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Antiphospholipid syndrome (APS) is an entity with specific clinical and analytical features independent of other autoimmune entities. The etiopathogenesis of the condition is unknown. This means that the mechanism by which antiphospholipid antibodies cause fetal losses is not known. However, it seems that a coagulation phenomenon (thrombosis) may be at the basis of the problem.
Ultimately, pregnant patients affected by SAP are at risk of recurrent miscarriages and recurrent late fetal losses. Therefore, it is imperative to rule out this syndrome in these patients by determining the possible presence of APL or ACA.
Once other causes of miscarriage have been ruled out, and a diagnosis of SAP has been made, treatment will be based fundamentally on drugs with an antiplatelet (acetylsalicylic acid) and/or anticoagulant (Heparin) effect.
The truth is that, after a detailed study of the individual case, we are sometimes unable to make an aetiological diagnosis. That is, we do not determine the cause of the miscarriages. It is important to note that in couples with repeated miscarriages in which the cause of the miscarriages is not found, the probability of a subsequent full-term pregnancy is greater than 50%.
Among the most common causes of repeat miscarriages are genetic causes and the so-called primary antiphospholipid syndrome.
However, recent studies point to a possible male factor as the origin of repeat miscarriages. In recent years, semen quality has declined, largely due to stress, long working hours, environmental pollution, exposure to heat, alcohol and tobacco, poor eating habits and even the use of tight underwear.
Tests are available to identify chromosomal alterations in semen samples.