Recurrent Miscarriage for the MRCOG. 10 Questions to MRCOG Mastery. RCOG Guideline (Green Top).

[@sadiaalim2185]

❤ amazing 😍

[@nayrouzalmukhtar3515]

Very nice summary, thank you 🌹

[@johnsonzhong6967]

I see, the last question is based on your research published in NEJM.

[@johnsonzhong6967]

Dear Professor, I have a clinical question for you. I have read your meta-analysis study published on BMJ in 2012 regarding the single progesterone level to predict pregnancy outcome for women presenting pain and/or bleeding. I've got a patient recently who is a nulliparous presenting with pain in her early pregnancy. Her initial progesterone level is only 4ng/ml, which is way below the safe level from my perspective. As this is her first pregnancy, we did not intervene and she is now at 18wks of gestation. From your perspective, is this case worth a case reporting for her extremely low progesterone level? I'm looking forward to your kind response. Thank you in advance.

[@drnourala]

Love it 🤩

[@Prof_Arri_MRCOG]

Thank you!

[@parajsashqiptare9118]

so, if a person had 5 miscarriages in first trimester what analysis should do? how to find the cause?

[@Prof_Arri_MRCOG]

I would do all the investigations recommended in the RCOG guideline, and depending on the results and clinical history, consider other tests (e.g., sperm DNA fragmentation test).

[@parajsashqiptare9118]

@@Prof_Arri_MRCOG Dear Professor Coomarasamy, We have conducted a series of investigations, and with the fragmentation of spermatic DNA, everything seems to be in order. The only issues that have arisen are: endometritis (following an endometrial biopsy), low progesterone in the luteal phase, vitamin D deficiency, hypothyroidism (medicinally treated) , ANA 1:320, and borderline insulin resistance. Are these reasons compatible with first-trimester miscarriages? Professor, do you offer counseling services? We are from Milan, Italy, and would appreciate hearing your opinion, after 5 miscarriages we are desperate. Thank you.

[@parajsashqiptare9118]

@@Prof_Arri_MRCOG Dear Professor Coomarasamy, We have conducted a series of investigations, and with the fragmentation of spermatic DNA, everything seems to be in order. The only issues that have arisen are: endometritis (following an endometrial biopsy), low progesterone in the luteal phase, vitamin D deficiency, hypothyroidism (medicinally treated) , ANA 1:320, and borderline insulin resistance. Are these reasons compatible with first-trimester miscarriages? Professor, do you offer counseling services? We are from Milan, Italy, and would appreciate hearing your opinion. Thank you.