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Plasma homocysteine levels in polycystic ovarian syndrome with early recurrent pregnancy loss

Background A pregnancy loss (miscarriage) is defined as the spontaneous demise of a pregnancy before the fetus reaches viability. The term therefore includes all pregnancy losses (PLs) from the time of conception until 24 weeks of gestation. Polycystic ovary syndrome (PCOS) is a common endocrine system disorder among women in which levels of the sex hormones are disrupted. Hyperhomocysteinemia has been associated with clinical vascular thrombosis, and this could be the cause for early decidual and chorionic vessel damage that might result in disturbed implantation of the conceptus. Objective To determine the plasma homocysteine levels in patients with PCOS having recurrent pregnancy loss (RPL) compared with women with PCOS without RPL. Patients and methods This is a case–control study on 30 women with PCOS with RPL and 30 control women with PCOS without RPL. Plasma homocysteine levels were assessed from February 2019 to February 2020 at Al Zahraa University Hospital. Results There was a significant increase in the mean homocysteine level in the case group (20.14±3.21) compared with controls (9.01±2.24) (P=0.001), with odds ratio=2.193 (confidence interval 0.171–23.294) by homocysteine through cut-off more than 12 mmol/l. Conclusion Risk of RPL in patients with PCOS is increased with hyperhomocysteinemia (P<0.001).