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Article ; Online: Progestogens and pregnancy loss.

Carp, H J A

Climacteric : the journal of the International Menopause Society

2018 Volume 21, Issue 4, Page(s) 380–384

Abstract: Progestational agents are often prescribed to prevent pregnancy loss. Progestogens affect implantation, cytokine balance, natural killer cell activity, arachidonic acid release and myometrial contractility. Progestogens have therefore been used at all ... ...

Abstract	Progestational agents are often prescribed to prevent pregnancy loss. Progestogens affect implantation, cytokine balance, natural killer cell activity, arachidonic acid release and myometrial contractility. Progestogens have therefore been used at all stages of pregnancy including luteal-phase support prior to pregnancy, threatened miscarriage, recurrent miscarriage, and to prevent preterm labor. In luteal support, a Cochrane review reported that progestogens were associated with a higher rate of live births or ongoing pregnancy in the progesterone group (odds ratio 1.77, 95% confidence interval (CI) 1.09-2.86). Evidence suggests that progestogens are also effective for treating threatened miscarriage. Again, in a Cochrane Database review, progestogens were associated with a reduced odds ratio of 0.53 (95% CI 0.35-0.79) when progestogens were used. In recurrent miscarriage, progestogens also seem to have a beneficial effect. A meta-analysis of progestational agents showed a 28% increase in the live birth rate (relative risk 0.72, 95% CI 0.53-0.97). For the last 30 years, progestogens have been used to prevent preterm labor. Recent meta-analyses also report beneficial effects. This review summarizes the literature and the author's experience using progestogens to prevent pregnancy loss.
MeSH term(s)	Abortion, Habitual/prevention & control ; Abortion, Threatened/prevention & control ; Female ; Humans ; Obstetric Labor, Premature/prevention & control ; Pregnancy ; Progesterone/adverse effects ; Progesterone/therapeutic use ; Progestins/adverse effects ; Progestins/therapeutic use ; Randomized Controlled Trials as Topic
Chemical Substances	Progestins ; Progesterone (4G7DS2Q64Y)
Language	English
Publishing date	2018-03-22
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Review
ZDB-ID	1469153-x
ISSN	1473-0804 ; 1369-7137
ISSN (online)	1473-0804
ISSN	1369-7137
DOI	10.1080/13697137.2018.1436166
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Zs.A 5245: Show issues

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Article ; Online: Recurrent miscarriage and hCG supplementation: a review and metaanalysis.

Carp, H J A

Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology

2010 Volume 26, Issue 10, Page(s) 712–716

Abstract: Human chorionic gonadotropin (hCG) has been used to prevent subsequent miscarriages after previous recurrent miscarriages. In addition to the luteotrophic effects, hCG has uterine immune and autocrine actions. hCG also affects cytokine expression. A ... ...

Abstract	Human chorionic gonadotropin (hCG) has been used to prevent subsequent miscarriages after previous recurrent miscarriages. In addition to the luteotrophic effects, hCG has uterine immune and autocrine actions. hCG also affects cytokine expression. A Cochrane database systematic review has indicated that hCG seems to prevent further miscarriages, (OR for miscarriage = 0.26, 95% CI 0.14-0.52). However, the trials in the Cochrane database were not matched for the number of miscarriages, 1°, 2° or 3° aborter status, maternal age, etc. and no account was made for chromosomally abnormal pregnancies. All of these impact on the subsequent prognosis and may confound the results. The previous trials in the literature all assessed urinary (u-hCG) rather than recombinant hCG (r-hCG), raising the question whether the effect on pregnancy outcome is due to hCG itself, or other urinary proteins present in u-hCG. A new trial is indicated in which r-hCG is compared to u-hCG and the most effective compared to placebo. Treatment and placebos arms should be stratified for the prognostic factors above and the results corrected for fetal chromosomal aberrations. Until such a trial is carried out, the use of hCG supplementation is empiric.
MeSH term(s)	Abortion, Habitual/diagnosis ; Abortion, Habitual/immunology ; Abortion, Habitual/prevention & control ; Autocrine Communication ; Chorionic Gonadotropin/pharmacology ; Chorionic Gonadotropin/therapeutic use ; Female ; Humans ; Pregnancy ; Prognosis ; Uterus/drug effects
Chemical Substances	Chorionic Gonadotropin
Language	English
Publishing date	2010-10
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Review
ZDB-ID	639237-4
ISSN	1473-0766 ; 0951-3590
ISSN (online)	1473-0766
ISSN	0951-3590
DOI	10.3109/09513590.2010.488779
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Zs.A 2284: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 608: Show issues

