I Had a Miscarriage at 29. Then I Had Two Healthy Pregnancies: Our Co-Founder Niharikka's Story of Autoimmunity, Blood Thinners and Hope

I thought the positive pregnancy test was supposed to be the end of the fear. For a lot of women, it is. For me, the first time, it turned out to be the beginning of a much longer story — one that included a miscarriage, a frightening lab report, daily injections into my own stomach, and two children I now get to raise.

If you're reading this because you've just lost a pregnancy, or because a blood test came back with a word like "positive" attached to it and no one has properly explained what that means for you, I want to say something plainly before anything else: what you're feeling makes complete sense, and it does not mean your story is over.

My first pregnancy ended before I was ready

I was 29 when I had my first miscarriage.

There is no gentle way to describe what that was. It wasn't just a medical event. It was the sudden absence of something I had already started building a future around and I don't think anything fully prepares you for how physically and emotionally disorienting that absence feels.

The week I couldn't talk to anyone

For about a week afterward, I went quiet. Not dramatically, just quietly, in a way that surprised people who knew me. I felt numb, and I remember having what I can only describe as a lump in my throat that didn't go away, a feeling of being unable to get past what had happened, even for a few minutes at a time.

There's one memory from that week I still carry clearly: looking at my husband and crying, not just from grief, but from a feeling that I had somehow failed him, that I hadn't been able to give him a baby. I know, intellectually, how unfair that feeling is. I understood then, and I understand even more now, that a miscarriage is not something a woman does or fails to do. But understanding a fact and feeling it are two very different things, and in that week, the feeling was louder.

Then came the fear: "What if I can never have a baby?"

Not long after, testing showed an autoimmune-related concern. I don't remember the details clinically softening the moment. I remember the fear sharpening. A positive report, in my mind, stopped being a data point and started feeling like a prediction. I found myself genuinely afraid that I might never be able to carry a baby.

I want to be honest about something here, because I think it matters for anyone reading this in the same position: that fear was not irrational, and it was not weakness. It was a completely understandable response to incomplete information delivered at the most vulnerable possible moment. What changed things for me wasn't willing the fear away. It was getting the fuller picture.

I needed more than hope. I needed the right medical care.

I conceived again relatively soon after the miscarriage. That pregnancy went on to become my daughter but it wasn't a simple, worry-free nine months, and I don't want to tell it that way.

During that pregnancy, testing showed a marginally positive ANA - antinuclear antibody. Based on my full clinical picture, my doctor managed the pregnancy with daily subcutaneous injections of a blood-thinning medication, low-molecular-weight heparin, which I took exactly as prescribed for the length of the pregnancy. My doctor was also honest with me that there could potentially be concerns about the baby's growth, which meant closer monitoring, more scans, more appointments than a completely uncomplicated pregnancy would have involved.

My daughter was born a little over six years ago, weighing 3.2 kilograms. The pregnancy, in the end, went well.

I want to be very deliberate about how I describe this part of my story, because it's the part most likely to be misunderstood. I did not take blood thinners because a single blood test came back positive. I took them because my treating doctor, looking at my complete clinical situation, determined that anticoagulation was the appropriate management for my individual case. That distinction is the single most important thing I want another woman with a similar report to take from this article.

What does a positive ANA actually mean?

Let me put on my nutrition-professional hat for a moment, because I think this is the part that gets least explained to women who are handed a result like mine.

ANA is a nonspecific marker. Antinuclear antibodies show up in a meaningful percentage of healthy people, and they're associated with a wide range of autoimmune conditions- not one specific disease, and not automatically a fertility diagnosis. A "marginally" or "weakly" positive ANA is common enough that, on its own, it usually raises a question rather than answers one.

ANA positivity is not the same thing as antiphospholipid syndrome (APS). This is the distinction I most wish someone had drawn a clear line under for me early on. APS is a specific, well-defined condition, and it requires two things together: a defined clinical event (such as a blood clot, or specific patterns of pregnancy loss) and confirmed, persistent antiphospholipid antibodies, a different test panel from ANA, including lupus anticoagulant, anticardiolipin antibodies, and anti-β2-glycoprotein I antibodies. Positive on two occasions at least 12 weeks apart. A positive ANA does not, by itself, mean a person has APS.

Research does show an association between ANA positivity and some adverse reproductive outcomes, including in women experiencing infertility or recurrent pregnancy loss, across several meta-analyses of observational studies. That's real and worth taking seriously. But association is not the same as proof of cause, and importantly, major reproductive medicine bodies, including ASRM's most recent guidance, do not recommend routinely testing for ANA in the standard recurrent pregnancy loss work-up, specifically because a positive result doesn't reliably change what treatment should follow.

