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Female infertility is defined as the inability to conceive after a year of regular, unprotected intercourse and affects about 10–15% of couples worldwide. The primary cause of female infertility is ovulatory disorders, which hinder the release of eggs. These disorders can be classified as hypothalamic amenorrhea, polycystic ovarian syndrome (PCOS), premature ovarian failure, and hyperprolactinemic anovulation disorders.
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The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
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Multiplexed Fluorescent Immunohistochemical Staining of Four Endometrial Immune Cell Types in Recurrent Miscarriage
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Guideline No. 464: Recurrent Pregnancy Loss.

Tarek Motan1, Heather Cockwell2, Jason Elliott3

  • 1Edmonton, AB.

Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC
|November 1, 2025
PubMed
Summary
This summary is machine-generated.

Recurrent pregnancy loss (RPL) management involves evaluating causes like lifestyle, genetic, and anatomical factors. Evidence-based investigations and personalized care, including trauma-informed approaches, are crucial for improving live birth rates.

Keywords:
idiopathic pregnancy lossrecurrent abortionsrecurrent early pregnancy lossrecurrent miscarriages

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Area of Science:

  • Reproductive Medicine
  • Genetics
  • Endocrinology

Background:

  • Recurrent pregnancy loss (RPL) affects numerous women, with causes often remaining unexplained.
  • Causes can range from chromosomal and anatomical to endocrine, immune, infectious, and lifestyle factors.

Purpose of the Study:

  • To provide clinicians with the most up-to-date evidence for evaluating and managing patients experiencing recurrent pregnancy loss.
  • To outline evidence-based strategies for improving live birth rates in women with RPL.

Main Methods:

  • A comprehensive literature search was conducted in major databases (PubMed, Cochrane Library, etc.) from 2008 to 2025.
  • Search terms included various forms of recurrent pregnancy loss and abortion.
  • Evidence quality and recommendation strength were assessed using the GRADE approach.

Main Results:

  • Management strategies include lifestyle modifications, screening for conditions like thyroid dysfunction and antiphospholipid syndrome, and treating uterine anomalies.
  • Genetic testing and parental karyotyping can identify chromosomal issues.
  • Progesterone therapy and antibiotics for chronic endometritis may be beneficial, with cautious use of empirical treatments.

Conclusions:

  • Personalized evaluation and care are essential for patients with recurrent pregnancy loss.
  • Trauma-informed care, shared decision-making, and equitable access to investigations are critical components of management.
  • While evidence for some treatments varies, a systematic approach can improve outcomes and provide etiological answers.