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Article: Recurrent spontaneous abortions in antiphospholipid syndrome: natural killer cells - an additional mechanism in a multi factorial process.

Carp, H J A / Shoenfeld, Y

Rheumatology (Oxford, England)

2007 Volume 46, Issue 10, Page(s) 1517–1519

MeSH term(s)	Abortion, Habitual/immunology ; Antibodies, Antiphospholipid/immunology ; Antiphospholipid Syndrome/immunology ; Female ; Humans ; Killer Cells, Natural/immunology ; Pregnancy
Chemical Substances	Antibodies, Antiphospholipid
Language	English
Publishing date	2007-10
Publishing country	England
Document type	Comment ; Editorial
ZDB-ID	1464822-2
ISSN	1462-0332 ; 1462-0324
ISSN (online)	1462-0332
ISSN	1462-0324
DOI	10.1093/rheumatology/kem219
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Zs.B 240: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 497: Show issues

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Article: Anti-phospholipid antibodies and infertility.

Carp, H J A / Shoenfeld, Y

Clinical reviews in allergy & immunology

2007 Volume 32, Issue 2, Page(s) 159–161

Abstract: Antiphospholipid syndrome (APS) or the presence of antiphospholipid antibodies (aPL), usually presents as pregnancy loss. However, aPL have also been reported to affect implantation, placentation, and early embryonic development. The binding of aPl to ... ...

Abstract	Antiphospholipid syndrome (APS) or the presence of antiphospholipid antibodies (aPL), usually presents as pregnancy loss. However, aPL have also been reported to affect implantation, placentation, and early embryonic development. The binding of aPl to beta2GP1 may lead to breakdown of the phospholipid adhesion molecules between different elements of trophoblast. As aPL affect placental growth and function, aPl may prevent implantation presenting as infertility. Lupus anticoagulant and anticardiolipin antibody have been implicated in the prothrombotic effects of APS. Antibodies to other phospholipids such as anti-phosphatidylserine, phosphatidyl ethanolamine, phosphatidyl choline, phosphatidyl glycerol, phosphatidyl Inositol etc. may be more relevant in infertility. Their role remains to be clarified. There is theoretical evidence from animal models and clinical infertility practice that aPL has a role in infertility. However, a large-scale meta-analysis has failed to confirm the association. To determine whether infertility or even pregnancy loss is associated with aPL, it is necessary to know that the embryo is chromosomally normal. Pregestational diagnosis has shown that up to 60% of embryos may be chromosomally aneuploid in failed in vitro fertilization (IVF); hence, may confound our understanding concerning the association between aPL and infertility, failed IVF or even pregnancy loss.
MeSH term(s)	Abortion, Habitual/immunology ; Animals ; Antibodies, Antiphospholipid/immunology ; Antiphospholipid Syndrome/complications ; Antiphospholipid Syndrome/immunology ; Female ; Humans ; Infertility, Female/etiology ; Infertility, Female/immunology ; Male ; Pregnancy ; beta 2-Glycoprotein I/immunology
Chemical Substances	Antibodies, Antiphospholipid ; beta 2-Glycoprotein I
Language	English
Publishing date	2007-10-04
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1239045-8
ISSN	1559-0267 ; 1080-0549
ISSN (online)	1559-0267
ISSN	1080-0549
DOI	10.1007/s12016-007-0010-2
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Zs.A 1844: Show issues

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Article ; Online: Autoantibodies as predictors of pregnancy complications.

