Lipid metabolism imbalance: potential pathological mechanism and new intervention ideas for recurrent miscarriage

Recurrent miscarriage is defined as three or more consecutive spontaneous abortions. Its etiology is complex, involving genetic, immune, and endocrine factors. In recent years, lipid metabolism disorders have attracted increasing attention for their potential role in recurrent miscarriage. Abnormalities in lipid metabolism can adversely affect endometrial receptivity, contributing to implantation failure. However, the precise underlying mechanisms remain to be fully elucidated. In this review, we provide an overview of the pathological mechanisms and recent advancements in research pertaining to the relationship between lipid metabolic disorders, embryonic development, and the establishment of endometrial receptivity. Special emphasis is placed on the influence of cholesterol and fatty acid metabolism on recurrent miscarriage. Furthermore, we examine the contributions of lipid metabolism to hormone synthesis and regulation, as well as the pathological changes that can arise from lipid-mediated local inflammation within the endometrium. Finally, we discuss the potential roles of lipid profile monitoring, dietary interventions, and lipid metabolism-targeted therapies in the early diagnosis and treatment of recurrent miscarriage. We hope this review can enhance understanding of the mechanisms underlying lipid metabolic dysfunction in this context and inform the development of tailored therapeutic strategies.