Use of human menopausal gonadotropins in the treatment of endometrial defects associated with recurrent miscarriage: preliminary report

Objective: To test the hypothesis that controlled ovarian stimulation by gonadotropins, which enhances estrogen priming, is of beneficial value in the treatment of endometrial defects associated with recurrent miscarriage. Design: A retrospective, observational, nonrandomized study. Setting: A regional recurrent miscarriage clinic in a teaching hospital. Patient(s): Twenty-one subjects with otherwise unexplained recurrent miscarriage who had retarded endometrial development in the mid–luteal phase. Endometrial biopsies were timed by the luteinizing hormone surge. Intervention(s): Controlled ovarian stimulation using human menopausal gonadotropins and repeat endometrial biopsy in the treatment cycle in 13 subjects. Main Outcome Measure(s): Histological dating of endometrial biopsy in treatment cycles and miscarriage rate in treatment and nontreatment cycles. Result(s): Eleven (85%) of the 13 biopsies in the treatment cycle were found to be normal. The miscarriage rate in the treatment group, 2 of 13, was significantly lower than that in the nontreatment group (7/12) (χ 2 5.0, P