Carp, H J A / Meroni, P L / Shoenfeld, Y

Rheumatology (Oxford, England)

2008 Volume 47 Suppl 3, Page(s) iii6–8

Abstract: Certain autoantibodies which are found in autoimmune diseases including CTDs can impair fertility. Reproductive failure may present as pregnancy loss, either as miscarriage, intrauterine fetal death or stillbirth. There are also late obstetric ... ...

Abstract	Certain autoantibodies which are found in autoimmune diseases including CTDs can impair fertility. Reproductive failure may present as pregnancy loss, either as miscarriage, intrauterine fetal death or stillbirth. There are also late obstetric complications such as intrauterine growth restriction, pre-eclampsia and pre-term birth. This review summarizes the possible influences of autoantibodies in reproductive failure, and particularly their predictive value (if available). The aPLs detectable by lupus anticoagulant, anti-cardiolipin or anti-beta2 glycoprotein I assays are associated with pregnancy loss and have a positive predictive value (PPV) of 75%. In spite of the general consensus on the management of pregnant aPL-positive women, few well-designed clinical trials have been reported and there is also insufficient data about the PPV of treatment. Anti-thyroid antibodies have been associated with pregnancy loss, and indeed have a PPV of 40%. However, no antibody is pathognomic for pregnancy loss. It may be more appropriate to assess a combination of antibodies rather than one antibody. However, a large meta-analysis of published trials is required in order to determine the prevalence of each particular autoantibody and different combinations of antibodies in different forms of reproductive failure.
MeSH term(s)	Abortion, Habitual/immunology ; Animals ; Autoantibodies/blood ; Autoimmune Diseases/immunology ; Biomarkers/blood ; Female ; Fetal Growth Retardation/immunology ; Humans ; Models, Animal ; Obstetric Labor, Premature/immunology ; Pregnancy ; Pregnancy Complications/immunology ; Pregnancy Outcome
Chemical Substances	Autoantibodies ; Biomarkers
Language	English
Publishing date	2008-06
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1464822-2
ISSN	1462-0332 ; 1462-0324
ISSN (online)	1462-0332
ISSN	1462-0324
DOI	10.1093/rheumatology/ken154
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Zs.B 240: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 497: Show issues

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Article: ART in recurrent miscarriage: preimplantation genetic diagnosis/screening or surrogacy?

Carp, H J A / Dirnfeld, M / Dor, J / Grudzinskas, J G

Human reproduction (Oxford, England)

2004 Volume 19, Issue 7, Page(s) 1502–1505

Abstract: Recently, assisted reproductive techniques have been used to prevent further miscarriages in women with recurrent miscarriage. One approach uses either screening or diagnosis of embryonic chromosomes prior to embryo replacement [preimplantation genetic ... ...

Abstract	Recently, assisted reproductive techniques have been used to prevent further miscarriages in women with recurrent miscarriage. One approach uses either screening or diagnosis of embryonic chromosomes prior to embryo replacement [preimplantation genetic screening (PGS)/preimplantation genetic diagnosis (PGD)]. The second approach involves surrogacy. However, PGS/PGD assumes that the embryo is chromosomally abnormal, and that the mother should receive a chromosomally normal embryo. Surrogacy assumes that the embryo is normal and that the maternal environment needs to be substituted. This article examines the place of both techniques in different types of recurrent miscarriage, and tries to give guidelines as to which technique is preferable depending on the likelihood of an embryonic chromosome aberration. In repeated fetal aneuploidy or in the older patient, PGS or PGD are preferable. However, with high numbers of miscarriages, or in autoimmune pregnancy loss, surrogacy is preferable. In the light of recent work, it is uncertain which treatment mode is indicated in balanced parental chromosome aberrations. In conclusion, both techniques have a place, but probably only in those patients with a poor prognosis in whom assisted reproductive techniques will be shown to improve the subsequent live birth rate above the spontaneous rate.
MeSH term(s)	Abortion, Habitual/therapy ; Female ; Genetic Testing ; Humans ; Pregnancy ; Preimplantation Diagnosis ; Reproductive Techniques, Assisted ; Surrogate Mothers
Language	English
Publishing date	2004-07
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	632776-x
ISSN	1460-2350 ; 0268-1161 ; 1477-741X
ISSN (online)	1460-2350
ISSN	0268-1161 ; 1477-741X
DOI	10.1093/humrep/deh293
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Zs.B 2892: Show issues

