677T, and MTHFR A1298C can identify individuals at risk for Recurrent Pregnancy Loss.

  • Which thrombophilic gene mutations are risk factors for Recurrent Pregnancy Loss
    American journal of reproductive immunology (New York N.Y. : 1989), 2006
    Co-Authors: Cyle S Goodman, Carolyn B. Coulam, Rajasingam S Jeyendran, Vida A Acosta, Roumen G Roussev
    Abstract:

    Problem  Thrombophilia has been associated with poor obstetrical outcomes. To determine the association of specific inherited thrombophilias and Recurrent Pregnancy Loss, 10 thrombophilic genes were investigated. Method of study  A total of 550 women with a history of Recurrent Pregnancy Loss had buccal swabs taken for DNA analyses of the following gene mutations: factor V G1691A, factor V H1299R (R2), factor V Y1702C, factor II prothrombin G20210A, factor XIII V34L, β-fibrinogen -455G>A, PAI-1 4G/5G, HPA1 a/b(L33P), methylenetetrahydrofolate reductase (MTHFR) C677T, MTHFR A1298C. The frequencies of these mutations were compared with controls published in the literature. Results  When examined individually, PAI-1 4G/5G (P = 0.009), factor XIII V34L (P