Research Shows That Progesterone From Migratory Cells Increases Miscarriage Risk
Source: Thailand Medical News Jan 07, 2020 4 years, 10 months, 6 days, 23 hours, 12 minutes ago
Roughly about twenty percent of confirmed pregnancies end in
miscarriage, most often in the first trimester, for reasons ranging from infection to chromosomal abnormality. But some women have recurrent
miscarriages, a painful process that points to underlying issues. Clinical studies have been uneven, but some evidence shows that for women with a history of recurrent
miscarriage, taking
progesterone early in a pregnancy might moderately improve these women's chances of carrying a pregnancy to term.
A new research that was published in the
Journal of Lipid Research sheds some light on a new facet of
progesterone signaling between maternal and embryonic tissue, and hints at a preliminary link between
disruptions to this signaling and recurrent
miscarriage.
Typically,
progesterone plays an important role in embedding the placenta into the endometrium, the lining of the uterus. The hormone is key for thickening the endometrium, reorganizing blood flow to supply the uterus with oxygen and nutrients, and suppressing the maternal immune system.
The hormone
progesterone is made in the ovary as a normal part of the menstrual cycle, and at first, this continues after fertilization. About six weeks into pregnancy, the placenta takes over making
progesterone, a critical handoff. (The placenta also makes other hormones, including human chorionic gonadotropin, which is detected in a pregnancy test.)
Placental
progesterone comes mostly from surface tissue organized into fingerlike projections that integrate into the endometrium and absorb nutrients. Some cells leave those projections and migrate into the endometrium, where they help to direct the reorganization of arteries.
Utilizing cells from terminated
pregnancies, Austrian researchers led by Dr Sigrid Vondra and supervised by Dr Jürgen Pollheimer and Dr Clemens Röhrl compared the cells that stay on the placenta's surface with those that migrate into the endometrium. They discovered that the enzymes responsible for
progesterone production differ between the two cell types early in
pregnancy.
Progesterone which is steroid hormone, is derived from cholesterol. Although the overall production of
progesterone appears to be about the same in migratory and surface cells,
migratory cells accumulate more cholesterol and express more of a key enzyme for converting cholesterol to
progesterone. Among women who have had recurrent
miscarriages, that enzyme is lower in
migratory cells from the placenta compared to women with healthy
pregnancies. In contrast, levels of the enzyme don't differ between healthy and
miscarried pregnancies in cells from the surface of the placenta.
;
The researchers told
Thailand Medical News that the study findings suggest that production of
progesterone by the
migratory cells may have a specific and necessary role in early
pregnancy and that disruption to that process could be linked to
miscarriage.
Reference : Sigrid Vondra et al, Metabolism of cholesterol and progesterone is differentially regulated in primary trophoblastic subtypes and might be disturbed in recurrent miscarriages, Journal of Lipid Research (2019). DOI: 10.1194/jlr.P093427
