Managing couples with recurrent miscarriage: A narrative review and practice recommendations

Area of Science:

• Reproductive Medicine
• Obstetrics and Gynecology
• Clinical Practice Guidelines

Background:

• Significant practice variations exist in managing recurrent miscarriage (RM).
• Current guidelines differ on RM definition, investigations, and treatments.
• Lack of standardized, evidence-based guidance complicates patient care.

Purpose of the Study:

• To propose a global, holistic approach for managing recurrent miscarriage.
• To provide graded recommendations based on the best available evidence.
• To build upon previous FIGO (International Federation of Gynecology and Obstetrics) recommendations on progesterone use.

Main Methods:

• Narrative review of existing literature and guidelines.
• Synthesis of evidence to formulate recommendations.
• Focus on a holistic management strategy for recurrent first-trimester miscarriage.

Main Results:

• Identified key areas of practice variation in recurrent miscarriage management.
• Developed a framework for a comprehensive, patient-centered approach.
• Presented graded recommendations applicable to diverse clinical settings.

Conclusions:

• A unified, holistic approach is needed to manage recurrent miscarriage effectively.
• Graded recommendations can guide clinicians in the absence of universal guidelines.
• Further research and consensus are crucial for optimizing recurrent pregnancy loss care.