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Abstract The definition of RPL has long been debated and differs among international societies. The European Society for Human Reproduction and Embryology (ESHRE) suggested inclusion of two or more pregnancy losses including non-consecutive pregnancy losses while the other guidelines focus on including only consecutive pregnancy losses (El Hachem et al., 2017). RPL affects approximately 1 to 2% of women taking into consideration three consecutive pregnancy losses occurring before 20 weeks of gestation (Sultana et al., 2020). Factors generally accepted to be associated with RPL include uterine anomalies, maternal antiphospholipid syndrome (APS), maternal thrombophilia, endocrine disease, autoimmune diseases and parental structural chromosomal abnormalities (Youssef et al., 2020). Standard investigations will be normal for many couples and the cause of RPL is deemed (Ng et al., 2021). Vitamin D is a crucial modulator of essential biological effects, such as immune function and hormone secretion via the vitamin D receptors. Vitamin D affects the innate and acquired immune response (Mora et al., 2008), as well as exerts an inhibitory function on the adaptive immune system (Ota et al., 2015). Vitamin D deficiency during pregnancy is a common problem worldwide. Vitamin D deficiency in pregnant women is associated with increased risk of obstetrical complications, such as preeclampsia, bacterial vaginosis and the associated preterm delivery, gestational diabetes mellitus, and small-for-gestational age births (Ghaedi et al., 2016). Summary 86 With these immune modulatory effects of vitamin D, it has been speculated that vitamin D could act as an immune regulator during implantation and play an important role in reproductive capacity. In early pregnancy, trophoblasts produce and respond to vitamin D, and some investigators have demonstrated that vitamin D influences local anti-inflammatory responses and induces decidualization for successful pregnancy (Ota et al., 2014). This study was performed to evaluate the role of vitamin D supplementation in prevention of unexplained recurrent pregnancy loss in patients with vitamin D deficiency. The study involved two groups of pregnant females in early first trimester (6 weeks) with history of unexplained recurrent pregnancy loss (two or more consecutive miscarriage before 20 weeks of gestation) and had had low serum vitamin D <30 ng/ml. group I included 50 pregnant females who received oral vitamin D3 supplementation cholecalciferol by dose 4000 IU daily in the form of 40 DROP daily (DROP =100 IU) of ViDROP (Manufactured by Medical Union Pharmaceuticals AbuSultan, Ismailia, Egypt) , group II included 50 age matched pregnant females who received only the daily requirements of vitamin D3 400 IU daily in the form of 4 drops daily of Vidrop. Pregnant females with a known risk factor for subsequent were excluded from the study. Methodology: Pregnant females of both groups were subjected to full history taking, complete general and obstetric examination, ultrasonographic assessment and routine laboratory investigations. Summary 87 About 3 ml of venous blood were aseptically withdrawn from all the studied subjects. Serum levels of 25 (OH)D were measured by enzyme linked immunosorbent assay (ELISA) technique according to the manufacturer’s instructions using commercial ELISA Kits .The pregnant females in both groups were followed up and pregnancy outcome was determined. Pregnancy was considered successful if continued beyond 20th weeks gestation. Results: There was no statistically significant difference (P > 0.05) between both groups regarding age, occupation, special habits, BMI, number of miscarriage and number of living children, and parity. There was no statistically significant difference between the two groups regarding vitamin D level. There was no association between serum vitamin D level and number of patients continuing pregnancy in both groups. There were no association between pregnancy outcome and patient age, residence, BMI, and number of previous miscarriages. However, there were association between pregnancy outcome and parity of the patient, her occupation, and number of living children. |