This is exactly why my case was managed the way it was, not based on the ANA number in isolation, but based on my doctor's judgment of my situation as a whole.

Why blood thinners may be prescribed in some pregnancies

I know how alarming it can feel to be told you need an injectable blood thinner during pregnancy. I felt that alarm myself, even with my professional background. So let me explain, in plain terms, what low-molecular-weight heparin (LMWH) is and why it's sometimes used without telling you what your own situation calls for, because that's not something an article can responsibly do.

LMWH is an anticoagulant, meaning it reduces the blood's tendency to clot. In certain pregnancies, doctors prescribe it because some conditions most clearly antiphospholipid syndrome are associated with an increased risk of clotting-related placental problems, and evidence specifically in women with confirmed APS shows that combining aspirin with heparin is associated with better pregnancy outcomes than aspirin alone.

That evidence, however, is specific to APS. It does not automatically extend to every autoimmune marker, or to every case of recurrent miscarriage. Large, well-designed trials including a major international trial published in 2023, and a Cochrane systematic review pooling nine randomized trials in over a thousand women found that adding heparin did not improve live birth rates for women with unexplained recurrent miscarriage or inherited clotting tendencies without confirmed APS. In other words: this medication works well for a specific diagnosis, and the evidence does not support using it simply because a test came back abnormal in a more general sense.

I didn't take blood thinners because a report frightened my doctor into "doing something." I took them because, in my individual case, my doctor judged that the benefit was there. That's the difference between fear-driven medicine and evidence-based, individualised medicine, and it's a difference every woman deserves to have explained to her.

What I changed outside the doctor's office

Alongside my medical care, never instead of it, I was very particular about my nutrition and lifestyle during both pregnancies. I want to be careful here, because I think this is where stories like mine are most often misused.

I am not going to tell you that changing what I ate prevented another miscarriage, treated my ANA result, or is the reason my children are healthy. I have no evidence for any of that, and I won't imply it. What I can tell you is that I believe the way I managed my nutrition, lifestyle, and medical treatment together suited my body well and that nutrition, sleep, movement, and stress management were things I could actively work on, alongside the treatment my doctor prescribed, rather than instead of it.

My anti-inflammatory approach to food

I followed what I'd describe as an anti-inflammatory eating pattern built around vegetables, whole grains, legumes, nuts and seeds, healthy fats, and minimally processed foods, with less reliance on refined and ultra-processed products.

I want to be precise about what the evidence actually supports here, because "anti-inflammatory" gets used loosely, and a premium, evidence-based brand shouldn't use it loosely. There is genuine, growing evidence that overall dietary quality and nutritional adequacy matter for reproductive and pregnancy health.

What eating this way gave me, practically, was a foundation. Steadier blood sugar, better nutrient intake, and, subjectively, a sense that I was doing something constructive with the parts of the situation I could actually influence.

I turned vegan during pregnancy and here's what I learned

I turned vegan during my first pregnancy. For reasons connected to my personal ethics around animal welfare, not for any pregnancy-related claim. I want to separate that choice clearly from everything else in this story: I did not go vegan because I believed it would help my pregnancy succeed, and I'm not suggesting it did. It was simply what I chose to eat, and because of that choice, I had to be far more deliberate about my nutrition than I might otherwise have been.

Here's the honest, evidence-based picture of vegan pregnancy nutrition, because I think it's more useful than either extreme "veganism is dangerous in pregnancy" or "veganism is automatically fine."

The real question isn't vegan versus non-vegan. It's whether a diet, whatever its shape, is nutritionally adequate for pregnancy. Research bears this out directly: a 2024 systematic review of strict vegetarian and vegan pregnancies found associations with lower infant birth weight and a higher risk of a baby being small for gestational age, and pointed specifically to under-supplementation of vitamin B12, iron, omega-3s, and calcium as the likely explanation. A separate 2024 systematic review of vegan pregnancies found the same pattern: nutrient intake was often lower among vegan mothers who weren't deliberately supplementing, though B12 supplementation specifically was shown to be effective at correcting maternal and cord blood B12 levels when it was actually used.

That's the finding that matters most, practically: the risk in these studies wasn't "vegan" as an idea. It was inadequate planning around specific nutrients. A well-planned vegan diet can meet the demands of pregnancy but "well-planned" is doing real work in that sentence, and it requires attention to a short, specific list of nutrients that plant-based diets don't supply as easily.

I did not build my own approach to supplements like a fixed checklist. I made deliberate choices about food and, where relevant, supplementation, based on my own labs and needs. The broader point stands regardless of my specifics: a plant-based pregnancy is not automatically deficient, and it is not automatically fine. It requires the same thing every pregnancy diet requires genuine attention, not assumptions in either direction.