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Article ; Conference proceedings: Sixth meeting of the European Forum on antiphospholipid antibodies. How to improve the understanding of the antiphospholipid syndrome?

Rotar, Z / Rozman, B / de Groot, P G / Sanmarco, M / Shoenfeld, Y / Meroni, P L / Cervera, R / Pengo, V / Cimaz, R / Avcin, T / Carp, H J A / Tincani, A

Lupus

2009 Volume 18, Issue 1, Page(s) 53–60

Abstract: The main objective of these meetings is to promote international collaboration in various clinical and research projects. This paper is the summary of the 2007 Ljubljana meeting, and offers an overview of the proposed projects. The technical and ... ...

Abstract	The main objective of these meetings is to promote international collaboration in various clinical and research projects. This paper is the summary of the 2007 Ljubljana meeting, and offers an overview of the proposed projects. The technical and methodological details of the projects will be published on the forum's web site (http://www.med.ub.es/MIMMUN/FORUM/STUDIES.HTM).
MeSH term(s)	Animals ; Antibodies, Anticardiolipin/metabolism ; Antiphospholipid Syndrome/diagnosis ; Antiphospholipid Syndrome/physiopathology ; Antiphospholipid Syndrome/therapy ; Clinical Trials as Topic ; Disease Models, Animal ; Humans ; Risk Factors
Chemical Substances	Antibodies, Anticardiolipin
Language	English
Publishing date	2009-01
Publishing country	England
Document type	Congresses
ZDB-ID	1154407-7
ISSN	0961-2033
ISSN	0961-2033
DOI	10.1177/0961203308097569
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Zs.A 3717: Show issues

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Article ; Online: Influence of Insemination on the Implantation of Transferred Rat Blastocysts

Carp, H. J. A. / Serr, D. M. / Mashiach, S. / Nebel, L.

Gynecologic and Obstetric Investigation

1984 Volume 18, Issue 4, Page(s) 194–198

Abstract: Embryo transfer probably produces a lower incidence of implantation than the physiological incidence despite all other factors seeming similar. The only factor known to be present physiologically and absent in embryo transfer is the presence of sperm in ... ...

Abstract	Embryo transfer probably produces a lower incidence of implantation than the physiological incidence despite all other factors seeming similar. The only factor known to be present physiologically and absent in embryo transfer is the presence of sperm in the uterine cavity. Implantation and deciduahzation are often considered a modified form of inflammatory reaction. Semen contains factors which excite an inflammatory response. This project attempted to determine whether insemination would affect the implantation rate of transferred blastocysts in the rat. The figures showed a significantly increased implantation rate after insemination at day 4 of pseudopregnancy as compared to controls.
Keywords	Rat blastocysts ; Implantation ; Insemination and implantation ; Embryo transfer
Language	English
Publisher	S. Karger AG
Publishing place	Basel
Publishing country	Switzerland
Document type	Article ; Online
ZDB-ID	800003-7
ISSN	1423-002X ; 0378-7346 ; 0378-7346
ISSN (online)	1423-002X
ISSN	0378-7346
DOI	10.1159/000299080
Database	Karger publisher's database

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Zs.A 688: Show issues

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Article ; Online: Comparison of Cornual Transfer via Laparotomy with Utero-Cervical Transfer of Cultured Preimplantation Rat Embryos

Carp, H. J. A. / Shalgi, R. / Mashiach, S. / Serr, D. M. / Nebel, L.

