Serum ferritin level is inversely related to number of previous pregnancy losses in women with recurrent pregnancy loss

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Authors:

Maja Georgsen, M.D., Maria Christine Krog, M.D., Anne-Sofie Korsholm, M.D., Ph.D., Helene Westring Hvidman, M.D., Ph.D., Astrid Marie Kolte, M.D., Ph.D., Andreas Stribolt Rigas, M.D., Ph.D., Henrik Ullum, M.D., Ph.D., Søren Ziebe, D.Sc., Anders Nyboe Andersen, M.D., D.M.Sc., Henriette Svarre Nielsen, M.D., D.M.Sc., Morten Bagge Hansen, M.D., D.M.Sc.

Abstract:

Objective

To study whether low serum ferritin (s-ferritin) levels are associated with recurrent pregnancy loss (RPL), and whether low s-ferritin predicts the risk of another pregnancy loss or the ability to conceive.


Design

Cohort study.


Setting

Fertility clinic at a university hospital.


Patient(s)

Eighty-four women referred to the RPL Unit and 153 women of reproductive age with no known fertility problem. s-Ferritin levels were measured in serum samples taken before pregnancy attempt.


Intervention

None.


Main Outcome Measure(s)

s-Ferritin levels were correlated to pregnancy history, ability to conceive, and time to conception during the first 2 years after sampling. Furthermore, s-ferritin levels were correlated to outcome of the first pregnancy after referral for RPL.


Result(s)

Women with RPL had lower s-ferritin than the comparison group, 39.9 μg/L versus 62.2 μg/L, and had a higher prevalence of low iron stores (s-ferritin <30 μg/L), 35.7% versus 13.7%. We found an inverse relationship between s-ferritin level and number of pregnancy losses before referral. We did not find s-ferritin level to be associated with ability to conceive or time to pregnancy in either group. Nor did s-ferritin level predict the risk of losing the first pregnancy after referral for RPL.


Conclusion(s)

The inverse relationship between s-ferritin levels and previous pregnancy losses suggests that low s-ferritin is associated with a more severe reproductive disturbance in women with RPL. Whether low s-ferritin is causally related to RPL and if such women could benefit from iron supplementation to achieve a live birth warrants further investigation.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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