The Posttraumatic Impact of Recurrent Pregnancy Loss in Both Women and Men.

Introduction Recurrent pregnancy loss is usually associated with significant psychological distress for both partners of the couple. It may act as a traumatic experience resulting in a posttraumatic stress disorder. The object of this study is to examine the posttraumatic impact of recurrent pregnancy loss on men and women and their interdependencies. Methods Cross-sectional study. All couples referred to the special unit for recurrent pregnancy loss between March 2019 and October 2020 were asked to participate with a sample size of 105 couples and 17 women. They were invited to complete a questionnaire package estimating the prevalence of posttraumatic stress, with anxiety, depression, lack of social support and dysfunctional coping strategies as contributing risk factors. Couple data were analysed with the Actor Partner Interdependence Model, taking the couple as a dyad. Results The response rate was 82.3 percent, with posttraumatic stress being measured in 13.7% of the women versus 3.9% of the men (p = 0.017). For women, number of curettages, controlled for the number of losses, correlated with the severity of posttraumatic stress (p < 0.05). Higher levels of anxiety, depression and lack of social support in women correlated positively with posttraumatic stress in their partners. The men's coping strategy "trivialization and wishful thinking" as well as "avoidance" correlated with more severe posttraumatic stress in the female partners (both p < 0.05). Conclusion The posttraumatic risks within a couple with recurrent pregnancy loss are interdependent. Recurrent pregnancy loss clinics should assess posttraumatic risks of both partners in their routine diagnostic process.

Recurrent pregnancy loss: a shared stressor---couple-orientated psychological research findings.

OBJECTIVE: To compare the psychological impact of recurrent pregnancy loss (RPL) on affected men and women and to determine risk and protective factors in both partners. DESIGN: Cross-sectional study. SETTING: University-affiliated fertility center. PATIENT(S): Ninety female/male couples and 14 women. INTERVENTION(S): Participants completed a questionnaire covering psychological risk factors (ScreenIVF), experience of pregnancy losses, coping strategies, and partnership satisfaction. MAIN OUTCOME MEASURE(S): Comparison of psychological risk factors, perception of RPL, and coping strategies between both partners and analysis of the influence of risk and protective factors. RESULT(S): In the ScreenIVF, 47.7% of women versus 19.1% of men showed a risk for anxiety, 51.7% versus 19.1% a risk for depression, and 28.1% versus 30.7% a risk for limited social support. The use of avoiding coping styles seems to be less favorable with regard to the psychological risk than active strategies. Having a child together and a satisfying partnership correlated with a lower risk for depression. Sharing the experience of RPL with others and being in a satisfying relationship correlated with a higher social support. CONCLUSION(S): Both men and women affected by RPL show high risks for developing depression and anxiety, underlining the importance of also including the male partners. The factors of communication with others, a satisfying relationship, and already having a child together correlate with decreased psychological risks. We advocate for health care professionals to implement screening for anxiety, depression, and social support for both partners and support them in dealing with RPL. REGISTRATION NUMBER: The study is registered in the German Clinical Trials Register (DRKS), number DRKS00014965.

Resveratrol enhances decidualization of human endometrial stromal cells.

The differentiation of endometrial stromal cells (ESC), named decidualization, is essential to regulate trophoblast invasion and to support pregnancy establishment and progression. Decidualization follows ESC proliferation and it has been described that cell cycle arrest contributes to a proper decidualization. Interestingly, resveratrol, a natural compound derived from grapes with antioxidant properties, has been widely studied in relation to endometrial health. However, little is known about the effect of resveratrol supplementation during decidualization. Therefore, in this study we evaluate the effect of resveratrol supplementation during decidualization. We used primary and immortalized human ESC and we decidualized them in vitro with a decidualization cocktail containing medroxyprogesterone acetate, estradiol and 8-Bromo-cyclic AMP. Pre-decidualized cells were further treated with the decidualization cocktail supplemented with resveratrol. Our results show that resveratrol supplementation increased, in a dose-dependent manner, the expression levels of prolactin and IGFBP1 (RT-PCR and ELISA), indicating an enhanced in vitro decidualization of human ESC. This enhanced decidualization was accompanied by a decrease in cell proliferation (crystal violet and CellTiter proliferation assay) and by changes in the mRNA levels of key cell cycle regulators (RT-PCR). Furthermore, resveratrol supplementation seemed to enhance decidualization by reinforcing the effect of the decidualization cocktail. We believe that resveratrol could to be an effective supplementation to reinforce hormone action during human ESC decidualization and that further insights into resveratrol action and its interaction with estradiol and progesterone signaling pathways could facilitate the identification of new therapeutic strategies for the improvement of women's health.