Gynecologic and Obstetric Investigation

1982 Volume 14, Issue 2, Page(s) 121–126

Abstract: Most work on embryo transfer has used the cornual route via laparotomy for implantation. This method is time-consuming and costly in operating materials. Cervical transfer seems to offer a simpler route and the promise of time and cost saving. Technical ... ...

Abstract	Most work on embryo transfer has used the cornual route via laparotomy for implantation. This method is time-consuming and costly in operating materials. Cervical transfer seems to offer a simpler route and the promise of time and cost saving. Technical difficulties, however, have prevented this method from becoming widely used. It was thought that mastery of this technique is essential to allow large-scale experiments in order to determine the optimal time for reimplantation, the optimal stage whether 8 cells, morulae, or blastocysts, and to compare culture media. All of these will have significant clinical applications. In this work Vickery’s method of cervical transfer in mice was modified to include direct vision of the cervix and dilatation before implantation. With this modification equivalent results were found on cervical or cornual transfer, but a higher failure rate on cervical transfer. The results and implications are discussed.
Keywords	Blastocyst transfer ; Cervical transfer ; Cornual transfer ; Implantation failure ; Rat embryo culture
Language	English
Publisher	S. Karger AG
Publishing place	Basel
Publishing country	Switzerland
Document type	Article ; Online
ZDB-ID	800003-7
ISSN	1423-002X ; 0378-7346 ; 0378-7346
ISSN (online)	1423-002X
ISSN	0378-7346
DOI	10.1159/000299459
Database	Karger publisher's database

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Zs.A 688: Show issues

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Article ; Online: Fetal Demise Associated with Lupus Anticoagulant: Clinical Features and Results of Treatment

Carp, H. J. A. / Frenkel, Y. / Many, A. / Menashe, Y. / Mashiach, S. / Nebel, L. / Toder, V. / Serr, D. M.

Gynecologic and Obstetric Investigation

1989 Volume 28, Issue 4, Page(s) 178–184

Abstract: There are many reports in the literature associating lupus anticoagulant with fetal death. Successful pregnancies have been reported following suppression of the antibody by prednisone and the addition of antiaggre-gants and possibly anticoagulants. This ...

Abstract	There are many reports in the literature associating lupus anticoagulant with fetal death. Successful pregnancies have been reported following suppression of the antibody by prednisone and the addition of antiaggre-gants and possibly anticoagulants. This report describes our experience treating such patients and the outcome of subsequent pregnancies. The results are less successful than the figures in the literature, 13 live births out of 27 pregnancies in 19 patients. This may be due to lupus anticoagulant being diagnosed as the cause for a wide variety of clinical presentations including habitual first trimester abortion, mid trimester fetal death, intrauterine growth retardation and placental dysfunction in the third trimester. Our experience shows that steroids and antiaggregants have a definite place in cases of second and third trimester fetal death and in cases of clinical systemic lupus erythematosus. However, lupus anticoagulant is one of a spectrum of autoantibodies whose pathophysiology has not been fully elucidated. It is questionable whether this regimen of treatment has a place in patients with no previous fetal loss or in cases of primary habitual abortion.
Keywords	Abortion ; Fetal death ; Lupus anticoagulant
Language	English
Publisher	S. Karger AG
Publishing place	Basel
Publishing country	Switzerland
Document type	Article ; Online
ZDB-ID	800003-7
ISSN	1423-002X ; 0378-7346 ; 0378-7346
ISSN (online)	1423-002X
ISSN	0378-7346
DOI	10.1159/000293573
Database	Karger publisher's database

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