Recurrent Pregnancy Loss Etiology, Risk Factors, Diagnosis, and Management. Fresh Look into a Full Box

Journal of Clinical Medicine, Journal Year: 2023, Volume and Issue: 12(12), P. 4074 - 4074

Published: June 15, 2023

Recurrent pregnancy loss is a complex health challenge with no universally accepted definition. Inconsistency in definitions involves not only the number of spontaneous abortions (two or three) that are for recurrent but types and gestational age at miscarriage. Due to heterogeneity criteria applied by international guidelines loss, true incidence miscarriage, which reported range from 1% 5%, difficult estimate. Moreover, exact etiology remains questionable; thus, it considered polyetiological multifactorial condition many modifiable non-modifiable factors involved. Even after thoroughly evaluating risk factors, up 75% cases remain unexplained. This review aimed summarize critically analyze accumulated knowledge on etiology, relevant diagnostic options, management approach loss. The relevance various their proposed roles pathogenesis matter discussion. largely depend taken into consideration healthcare professional as cause miscarriage particular woman couple. Underestimation social consequences leads compromised reproductive psychological well-being women Studies especially idiopathic, should be continued. existing require updates assist clinical practice.

Language: Английский

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Exploring the Immunological Aspects and Treatments of Recurrent Pregnancy Loss and Recurrent Implantation Failure

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(3), P. 1295 - 1295

Published: Feb. 3, 2025

Recurrent pregnancy loss (RPL) is defined as the occurrence of two or more consecutive losses before 24 weeks gestation. It affects 3-5% women who are attempting to conceive. RPL can stem from a variety causes and frequently associated with psychological distress diminished quality life. By contrast, recurrent implantation failure (RIF) refers inability achieve successful after three high-quality embryo transfers at least instances egg donation. RIF shares several causative factors RPL. The immunological underpinnings these conditions involve alterations in uterine NK cells, reductions M2 macrophages myeloid-derived suppressor an increased Th1/Th2 ratio, decreased Treg/Th17 presence shared ≥3 HLA alleles between partners, autoimmune disorders. Various therapeutic approaches have been employed address concerns, achieving varying degrees success, although some therapies remain contentious within medical community. This review intends explore implicated analyze treatments for conditions, which may include steroids, intravenous immunoglobulins, calcineurin inhibitors, anti-TNF antibodies, intralipid infusions, granulocyte colony-stimulating factor, lymphocyte immunotherapy.

Language: Английский

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Endometrial Microbiota and Immune Tolerance in Pregnancy

International Journal of Molecular Sciences, Journal Year: 2023, Volume and Issue: 24(3), P. 2995 - 2995

Published: Feb. 3, 2023

Recent studies have demonstrated that the uterus has its own microbiota. However, there is no consensus on endometrial microbiota composition, thus role in healthy uterine environment still a frontier topic. Endometrial receptivity key to embryo implantation, and this specific context immunological tolerance against fetal antigens tightly regulated expression of inflammatory mediators are fundamental. According recent evidence, may interact very dynamic way with immune system during peri-conceptional stage later pregnancy. For reason, condition dysbiosis might lead adverse pregnancy outcomes. The aim review summarize evidence molecular mechanisms by which system. purpose, link between reproductive disorders, such as infertility, recurrent loss (RPL), preterm birth, will be discussed. In conclusion, most findings from analyses reported illustrate possibly overcome intrinsic limitations detection (low biomass, high risk contamination sampling, lack standardization).

Language: Английский

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The Diagnostics and Treatment of Recurrent Pregnancy Loss

Journal of Clinical Medicine, Journal Year: 2023, Volume and Issue: 12(14), P. 4768 - 4768

Published: July 19, 2023

Recurrent pregnancy loss is a common problem in the reproductive age population of women. It can be caused by many different conditions. This addressed international guidelines that take slightly approach to its diagnosis and treatment. The used this review mainly use Royal College Obstetricians Gynaecologists (RCOG), American Society Reproductive Medicine (ASRM) European Human Reproduction Embryology (ESHRE). shows how much miscarriages has changed more needs explored refined. also addresses topic unexplained loss, which continues challenge for clinicians.

