UNRAVELLING THE COMPLEXITY OF RECURRENT SPONTANEOUS ABORTION: COMPREHENSIVE INSIGHTS INTO CONTRIBUTING FACTORS AND FUTURE DIRECTIONS

Recurrent spontaneous abortion (RSA), characterized by two or moreconsecutive pregnancy losses, remains a significant reproductive challenge,affecting approximately 1-3% of couples of reproductive ages. Its etiology ishighly complex and multifactorial, encompassing genetic, anatomical,hormonal, immunological, infectious, environmental, and acquiredthrombophilia factors. Despite considerable progress in reproductivemedicine and diagnostics, over half of RSA cases remain unexplained,underscoring the intricacies of its pathogenesis. This review synthesizescurrent knowledge on the diverse contributors to RSA, includingchromosomal abnormalities, uterine anomalies, endocrine dysfunctions,immune dysregulation, infections, and both inherited and acquiredthrombophilia’s. It examines the physiological mechanisms underlyingpregnancy maintenance and loss, highlighting the roles of hemostaticchanges, immune tolerance, and genetic predispositions. Additionally, thereview identifies existing gaps in research and clinical practice, emphasizingthe importance of integrated, personalized approaches for diagnosis andmanagement. Recognizing key risk factors such as thrombophilia andchromosomal aberrations is essential for targeted interventions. Futureresearch should prioritize elucidating gene-environmental interactions anddeveloping innovative diagnostic and therapeutic strategies, ultimatelyaiming to improve pregnancy outcomes and provide comprehensive supportfor affected individuals and couples.