Journal of Clinical Medicine · 13 authors, 9 centres
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This non-systematic narrative review summarizes evidence on the etiology, risk factors, diagnosis, and management of recurrent pregnancy loss. It finds that RPL is a polyetiological and multifactorial condition affecting 1% to 5% of reproductive-age women, with up to 75% of cases remaining unexplained after thorough evaluation.
This narrative review synthesized literature from PubMed, Google Scholar, Scopus, Web of Science, and EBSCO up to 2023 on recurrent pregnancy loss (RPL) etiology, risk factors, diagnosis, and management. The authors note no universally accepted definition of RPL, with guidelines differing on whether two or three losses constitute RPL, making true incidence estimation difficult. RPL is described as a polyetiological and multifactorial condition involving both modifiable and non-modifiable factors, with reported incidence ranging from 1% to 5%. The review identifies chromosomal abnormalities, uterine pathologies, endocrine disorders, thrombophilia, and autoimmune diseases as key risk factors requiring investigation. A major limitation is that up to 75% of cases remain unexplained even after comprehensive evaluation. The authors call for evidence-based updates to international guidelines and continued research into idiopathic RPL and genetic contributions. Limitations of the review itself include restriction to English-language papers and heterogeneous study designs permitting only narrative synthesis.
