■复发性流产定义为2次或以上临床妊娠失败,通常被称为反复怀孕失败,发生在20孕周之前,并进一步分为主要和次要类型。它代表了生殖医学领域中常见而令人痛苦的情况,通常影响<5%的夫妇,高达50%的病例缺乏明确的病因。流行病学也因产妇年龄而异。值得注意的是,这种情况严重困扰着期待父母,而母性因素,如年龄和以前的妊娠损失率,通常被报告为风险因素。虽然以前被低估了,现有证据表明,男性因素可能是复发性妊娠丢失的原因。
■在PubMed和Scopus数据库中进行了非系统的文献综述,以英文撰写的文章调查男性因素在复发性妊娠丢失中的可能关联。在先前独立评估和选择后,在作者之间进行讨论和达成共识后,以叙述性综述格式综合了符合条件的研究。
■生活方式,肥胖,遗传易感性,染色体异常,内分泌功能障碍,解剖学异常,免疫因素,感染,氧化应激可导致胚胎发育不良和复发性流产。尽管专业组织目前认为男性是一个可能的危险因素,诊断和治疗领域的具体建议仍然缺乏,这种情况需要高度怀疑和逐案管理。
■在这篇评论中,我们更深入地研究男性因素在复发性流产概念中的作用。
UNASSIGNED: Recurrent miscarriage is defined as 2 or more failed clinical pregnancies, typically known as repeated pregnancy loss, occurring before 20 gestational weeks, and further categorized into primary and secondary types. It represents a common and distressing condition to deal with in the field of reproductive medicine, usually affecting <5% of couples, with up to 50% of cases lacking a clearly defined aetiology. The epidemiology also varies depending on maternal age. Remarkably, the situation significantly afflicts expecting parents, whereas maternal factors, such as age and previous pregnancy loss rate, are commonly reported as risk factors. Although previously underestimated, existing evidence suggests the male factor is a possible cause of recurrent pregnancy loss.
UNASSIGNED: A non-systematic literature
review was conducted in the PubMed and Scopus databases for articles written in English investigating the possible association of the male factor in recurrent pregnancy loss. The eligible studies were synthesized in a narrative
review format upon discussion and consensus among the authors after being previously independently assessed and selected.
UNASSIGNED: Lifestyle, obesity, genetic predisposition, chromosomal anomalies, endocrine dysfunction, anatomical abnormalities, immunological factors, infections, and oxidative stress can result in poor embryo development and recurrent miscarriage. Although professional organizations currently recognize male gender as a possible risk factor, specific recommendations on the diagnostic and therapeutic field are still lacking, and the condition necessitates a high level of suspicion and case-by-case management.
UNASSIGNED: In this
review, we delve deeper into the contribution of the male factor in the concept of recurrent miscarriage.