Prophylactic Measures in Early Recurrent Pregnancy Loss in Women with Polycystic Ovary Syndrome and Hyperhomocysteinemia

Abstract
Background: The Polycystic Ovary Syndrome (PCOS) is the commonest endocrine disturbance affecting women, several complications of pregnancy in women with Polycystic Ovary Syndrome (PCOS) including recurrent pregnancy loss, the exact mechanisms that may cause RPL in PCOS patients are obscure. Several etiologies have been proposed, hyperhomo-cysteinemia is a common finding in women with PCOS and was found to be associated with both RPL and PCOS.
Aim of Study: Aim of the study is to evaluate prophylactic measures against early recurrent pregnancy loss before 20 weeks of gestation in women with polycystic ovary syndrome and hyperhomocysteinemia by either Low Dose Aspirin (LDA), LMWH or both.
Patient and Methods: The present study was carried out on 120 pregnant women in reproductive period, their age ranged between 20 and 35 years. They were classified into three groups, group I treated with Low Dose Aspirin (LDA) (40), group II treated with low molecular weight heparin (40) and group III treated with low dose aspirin and low molecular weight heparin (40).
Result: Hyperhomocysteinemia is a common finding in women with PCOS and was found to be associated with both RPL and PCOS. It was shown that combined treatment with aspirin and Low Molecular Weight Heparin (LMWH) in women with hyperhomocysteinemia improved successful pregnancy rates.
Conclusion: The use of clexane or Clexane with LDA prevent early recurrent pregnancy loss in patients with PCOS and hyperhomocysteinemia better than LDA alone.