Ibn Sina Journal of Medical Science, Health & Pharmacy

Abstract

Introduction: During pregnancy, the placenta is the primary source of the gonadal protein ACTIVIN A in the mother's bloodstream. From mid-pregnancy until close to term, the mother's blood levels of ACTIVIN A rise. Placental malfunction complicates pregnancies, as evidenced by intrauterine foetal growth restriction and significantly higher levels of ACTIVIN A in the mother's blood compared to a normal pregnancy. Experts believe that the elevated blood levels of ACTIVIN A stem from heightened placental synthesis.
OBJECTIVE: This study aimed to determine the levels of the ACTIVIN A hormone in the blood of women with PCOS who experience recurrent miscarriages, compare those levels to those of the control group, and confirm the association between the hormone and maternal age and obesity.
Method: We included ninety women between the ages of fifteen and forty-five in a case-control study; fifty of them had a diagnosis of polycystic ovarian syndrome, while the remaining forty belonged to the healthy control group. The USA-based BioTek Company collected samples between October 2021 and March 2022, using its absorbance ELISA microplate reader and ELISA microplate washer to assess the samples' levels of ACTIVIN A. We calculated the concentration of ACTIVIN A by dividing the weight by the height in square meters.
RESULTS: When compared to the control group, the sick women's levels of ACTIVIN A considerably decreased (P = 0.05). Furthermore, compared to polycystic ovary syndrome patients, the control group had the highest level of AVTIVIN. The concentration was measured based on the body mass index.
CONCLUSION: Patients with polycystic ovarian syndrome had lower levels of ACTIVIN A. Obese women formed a greater percentage of the patients' BMI. Researchers discovered a high amount of ACTIVIN A in the first month of pregnancy. Furthermore, research has linked this hormone to an increase in the frequency of recurrent miscarriages, with the hormone concentration being higher on the day of the most recent miscarriage, which occurs between one and four months, than it is over the longest period of time.

