Luteal phase defect, or deficient progesterone production in the luteal phase, has long been suspected to be a cause of RPL. Recent data suggests, however, that the presence of a low luteal phase progesterone level in a woman with RPL does not predict a greater likelihood of future loss than women with a normal progesterone level. If a progesterone level is low during pregnancy, it is likely to be a result rather than the cause of a failing pregnancy. Because of normal cycle variation and the poor specificity of diagnostic tests such as serum progesterone levels and endometrial biopsies, the condition tends to be overdiagnosed and over treated.
Another endocrine abnormality suggested to be a cause of RPL is polycystic ovarian syndrome (PCOS), with an abortion rate of up to 50% having been reported in women with PCOS. Although women who hypersecrete LH or are hyperandrogenic have been reported to be at increased risk for SAB, it has been shown that suppression of LH levels prior to pregnancy in those women does not improve the live birth rate. A recent ultrasound study showed that the presence of PCO morphology does not increase a woman's risk of SAB.
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