My diet didn't look like the diet you see on Instagram

Here's something that might surprise people who assume a fertility-nutrition professional eats a certain, photogenic way: I don't, and I never have.

For years, my normal pattern has been two main meals a day what I think of as brunch, and then dinner. My first meal is usually somewhere around 11am to noon, and dinner around 5:30 to 6pm. In between, I might have black coffee, a small handful of nuts, or popcorn. I do weight training three to four times a week, and on those days, I have a scoop of protein after training. I don't routinely eat breakfast, and I never have believed that everyone needs to, simply because it's often called "the most important meal of the day." I eat according to my appetite and my routine, and that routine has served me well for years.

Pregnancy changed that pattern but not because I decided it should. In the second and third trimesters of both pregnancies, I started genuinely feeling hungry in the mornings, and breakfast became a natural part of my day without any deliberate planning on my part. After my daughter was born, it took around ten months for my appetite to settle back into my usual two-meal pattern, where early-morning hunger mostly isn't part of my day.

I'm telling you this not to suggest that two meals a day is some kind of fertility strategy, it isn't, and I'd actively discourage anyone from reading it that way. I'm also not suggesting intermittent fasting or skipped breakfasts as a pattern for pregnancy; when I was pregnant and hungry in the morning, I ate breakfast, because that's what my body was asking for. The point I actually want to make is the opposite of a prescription: there is no single meal schedule every woman needs to follow, in fertility or in pregnancy. What matters is nutritional adequacy, that your body is getting what it needs. Built around your appetite, your activity, your pregnancy stage, and your individual life, not around a rule you read somewhere.

The rules I stopped believing in

A few misconceptions I ran into, and unlearned, along the way:

• "Everyone needs breakfast." No, nutritional adequacy across the day matters more than which meal you eat it at.
• "One miscarriage means you'll keep miscarrying." Most women who experience a single miscarriage go on to have a successful subsequent pregnancy. One loss is not a pattern.
• "A positive ANA means your body can't sustain a pregnancy." A positive ANA is a marker associated with somewhat higher risk in some studies. It is not a diagnosis of infertility, and it doesn't mean pregnancy is unlikely.
• "Needing blood thinners means something is terribly wrong with the baby." Anticoagulation, when it's actually indicated, is about supporting placental blood flow in a specific maternal condition, it isn't a signal that the baby is in danger, and plenty of women on LMWH have completely healthy pregnancies.
• "You need a perfect diet to have a healthy pregnancy." Nutritional adequacy, not perfection, is what the evidence supports. My own diet, by design, doesn't look like a curated feed.
• "Vegan pregnancy is automatically nutritionally deficient." It's only deficient if it's not planned around the nutrients like B12, iron, iodine, omega-3s, choline, that need deliberate attention on a plant-based diet.
• "A miscarriage happens because of something you did." The overwhelming majority of early miscarriages are caused by random chromosomal abnormalities in the developing pregnancy not something a woman ate, did, or failed to do.
• "Nutrition can replace medical treatment." It can't, and it shouldn't try to. Nutrition and medical care work alongside each other, not in competition.

Six years later, I was pregnant again

Six years after my daughter was born, I became pregnant again. My ANA was still marginally positive the same finding as before. Once again, my pregnancy was medically managed, and once again, based on my doctor's assessment of my individual situation, I was prescribed subcutaneous LMWH.

I want to note something about this, because I think it's easy to miss: the fact that the same finding appeared again, and the same category of treatment was used again, doesn't mean anything had "gone wrong" the first time, or that my body had failed to learn or heal. It meant my clinical picture was consistent, and my doctor's approach to managing it was consistent too. Continuity, in this case, was reassuring rather than alarming.

My son arrived a month early and weighed 3.2 kg

My son was born about a month early, because of pregnancy complications that required earlier delivery. He weighed approximately 3.2 kilograms and is healthy. Almost identical to his sister's birth weight.

I share the early delivery honestly because I don't want this story to read as a tidy, symmetrical narrative where everything simply worked out the same way twice. It didn't. My second pregnancy had its own complications, its own monitoring, and its own version of uncertainty. What I want you to take from it isn't "everything turns out fine" I can't promise you that, and I won't. What I want you to take from it is that a complicated pregnancy, one that requires medication, monitoring, and an earlier delivery than planned, does not automatically mean a poor outcome. Today, I have two healthy children.

What actually made the difference? A team, not a single fix.

If you're looking for the one thing that "worked" the food, the supplement, the routine. I don't have that answer, and I'd be doing you a disservice if I invented one.

