Table 1. The summary of studies about use of isotretinoin during pregnancy .

References	Study design	Country	Total number of patients	Results
Entezari-Maleki T, et al.26 2012	Prospective, drug utilization evaluation	Iran	274	6.8% of patients used two methods of contraceptive 51.3% received isotretinoin under the usual recommended daily doses
Teichert M, et al.35 2010	Retrospective study	Dutch	4881	Concomitant use of oral hormonal or intrauterine contraceptives and isotretinoin was 59.3%.
Pinheiro SP, et al.43 2013	Prospective comparative study	USA	113 578	Temporary increase in concomitant use of isotretinoin and contraceptives was observed immediately after iPlEDGE implementation
Shin J, et al.44‏ 2011	Retrospective comparative study	USA	9912	The risk of fetal exposure after iPLEDGE implementation reduced significantly in comparison with the SMART program
Berard A, et al.45 2007	Prospective population-based study	‏‍Canada	8609	A total of 9 live births occurred.
Crijns HJ, et al.46 2011	Systematic review of 17 studies‏	Europe	141	0·2–1·0 per 1000 women of reproduction age receiving isotretinoin became pregnant whereas 65% – 87% of these pregnancies were terminated
Schaefer C, et al.47 2010	Observational prospective study	Germany	108	A total 18 live births occurred‏
Autret-Leca E. et al.48 2010	Prospective population-based study	France	147	A total of 147 cases of isotretinoin exposure were reported
Zomerdijk IM, et al.49 2014	Retrospective population-based study	Netherlands	203962	Among those potentially exposed to isotretinoin, three intrauterine deaths and two live-born infants with major congenital anomalies occurred.
Crijns I, et al.50 2013	Prospective descriptive study	Netherlands	556‏	In addition to poor compliance of pharmacists, that 25% of dermatologists were compliant with the PPP
Crijns HJ, et al.51 2012	Prospective drug utilization study	Netherlands	651	53% of the 651 patients on isotretinoin therapy were prescribed to use contraceptive before, during, and after discontinuation of isotretinoin in accordance to the PPP.
Crijns I, et al.52 2012	Prospective questionnaire- based study	Europe, Norway and Iceland	143	Exposing to isotretinoin in spite of the PPP implementation.