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International recommendations on complementary examinations in cases of recurrent pregnancy loss: Is there a consensus?

Par : Contributeur(s) : Type de matériel : TexteTexteLangue : français Détails de publication : 2026. Ressources en ligne : Abrégé : There is an international consensus on the value of investigating recurrent pregnancy loss (RPL) for dysthyroidism, antiphospholipid antibody syndrome (APAS), uterine anomalies (3D ultrasound), or sperm problems (complete spermogram). Most learned societies tend to recommend the prescription of karyotypes for the patient and her partner. There is no consensus on the need to test for coagulation anomalies, hyperprolactinemia, glucose intolerance or diabetes, or systemic lupus erythematosus, and some societies only recommend such tests in the case of a high-risk history or clinical signs. For “exploratory” purposes, luteal phase progesteronemia (particularly if there is an impression of a short luteal phase in short cycles) and sperm DNA fragmentation may be added to the RPL workup. We refer to these tests as “exploratory,” as there is no proven treatment for this type of situation. Hypovitaminosis should not be screened for. As for the search for chronic endometritis by endometrial biopsy and bacterial vaginosis by vaginal sampling, recent publications over the last ten years suggest that there is a tendency to screen for them, especially as some studies have also demonstrated the benefit of treatment in this context of RPL.
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There is an international consensus on the value of investigating recurrent pregnancy loss (RPL) for dysthyroidism, antiphospholipid antibody syndrome (APAS), uterine anomalies (3D ultrasound), or sperm problems (complete spermogram). Most learned societies tend to recommend the prescription of karyotypes for the patient and her partner. There is no consensus on the need to test for coagulation anomalies, hyperprolactinemia, glucose intolerance or diabetes, or systemic lupus erythematosus, and some societies only recommend such tests in the case of a high-risk history or clinical signs. For “exploratory” purposes, luteal phase progesteronemia (particularly if there is an impression of a short luteal phase in short cycles) and sperm DNA fragmentation may be added to the RPL workup. We refer to these tests as “exploratory,” as there is no proven treatment for this type of situation. Hypovitaminosis should not be screened for. As for the search for chronic endometritis by endometrial biopsy and bacterial vaginosis by vaginal sampling, recent publications over the last ten years suggest that there is a tendency to screen for them, especially as some studies have also demonstrated the benefit of treatment in this context of RPL.

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