Language: Английский

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The endometrial microbiota and early pregnancy loss

Human Reproduction, Journal Year: 2024, Volume and Issue: 39(4), P. 638 - 646

Published: Jan. 9, 2024

Abstract The human endometrium is a dynamic entity that plays pivotal role in mediating the complex interplay between mother and developing embryo. Endometrial disruption can lead to pregnancy loss, impacting both maternal physical psychological health. Recent research suggests endometrial microbiota may play this, although exact mechanisms are still being explored, aided by recent technological advancements our growing understanding of host immune responses. Suboptimal or dysbiotic vaginal microbiota, characterized increased microbial diversity reduced Lactobacillus dominance, has been associated with various adverse reproductive events, including miscarriage. However, linking lower tract loss remain unclear. observational studies implicate potential continuum niche patients loss; however, transcervical sampling low biomass highly prone cross-contamination, which often not controlled for. In this review, we explore emerging evidence supporting theory modulate key inflammatory pathways required for successful embryo implantation development. We also highlight greater its relationship local microenvironment, interventions focus future research.

Language: Английский

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Dietary Patterns and Fertility

Biology, Journal Year: 2024, Volume and Issue: 13(2), P. 131 - 131

Published: Feb. 19, 2024

Diet has a key role in the reproductive axis both males and females. This review aims to analyze impacts of different dietary patterns on fertility. It appears that Mediterranean diet predominantly protective against infertility, while Western seems be risk factor for infertility. Moreover, we focus attention also countries World (Middle Eastern diet, Asian diet). In particular, when analyzing single nutrients, rich saturated fatty acids, cholesterol, animal proteins, carbohydrates with high glycemic index is highly associated male female Finally, evaluate effects vegetarian, vegan, ketogenic diets fertility, which seem still unclear. We believe comprehension molecular mechanisms involved infertility will lead more effective targeted treatments infertile couples.

Language: Английский

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Immune Treatment Strategies in Unexplained Recurrent Pregnancy Loss

American Journal of Reproductive Immunology, Journal Year: 2025, Volume and Issue: 93(2)

Published: Feb. 1, 2025

ABSTRACT Recurrent pregnancy loss (RPL) is characterized by the occurrence of two or more consecutive losses. Approximately half these cases lack a clear etiology and are termed unexplained recurrent (URPL). Maternal–fetal immune dysfunction thought to be involved in causing URPL. Increased human leukocyte antigen compatibility, susceptibility genes, blocking antibodies, cells can all disrupt tolerance environment maternal–fetal interface. To correct imbalances, some immunotherapies were recently tried used for patients with This review summarizes characteristics mechanisms microenvironment at interface URPL patients, present serve as reference future research.

Language: Английский

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The microbiome in recurrent pregnancy loss – A scoping review

Journal of Reproductive Immunology, Journal Year: 2024, Volume and Issue: 163, P. 104251 - 104251

Published: April 25, 2024

Recurrent pregnancy loss (RPL) is a troubling condition that affects couples worldwide. Despite extensive research efforts, many RPL cases remain unexplained, highlighting the need for novel approaches to unravel its underlying mechanisms. Recent advances in microbiome have shed light on potential role of reproductive health and outcomes. Based systematic literature research, this review aims comprehensively explore current understanding microbiome's involvement RPL, focusing vaginal, endometrial, gut microbiomes. Evidence from available studies examined explain relationship between RPL. Furthermore, we discuss diagnostic microbiome, therapeutic interventions, future directions Understanding complex interactions holds promise developing targeted interventions help patients today diagnosed as unexplained.

Language: Английский

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Assessing causal relationships between gut microbiota and abortion: evidence from two sample Mendelian randomization analysis

Frontiers in Endocrinology, Journal Year: 2024, Volume and Issue: 15

Published: July 10, 2024

While some studies have suggested a link between gut microbiota (GM) and abortion, the causal relationship remains unclear.

Language: Английский

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Uma análise acerca dos aspectos clínicos da Doença Celíaca

Revista Eletrônica Acervo Médico, Journal Year: 2025, Volume and Issue: 25, P. e18506 - e18506

Published: Jan. 6, 2025

Objetivo: Examinar as características da Doença Celíaca (DC). Revisão bibliográfica: A DC é uma doença autoimune desencadeada após a ingesta proteína glúten por pessoas geneticamente suscetíveis. As principais manifestações são gastrointestinais como diarreia, dor abdominal, náuseas, vômitos e constipação crônica. Fadiga crônica, anemias carenciais sintomas neuropsiquiátricos também comuns. O diagnóstico deve ser feito maneira mais precoce possível, para melhorar qualidade de vida dos celíacos impedir que haja complicações. tratamento eficaz eliminação total do alimentação. Existem outras terapias, mas elas utilizadas em casos acidental glúten. Considerações finais: Conclui-se não tratada causa muitos prejuízos pacientes pode proporcionar complicações graves. É extrema importância o seja implementada quanto antes. Além disso, suporte psicológico acompanhamento nutricional especializado essenciais promover adesão dieta bem-estar emocional indivíduos vivem com celíaca.

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