Recurrent miscarriage: strategies for overcoming the problem in the pre-pregnancy stage

Literature review

Authors

DOI:

https://doi.org/10.18370/2309-4117.2025.79.39-50

Keywords:

recurrent miscarriage, pre-pregnancy preparation, lifestyle, nutrition, vitamin and microelement supplementation, chromosomal abnormalities, progesterone, infectious factor, routine vaccination, male factor, psychoemotional disorders

Abstract

The article highlights the relevance of the problem of miscarriage in the world and in Ukraine in modern conditions. Particular attention is paid to the problem of recurrent miscarriage (RM), which is faced by approximately 1–3% of all couples of reproductive age.
Approximately 50% of miscarriages occur for unknown reasons. Currently, the known causes of RM are genetic, anatomical, endocrine, immune, infectious factors, male factor, etc. Over the past 10–15 years, views on antiphospholipid syndrome as the cause of RM have changed significantly.
It is believed that most sporadic early pregnancy losses are associated with chromosomal abnormalities of the fetus and are not signs of problems in the woman’s body. Views on the significant role in the development of RM of such negative factors as smoking, alcohol, drug addiction, low socio-economic status, deficiency / excess body weight, stress remain unchanged.
A real way out of this situation can be adequately organized and timely conducted high-quality pre-pregnancy preparation, which is a complex of diagnostic, preventive and therapeutic measures aimed at assessing the health status and preparing the couple for conception, pregnancy and the birth of a healthy child. The best time for a new pregnancy is currently considered to be the period of 3–6 months after a spontaneous abortion. Compared with conception that occurred later, at this time the frequency of recurrent miscarriage, ectopic pregnancy, premature birth, low birth weight, cesarean section and induced labor is significantly lower.
Taking into account risk factors, key recommendations for pre-pregnancy preparation of women with RM were formulated. The basic principle is that testing and treatment after a first pregnancy loss is not recommended, as it is usually a sporadic event. The remaining recommendations include: a comprehensive approach (determination of the state of somatic health, detection of extragenital pathology and its correction with the involvement of related specialists if necessary); lifestyle modification and supplementation of vitamins and microelements; routine vaccination; genetic testing; correction of anatomical disorders of the female reproductive organs; correction of antiphospholipid syndrome and hereditary thrombophilias; elimination of infectious factors; restoration of normal vaginal biocenosis; correction of endocrine factors; correction of the male factor and psychoemotional disorders.
Special attention is focused on the role of progesterone in the prevention of RM. Most experts agree on the advantages of various forms (vaginal, sublingual) of micronized progesterone, which has been proven by numerous studies.

Author Biographies

I.A. Zhabchenko, SI «All-Ukrainian Center for Motherhood and Childhood National Academy of Sciences of Ukraine», Kyiv; Poltava State Medical University, Poltava

MD, professor, head of the Department of Pathology of Pregnancy and Childbirth;
professor of the Department of Obstetrics and Gynecology No. 2

V.K. Likhachev, Poltava State Medical University, Poltava

MD, professor, head of the Department of Obstetrics and Gynecology No. 2

N.G. Korniets, SI «Luhansk State Medical University», Rivne

PhD, associate professor, head of the Department of Obstetrics and Gynecology (Pediatrics)

I.S. Lishchenko, SI «All-Ukrainian Center of Motherhood and Childhood of the NAMS of Ukraine», Kyiv

PhD, researcher, Department of Pathology of Pregnancy and Childbirth

L.M. Dobrovolska, Poltava State Medical University, Poltava

PhD, associate professor, Department of Obstetrics and Gynecology No. 2

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2025-09-18

How to Cite

Zhabchenko, I., Likhachev, V., Korniets, N., Lishchenko, I., & Dobrovolska, L. (2025). Recurrent miscarriage: strategies for overcoming the problem in the pre-pregnancy stage: Literature review. REPRODUCTIVE ENDOCRINOLOGY, (79), 39–50. https://doi.org/10.18370/2309-4117.2025.79.39-50

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No. 79 (2025)

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Pregnancy and childbirth

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