Title : Male factors in recurrent pregnancy loss
Abstract:
Recurrent pregnancy loss (RPL), defined as the loss of two or more consecutive pregnancies, is a multifactorial condition influenced by both maternal and paternal factors. While maternal causes are extensively studied, male factors, including alterations in semen quality, sperm DNA integrity, infections such as human papillomavirus (HPV) are increasingly recognized as important contributors to RPL.
Published data indicate that in couples with RPL, alterations in semen quality, such as reduced sperm motility and abnormal morphology, are more frequent compared to fertile populations. These impairments may occur even when semen concentration and volume are within normal ranges, highlighting the importance of assessing motility and morphology as part of the diagnostic workup for RPL. Furthermore, advanced analyses reveal that elevated levels of sperm DNA fragmentation (SDF) are commonly observed in male partners of couples with RPL. This damage is strongly associated with impaired fertilization and pregnancy loss. Infections, particularly HPV, have also been linked to RPL. HPV can bind to spermatozoa, altering their function and contributing to genomic instability in early embryos. The presence of HPV in the male reproductive tract has been associated with increased miscarriage rates, underscoring the importance of infection screening and management in affected couples.
Evidence supports the significant role of male factors, including altered sperm motility, elevated sperm DNA fragmentation, HPV infection in the aetiology of RPL. Comprehensive evaluation of male partners should be a standard part of RPL diagnostics, integrating both traditional semen analysis and advanced assessments to improve reproductive outcomes.
