Recurrent pregnancy loss resulting in IVF (In Vitro Fertilization) series. Pathophysiologic mapping. A systematic review

Abstract

Objective: Assiduous depiction of recurrent pregnancy loss (RPL) in patients after in vitro fertilisation (IVF). Material and Method: Women undergoing IVF treatment who had experienced two or more consecutive pregnancy losses before 20 weeks’ gestation with or without a history of implantation failure. Systematic review resulting in specific data bases such as Pub Med and Cochrane data base. Results: Factors associated with RPL after IVF consist mainly genetic origin (approx. 30%) due to aneuploid embryos, followed by thrombophilia and autoimmune factors. Mainly predisposition factors associated with high risk of recurrent miscarriages include obesity, advanced maternal age, anatomic defects of the uterus and endocrine disorders. On the contrary, 10-15% of cases of RPL represent idiopathic origin (Unexplained RPL). The evaluation of preimplantation genetic testing (PGT) remains a controversial entity. Conclusion: The aim of our study is focusing on the pathophysiologic mapping, presented in current literature, concerning RPL after IVF. Although IVF procedures, including assisted hatching, PGT and immunologic therapy have been suggested to improve live birth rates, their efficacy is controversial, since the factors related to RPL after spontaneous abortion or IVF do not reveal any statistic differences. Additionally, assisted reproductive technique (ART) cannot be supported as a treatment intervention for couples with unexplained RPL, due to the lack of adequate clinical studies.