Association of Male Factors With Recurrent Pregnancy Loss

Recurrent pregnancy loss (RPL), which has an estimated prevalence of about 2.5%, is a heterogeneous multifactorial disorder defined as two or more clinical pregnancy losses, including embryonic and fetal loss before gestational weeks 20 to 24(Dimitriadis et al., 2020); resulting in a significant economic and psychological burden on the family and society. The causes include genetic, anatomical, and infectious factors, auto-immune system abnormalities and endocrine disorders, to name a few(Arias-Sosa et al., 2018). In recent years, there has been a growing focus on the role of male factors in inducing RPL since the integrity of the sperm genome is critical for the start and continuation of a successful pregnancy. Anomalies in sperm chromosome structure and number, sperm DNA fragmentation, genetic polymorphisms, epigenetic modifications, paternal age, sperm quantity and quality have been previously linked to RPL. In this review, we focused on the relationship between male factors and recurrent pregnancy loss, and classified the etiology into genetic factors, non-genetic factors, and other factors associated with RPL, depending on whether they are directly inherited from the next generation. Male genetic factors include chromosome structure and number abnormalities, Y-chromosome microdeletions, epigenetic alterations, and gene polymorphisms.Non-genetic factors include sperm DNA fragmentation and abnormalities in oxidative scavenging regulatory mechanisms. Other factors include the age of the father, semen parameters and lifestyle.

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