Research advances in management of recurrent spontaneous abortion

Abstract

Recurrent spontaneous abortion (RSA) was defined as three or more failed clinical pregnancies before 28 weeks with the same sexual partner, and the definition differs from areas and races. Factors associated with RSA are numerous, and the cause of most patients is still unknown. Clinical diagnosis and treatment are very difficult. RSA caused by anatomical abnormalities usually requires surgical treatment to help patients recover anatomy and function of uterus, endomembrane, cervix, etc., especially in patients with intrauterine adhesions, hysteroscopic adhesiolysis can effectively improve the pregnancy outcome of patients. Currently, there is no adequate evidence suggests that preimplantation genetic diagnosis can improve the live birth rate of RSA patients. For thyroid dysfunction in RSA patients, thyrotropin should be controlled to a certain level. Metformin can improve insulin resistance in RSA patients, but the efficacy to improve pregnancy outcome remains to be feather verified. There is insufficient evidence that progesterone supplement can improve live birth rate of RSA patients with luteal insufficiency. RSA patients with typical antiphospholipid syndrome (APS) should be treated with low molecular weight heparin (LMWH) and low dose aspirin. Whether LMWH, granulocyte colony-stimulating factor or lymphatic immunotherapy can effectively improve pregnancy outcome in patients with unexplained RSA is still unproven. This article reviewed the treatment of RSA according to different causes. Key words: Recurrent spontaneous abortion (RSA); Unexplained recurrent spontaneous abortion(URSA); Treatment