ArticleActa obstetricia et gynecologica Scandinavica2025
Primary versus secondary recurrent pregnancy losses: Clinical findings and live birth rate after comprehensive work-up and personalized management.
Article in Acta obstetricia et gynecologica Scandinavica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed.
- Large-Pore Channels at the Maternal-Fetal Interface: Progress and Open Research Avenues.Biology · 2026Review
- Clinical factors associated with recurrent pregnancy loss status in women with polyendocrine metabolic ovarian syndrome.Frontiers in endocrinology · 2026Article
- Between evidence and expectation: a retrospective cohort study on chronic endometritis in repeated implantation failure and recurrent pregnancy loss.Reproductive biology and endocrinology : RB&E · 2025Article
- Toward clarity: why we need to standardize the term 'recurrent pregnancy loss'.JBRA assisted reproduction · 2025Article
- Primary versus secondary recurrent pregnancy losses: Clinical findings and live birth rate after comprehensive work-up and personalized management.Acta obstetricia et gynecologica Scandinavica · 2025Article
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Abstract
introductionRecurrent pregnancy loss (RPL), defined as two or more consecutive pregnancy losses before 24 weeks of gestation, affects up to 1%-2% of couples. Aim of this retrospective cohort study was to report the main causes and pregnancy outcomes of a cohort of women with RPL and the efficacy of a personalized work-up and treatment in terms of live birth rate. MATERIAL AND
methodsWomen with primary (pRPL) and secondary (sRPL) RPL underwent a complete work-up and personalized therapeutic management. Data related to clinical findings and subsequent pregnancy outcomes were collected. A retrospective comparison between clinical findings and pregnancy outcomes of pRPL vs sRPL was performed by Mann-Whitney U or Chi-square test.
resultsMain findings after diagnostic work-up in pRPL (n = 157) vs sRPL (n = 138) couples were hormonal and metabolic factors (75% vs. 90%, p < 0.01), autoimmunity (52% vs. 59%, p = 0.2), acquired uterine/endometrial factors (43% vs. 34%, p = 0.2), vaginal and/or cervical infections (19% vs. 49%; p < 0.0001), congenital Mullerian anomalies (15% vs. 9%; p = 0.1), inherited thrombophilias (13% vs. 21%; p = 0.1), female karyotype abnormalities (2% vs. 2%; p = 0.9), sperm infections (27% vs. 22%; p = 0.1), abnormal semen analysis (17% vs. 14%; p = 0.1), male karyotype abnormalities (2% vs. 0%; p = 0.1). Higher pregnancy and fetal loss rate was observed in pRPL compared with sRPL (85% vs. 56%, p < 0.0001and 9% vs. 0%, p < 0.01, respectively). Higher live birth rate was found in pRLP vs sRPL women (76% vs. 56%, p < 0.001). Increased live birth rate was observed among pRPL women aged <40 years (OR 2.76; CI 1.36-5.64, p < 0.01) and/or with an AMH >1 ng/mL (OR 3.96; CI 1.34-12.52, p < 0.05). Among sRPL women, the age < 40 years was significantly associated to higher live birth rate (OR 3.23; 1.55-6.94, p < 0.01).
conclusionsRPL is a heterogeneous multifactorial syndrome. A customized management can lead to a good pregnancy outcome in more than a half of cases. Age <40 and AMH >1 ng/mL are the major positive predictors of live birth rate in RPL women.
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