References

[1]   Shankar, A., Mason, A. J. Functional analysis of the cysteine residues of activin A. Molecular Endocrinology 1994, 8(3), 325-332. https://doi.org/10.1210/mend.8.3.8183554
[2]   Ismail, A. M.; Abbas, A. M.; Ali, M. K.; Amin, A. F. Peri-conceptional progesterone treatment in women with unexplained recurrent miscarriage: A randomized double-blind placebo-controlled trial. The Journal of Maternal-Fetal & Neonatal Medicine 2018, 31(3), 388-394. https://doi.org/10.1080/14767058.2017.1286321
[3]   Wu, H. L.; Marwah, S.; Wang, P.; Wang, Q. M.; Chen, X. W. Misoprostol for medical treatment of missed abortion: A systematic review and network meta-analysis. Scientific Reports 2017, 7(1), 1-9. https://doi.org/10.15296/ijwhr.2019.49
[4]   Metwally, M.; Li, T. C.; Ledger, W. L. The impact of obesity on female reproductive function. Obesity Reviews 2007, 8(6), 515-523. https://doi.org/10.1530/REP-10-0203
[5]   Galamb, Á.; Pethő, B.; Fekete, D.; Petrányi, G.; Pajor, A. Uterine anomalies in women with recurrent pregnancy loss. Orvosi Hetilap 2015, 156(27), 1081-1084.
[6]   Mander, S.; Miller, Y. D. Perceived safety, quality and cultural competency of maternity care for culturally and linguistically diverse women in Queensland. Journal of Racial and Ethnic Health Disparities 2016, 3(1), 83-98. https://doi.org/10.1055/s-0033-1356479
[7]   Hussein, F. M.; Elmi, F. A.; Mus, N. A.; Mumin, A. Factors Influencing Miscarriage Among Pregnant Women in Banadir Hospital at Wadajir District. Jamhuriya University 2017, 23.
[8]   Ibrahim, F. M.; Al Awar, S. A. A. R.; Nayeri, N. D.; Al-Jefout, M.; Ranjbar, F.; Moghadam, Z. B. Experiences of Recurrent Pregnancy Loss Through the Perspective of United Arab Emirates Women: A Qualitative Study. International Journal of Women's Health and Reproduction Sciences 2019, 7, 306-312. https://doi.org/10.4236/oalib.1103289
[9]   Balakrishnan, S. Adolescent Polycystic Ovary Syndrome. Health Science 2013, 2(1), JS004B. https://doi.org/10.4236/oalib.1103289
[10]   Yousaf, J.; Khadija, S.; Arshad, N.; Amjad, M. R.; Gulzar, J.; Ullah, A. The Chances of Infertility in a Patient Presenting with PCOS in Childbearing Age. Saudi J Med 2022, 7(1), 15-21.
[11]   Whitney, E. Nutrition for Health and Care; Cengage Learning: 2007; pp. 142-143.
[12]   Mustafa, M. A.; AL-Samarraie, M. Q. Secondary menopause and its relationship to hormonal levels among women at Salah Al-Din Hospital. European Journal of Molecular & Clinical Medicine 2020, 7(09), 96-104.
[13]   Refaat, B.; Bahathiq, A. O. The performances of serum activins and follistatin in the diagnosis of ectopic pregnancy: A prospective case-control study. Clinica Chimica Acta 2020, 500, 69-74. https://doi.org/10.1016/j.cca.2019.10.035
[14]   Saghafi, F.; Gelini Moghadam, T.; Moradi, S. Diagnostic Value of Serum Levels of Vascular Endothelial Growth Factor as a Marker of Tubal Pregnancy. Journal of Mazandaran University of Medical Sciences 2020, 29(182), 21-30.
[15]   Naji, N. A.; Tahrr, G. N. The effect of Activin A and Steroid Hormones on the Recurrent and single Abortion. Tikrit Journal of Pure Science 2015, 20(5).
[16]   Xia, Y.; Schneyer, A. L. The biology of activin: recent advances in structure, regulation and function. The Journal of Endocrinology 2009, 202(1), 1-12. https://doi.org/10.1677/JOE-09-0036
[17]   Nakano, H.; Kinoshita, K.; Ishii, K.; Shibai, H.; Asashima, M. Activities of Mesoderm‐Inducing Factors Secreted by Mammalian Cells in Culture 1: [mesoderm‐induction/activin A/EDF/TGF‐β family/embryonic induction]. Development, Growth & Differentiation 1990, 32(2), 165-170. https://doi.org/10.1111/j.1440-169X.1990.tb02587.x
[18]   Vale, W.; Hsueh, A.; Rivier, C.; Yu, J. The inhibin/activin family of hormones and growth factors. In Peptide Growth Factors and Their Receptors II; Springer, Berlin, Heidelberg: 1990; pp. 211-248. https://doi.org/10.1007/978-3-642-74617-5_7
[19]   Norman, R. J.; Milner, C. R.; Groome, N. P.; Robertson, D. M. Circulating follistatin concentrations are higher and activin concentrations are lower in polycystic ovarian syndrome. Human Reproduction 2001, 16(4), 668-672. https://doi.org/10.1093/humrep/16.4.668
[20]   Shen, Z. J.; Chen, X. P.; Chen, Y. G. Inhibin B, activin A, and follistatin and the pathogenesis of polycystic ovary syndrome. International Journal of Gynaecology and Obstetrics 2005, 88(3), 336-337. https://doi.org/10.1016/j.ijgo.2004.11.012
[21]   Luisi, S.; Florio, P.; D’Antona, D.; Severi, F. M.; Sanseverino, F.; Danero, S.; Petraglia, F. Maternal serum inhibin A levels are a marker of a viable trophoblast in incomplete and complete miscarriage. European Journal of Endocrinology 2003, 148(2), 233-236. https://doi.org/10.1530/eje.0.1480233
[22]   Hansen, K. R. Predicting reproductive age with biomarkers of ovarian reserve—how [and what] are we measuring. In Seminars in Reproductive Medicine; Thieme Medical Publishers: 2013; Vol. 31, No. 06, pp. 416-426. https://doi.org/10.1055/s-0033-1356479
[23]   Glister, C.; Satchell, L.; Knight, P. G. Changes in expres

Article history_en

Received : Mar 02, 2025

Revised : Mar 14, 2025

Accepted : Jun 05, 2025

Authors Affiliations_en

Ahmed Adnan Majalia,1,*, Subhi Salehb,2

Ethics declarations_en

Acknowledgment	None
Author Contribution	All authors contributed equally to the main contributor to this paper. All authors read and approved the final paper.
Conflicts of Interest	“The authors declare no conflict of interest.”
Funding	“This research received no external funding”