ROLE OF MICROBIOME IN RECURRENT PREGNANCY LOSS: AN INTEGRATIVE STUDY WITH AYURVEDIC AND MODERN PERSPECTIVES

Recurrent abortion (RA), defined as the loss of two or more consecutive pregnancies before 20 weeks of gestation, remains a major global reproductive concern, with nearly half of the cases having no identifiable cause. Recent studies highlight the pivotal role of the human microbiome—particularly vaginal, endometrial, and gut microbial ecosystems—in pregnancy maintenance. Dysbiosis, characterized by decreased Lactobacillus dominance and overgrowth of pathogenic species such as Gardnerella vaginalis and Mycoplasma hominis, disrupts immune tolerance and cytokine balance, leading to inflammation and recurrent pregnancy loss (RPL). A Lactobacillus-dominant vaginal microbiome maintains acidic pH, prevents pathogenic invasion, and promotes implantation, whereas its imbalance correlates with infertility and abortion.5,12 Similarly, the gut microbiome influences maternal immunity and hormone regulation, linking microbial health to reproductive success. In Ayurveda, recurrent miscarriage corresponds to Garbhasrava and Garbhapata, primarily caused by Vata vitiation along with Pitta and Rakta dushti. Classical texts describe factors influencing conception through Garbhasambhava Samagri—Ritu, Kshetra, Ambu, and Beeja—and sustaining pregnancy through Garbhasthapaka dravyas. Disturbance in these elements leads to impaired Garbha poshana and fetal loss. The Ayurvedic notion of Krimi (microorganisms) aligns with the modern concept of microbial dysbiosis. Therapeutically, Ayurveda advocates Ahar, Vihar, Rasayana chikitsa, and Garbhas thapana measures. A pilot study using the Ayurvedic formulation TAB-GM, containing Rasayana and Garbhasthapana herbs, showed successful pregnancy continuation beyond 20 weeks in all participants. Integrating microbial modulation (probiotics, diet) with Ayurvedic approaches may restore Dosha-samyata and Kshetra-shuddhi, offering a holistic framework for managing recurrent abortion.