Rationale: Chronic inflammation of pelvic tissues related to increased cellular permeability may not only be responsible for diminished oocyte reserve (DOR) but may also contribute to recurrent miscarriage and other comorbidities.

Objective: To determine if treatment with dextroamphetamine sulfate to release more dopamine from sympathetic nerve fibers to decrease excessive cellular permeability, and thus reduce excessive cellular immune activity, coupled with progesterone supplementation from luteal phase throughout the first trimester to increase the amount of the immunomodulatory protein the progesterone induced blocking factor (PIBF) could prevent another miscarriage in a 37-year-old woman with recurrent pregnancy losses.

Findings: With this treatment, not only did she conceive in her first treatment cycle and delivered a full-term healthy baby, but the dextroamphetamine markedly improved her ulcerative colitis. Proof that the improvement of the ulcerative colitis was medication related and not merely fortuitous was determined by proving Koch’s postulates. The improvement was found to be long-lasting in that she has not had any symptoms of inflammatory bowel disease for 1 ½ years post-partum.

Conclusions: Dopaminergic drugs plus progesterone should be considered first in women with DOR and a manifestation of potential excessive inflammation as evidenced in this case by inflammatory bowel disease. This is the second case report of improving treatment refractory ulcerative colitis with dextroamphetamine, which is considerably safer to the patient and more efficacious than the standard immune suppressants.