A combination treatment of folic acid, aspirin, doxycycline and progesterone for women with recurrent early pregnancy loss; hospital based study

Objective: The study aims to state the effectiveness of a new combination treatment composed of folic acid, doxycycline, low dose aspirin and natural progesterone in cases of recurrent early pregnancy loss. Study design: A clinical comparative hospital-based study. Setting: Women Health Hospital – Assiut University – Egypt. Materials and methods: All patients with recurrent early pregnancy loss at 10 weeks or less attending our antenatal care unit were included. The patients were recruited over a period of 16 months and allocated into two groups. The study group received a regimen of folic acid, doxycycline, aspirin, and progesterone. The control group did not receive the previous regimen in the proposed way. The main outcome measures the live birth rate and complications of pregnancy in both groups. Results: Three hundred patients were recruited, with 150 women in each group. A high rate of live births was found in the study group (76.0%) more than the control group (59.3%). Women in the Control Group reported more complications (76.0% vs. 51.3%). These were mainly abortion (40.0% vs. 23.3%), pre-eclampsia (16.0% vs. 10.7%) and oligohydramnios (10.0% vs. 6.7%). Conclusion: The implementation of combination treatment of folic acid, doxycycline, low dose aspirin and natural progesterone resulted in a significant increase in the live birth rate, a significant reduction in miscarriages, and lower incidence of complications in patients with recurrent early pregnancy loss.