NON-DEVELOPING PREGNANCY IN THE HISTORY OF A MARRIED COUPLE: RISK FACTORS AND REHABILITATION

Genetic, anatomical, infectious, endocrine, and immune factors are identified as main risk ones for non-developing pregnancy (NDP). The latter is commonly caused by the abnormal development of the zygote, embryo, and fetus, or by structural abnormalities in the genetic program for placental development. Most pregnancy losses result from infection, mainly from persistent viral infection along with opportunistic microorganisms. Particular attention is paid to chronic endometritis that is an autoimmune disease, as well as to alloimmune disorders. About 40% of NDPs are of uncertain origin. The role of male factor for NDP is considered. Male sperm pathology may be characterized by increased viscosity, reduced motility of spermatozoa, their agglutination and aggregation, abnormal morphology, low sperm glycodelin levels, elevated sperm fragmentation, and viral infection. The negative influence of male factor is exhibited via sperm pathology, which is associated with the genetic risk of conception and ovum defects, whereas which is related to the risk of embryo chorionic insufficiency when the genetic program is undisturbed. Conclusion: Rehabilitation of married couples with NDP involves the consistent exclusion of possible causes, including sperm pathology. If the cause is identified, these factors need to be corrected. A set of measures for the rehabilitation of male reproductive health is considered to incorporate inositols as effective agents to improve fertility. © Posiseeva L.V., 2022.