Insulin Resistance Linked
to Repeat Miscarriages

NEW YORK (Reuters Health) - Woman who are resistant to the hormone insulin may face an increased risk of miscarriage, according to the results of a new study.

The findings, say the researchers, offer a possible strategy for preventing miscarriage in women with insulin resistance who have suffered repeated pregnancy loss.

Insulin is the hormone responsible for depositing glucose (sugar) from the blood into body cells for use as fuel. People who are overweight can grow resistant to the hormone, which in turn increases the risk of developing type 2 diabetes.

Women with polycystic ovary syndrome, a condition marked by insulin resistance and excessive amounts of "male hormones" like testosterone, face fertility problems and recurrent miscarriages. But one study found that treating these women with a drug that lowered blood insulin levels helped reduce their miscarriage risk, Dr. LaTasha B. Craig and colleagues from the University of Tennessee in Memphis note.

Craig and her team decided to investigate whether women without polycystic ovary syndrome who had suffered miscarriages repeatedly might also have insulin resistance. They report their findings in the September issue of Fertility and Sterility.

The researchers evaluated 74 women aged 22 to 46 who had suffered at least two previous miscarriages, comparing them with 74 similarly aged women who had at least one child. The control women and the study group were also similar in terms of their body mass index (BMI), a measure of weight in relation to height used to gauge obesity.

Among the women prone to miscarriages, 20 (27%) were insulin-resistant, compared with 7 (9.5%) of the women with children, the investigators found.

"Mechanisms to associate insulin resistance with recurrent pregnancy loss are unknown," the authors write. "One hypothesis is that insulin resistance causes an uncontrolled diabetic-like state in the fetal environment resulting in increased first trimester loss (of pregnancy)."

The findings suggest, according to Craig and colleagues, that drugs that decrease insulin levels in the blood may help insulin-resistant women who are prone to miscarriages have successful pregnancies.

SOURCE: Fertility and Sterility 2002;78:487-490.

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