The role of endocrine dysfunction in pregnancy loss and the modulating influence of genetic factors: A structured narrative review.

BACKGROUND

Pregnancy loss, including recurrent cases, is a common problem for couples worldwide, with serious medical and emotional effects. While many factors can cause pregnancy loss, hormonal imbalances stand out as the main, treatable reason. Genetics rarely causes pregnancy loss by itself, but it can affect hormone pathways and explain differences in risk among populations.

OBJECTIVE

This review looks at how key hormone-related conditions-like thyroid problems, PCOS with insulin resistance, luteal phase defects, poorly controlled diabetes, and high prolactin-raise the risk of miscarriage, and how genetics influence these processes.

METHODS

We conducted a structured review of studies from major databases (2010-2025), focusing on English-language research in humans about hormone disorders or genetics linked to pregnancy loss. Findings were combined and explained with supporting models.

RESULTS

Hormonal problems can interfere with implantation, placenta development, and the balance between mother and baby, which is seen consistently in different populations. Genetic differences can affect the immune system, hormone signaling, metabolism, and blood clotting, but hormone issues are still the main cause. Treatments that target these hormone problems-like thyroid medicine, insulin sensitizers, progesterone support, better blood sugar control, and dopamine drugs-consistently help lower miscarriage risk.

CONCLUSION

Hormone imbalances are the main, treatable cause of pregnancy loss, and genetics play a supporting role in shaping risk. Doctors should focus on finding and fixing hormone issues, using genetic information to personalize care when needed.