Reply to Comment on "Clinical Significance of Biochemical Pregnancy Loss in Recurrent Pregnancy Loss Patients: Insights From Euploid Embryo Transfers Minimizing Embryonic Bias".

Background: We appreciate the commentary by Satapathy, Mehta, and Sah on our study examining biochemical pregnancy loss (BPL) in recurrent pregnancy loss (RPL) following euploid embryo transfer. Their remarks on statistical interpretation, ascertainment bias, and sample size overlap coincide with limitations already acknowledged in our article. Methods: Our analysis was exploratory in nature and not powered for definitive conclusions. We acknowledge the need for larger prospective studies using standardized biochemical monitoring and advanced statistical approaches. Results: The commentary highlights methodological considerations that align with our stated limitations. Despite these, our findings indicate that BPL may provide clinically relevant information beyond conventional pregnancy outcomes. Conclusion: Against the backdrop of divergent international definitions regarding whether biochemically recognized losses should count toward RPL, our findings support multicenter investigations to clarify the prognostic and therapeutic implications of including BPL and to inform harmonized definitions and clinical practice.