What has to be pointed out in unexplained recurrent pregnancy loss research in the unsolved fields: Lessons from clinic. An Italian RPL Unit experience

Recurrent pregnancy loss (RPL) is a controversial field both in research and clinical approaches. Despite the most recent guidelines (ESHRE 2017), an agreement in diagnostic work-up to apply in these patients, as well as in management and treatment, has not been reached, especially in unexplained RPL (uRPL). This is due to the lack of a strong evidence-based level in this field, since the discrepancies among the different RPL research groups, in terms of definition, etiological factors and management cannot lead to organize all the results in systematic reviews. Therefore, common shared cornerstones are required to homogenize research parameters, since the right interplay between clinical management and experimental approaches could lead to contribute in the development of stronger evidences. In this review, we highlight what has to be pointed out in RPL debated subfields and how the experimental approach is necessary to overhaul discrepancies in clinical management. The experience of our RPL Unit has been reported to show how research experience could contribute in modifying the clinical approach.