Traditionally, recurrent miscarriage (RM) is defined as the loss of three or more consecutive pregnancies before 22 weeks of pregnancy. Recently, the American Society for Reproductive Medicine suggested changing this concept, moving to two or more consecutive miscarriages, although there is no consensus. This obstetric complication affects 1-3% of all people trying to conceive. Even in the face of advances in reproductive medicine over the last few decades, the management of women with RM is still a challenging, and is often a frustrating condition for couples and professionals involved. Only half of couples with RM can identify the cause for the pregnancy losses.
Studies suggest that RM has a multifactorial etiology, but there is no consensus on which causes should be routinely investigated. Environmental factors, obesity, chromosomal abnormalities in the couple, congenital uterine malformations, cervical insufficiency, some endocrinopathies and antiphospholipid syndrome are factors strongly associated with recurrent miscarriage. Chronic endometritis, hereditary thrombophilia, hypovitaminosis D, autoimmune and alloimmune factors are other possible causes that still lack further evidence. Management of couples with RM is multiprofessional and should include lifestyle modification, psychological support, and specific treatment of any identified cause. However, the therapeutic options recommended by the guidelines are limited. Thus, epidemiological studies, research for new diagnostic tools and clinical trials with new treatments should be encouraged.
This Articles collection aims to bring together original laboratory or clinical research articles, practice-relevant reviews or short communications, and case reports related to the impact and consequences of RM on obstetrics and gynecology practice worldwide.
Potential subtopics related to recurrent miscarriage include (but are not limited to):
- Epidemiological studies
- Environmental factors
- Undernutrition, overweight and obesity
- Genetic factors
- Chronic endometritis
- Hereditary thrombophilia
- Immune factors
- New diagnostic biomarkers
- Immunotherapies and other treatments
- Assisted Reproductive Technology in the treatment of RM
- Male factors associated with RM
Marcelo Cavalcante, M.D., Ph.D. is an Associate Professor of Postgraduate Program in Medical Sciences at University of Fortaleza (UNIFOR) and director of CONCEPTUS – Reproductive Medicine in Fortaleza, Brazil. He is Board-certified in OB/GYN and Reproductive Medicine, and was granted Fellow Clinical Reproductive Immunology (American Society for Reproductive Immunology). He has conducted scientific studies in the field of reproductive medicine focusing on recurrent miscarriage, reproductive immunology, ovarian reserve, and gonadal senescence mechanisms. He has over 40 publications listed on PubMed and is a co-author of a book entitled “Pregnancy Loss”. Also, he acts as a peer reviewer for many medical journals.
Ricardo Barini, M.D., Ph.D. is a Full Professor of Obstetrics at University of Campinas, SP, Brazil. Has worked as professor of obstetrics for 37 years at University of Campinas, has been the Head of Fetal Medicine Unit at UNICAMP Medical School for 25 years and Head of Recurrent Pregnancy Outpatient Clinics at UNICAMP for 25 years. After retirement from the university in 2016, he has an official Collaborative Professor position at UNICAMP. He was granted Fellow Clinical Reproductive Immunology, ASRI, and is actively working for ASRI society as a participant at Members Committee, forthcoming ASRI 2023 ASRI organizing committee and ASRI Fellowship Committee. Has many peer-reviewed publications and acts as a peer reviewer for many specialized journals.
Dr. Edward Araújo Júnior is Associate Professor, Discipline of Fetal Medicine, Department of Obstetrics, Federal University of São Paulo. He is board certified in Gynecology, Obstetrics, and Fetal Medicine. His main research areas are prenatal diagnosis, three-dimensional ultrasound, fetal cardiology, and magnetic resonance imaging. He has more than 600 articles indexed in PubMed/Medline database and is co-author of three international books in the Fetal Medicine speciality.
Dr. Fabricio Costa is a subspecialist on Ultrasound in Obstetrics and Gynaecology. He is a Consultant at the Maternal Fetal Medicine Unit, Gold Coast University Hospital and at Haven Ultrasound on the Gold Coast, Queensland, Australia. Also, he is a Professor of Obstetrics and Gynaecology at Griffith University. He is currently the Chair of the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) Scientific Committee. He has over 200 peer-reviewed publications and he is a national and international frequent speaker in maternal fetal medicine conferences.
Disclosure statement: Dr. Marcelo Cavalcante, Dr. Ricardo Barini, Dr. Edward Araújo Júnior and Dr. Fabrício da Silva Costa declare there is no conflict of interest.