What I can point to, honestly, is a combination: appropriate medical evaluation, a doctor I trusted, appropriate treatment when it was indicated, consistent monitoring throughout both pregnancies, deliberate attention to my nutrition, a lifestyle that fit my actual life rather than someone else's template, real attention to nutritional adequacy rather than trends, emotional support, patience with a process I couldn't rush, and maybe most importantly looking at the whole picture instead of fixating on one number.

That's not a dramatic answer. It's also, I think, the honest one, and it's the same philosophy behind how Health Hatch works with the women, men, and couples who come to us: not one fix, but a team's worth of attention pointed at the things that are actually within reach.

What I wish every woman after a miscarriage knew

A miscarriage is not a failure. The vast majority of early pregnancy losses happen because of random chromosomal abnormalities in the developing embryo, something that occurs at the moment of conception, entirely outside anyone's control, and unrelated to anything a woman ate, did, or didn't do.

One miscarriage does not predict the next pregnancy. A single early loss, on its own, does not mean you are likely to miscarry again. Most women who experience one miscarriage go on to have a successful pregnancy afterward.

Grief and hope can exist in the same week. I don't think anyone warns you about that. You can be devastated and still be actively working toward trying again. Neither feeling cancels the other out.

A previous loss can make the next pregnancy feel terrifying and that doesn't mean something is wrong with you. Anxiety after a miscarriage is common and understandable. It is not a sign that you're doing pregnancy "incorrectly."

Your fear is not a diagnosis, and your hope is not naivety. Both are simply what it feels like to want something this much while knowing it isn't fully within your control.

What actually matters if you've had recurrent miscarriage

If you've experienced two or more pregnancy losses, formal evaluation is worth pursuing rather than waiting to "see what happens" again. Recurrent pregnancy loss has many possible contributing factors, and a thorough work-up — not a single test — is what actually helps clarify the picture. This can include: genetic testing of pregnancy tissue where available, assessment of the uterus for structural factors, screening for antiphospholipid syndrome specifically (not ANA alone), evaluation of thyroid function, and, importantly, an assessment of the male partner.

It's also worth knowing something genuinely reassuring, and evidence-based: even after recurrent unexplained loss, a meaningful proportion of couples go on to have a successful subsequent pregnancy with careful monitoring and supportive care, even without a specific treatable cause being found. That is not a promise for any individual case — but it is a real, documented pattern in the research, and one I wish had been said to me more plainly at the time.

Don't forget the partner

Miscarriage happens, physically, to a woman's body. It does not happen only to her.

If you're the partner of someone going through this, I'd ask you to know that your grief is real too, even if it looks different, and even if the medical system speaks mostly to her. There isn't one right way to support someone through this, but a few things tend to help: listening without needing to fix the feeling immediately, showing up for appointments when you can, resisting any urge to look for blame in her or in yourselves, understanding the reasoning behind any treatment she's prescribed so you can be a genuine partner in it rather than a bystander, supporting the practical side of nutrition and rest rather than leaving it entirely to her, and being honest about your own emotional load instead of setting it aside indefinitely.

This is also, deliberately, why we built Health Hatch to work with women, men, and couples together. Not because miscarriage or fertility struggles are ever "just" a woman's responsibility, but because they never really were.

What I would do if I were trying again today

Find a doctor you actually trust, not just one who is qualified on paper but someone who explains their reasoning, not just their instructions.

Understand why you're being prescribed something, rather than fearing it. Ask your doctor directly what a medication is for and what evidence supports it in your specific situation.

Don't diagnose yourself from one blood test. A single marker, including ANA, is a starting point for a conversation with a specialist, not a conclusion you should reach on your own.

Don't blame yourself for a miscarriage. I know how hard this instruction is to actually follow. I'm giving it to you anyway, because it's true.

Look at nutrition before a positive test, not only after one. Preconception is a better time to build a foundation than the middle of an already anxious first trimester.

If you choose a plant-based diet, make sure it's a complete one. That means real attention to B12, iron, iodine, omega-3s, and choline. Not assuming a vegan diet is automatically fine, and not assuming it's automatically a problem either.

Don't ignore male fertility. Evaluation after recurrent loss should include the male partner. Sperm health, including things like DNA fragmentation, has a documented association with recurrent pregnancy loss in the research.

Ask for help instead of trying to work it all out alone. I say this as someone whose entire career was built on giving other people this exact advice, and who still needed to hear it herself.

A message from Niharikka

If you're reading this soon after a loss, or with a frightening lab result in front of you, I imagine the fear feels bigger than the facts right now. I remember that feeling precisely, the sense that a report had somehow decided my future before I'd had any real say in it.

A miscarriage is not proof that you cannot become a mother. Needing medication during a pregnancy does not mean that pregnancy is doomed. You may need a different plan than the one you imagined. You may need more monitoring than you expected. You may need the right doctor, nutrition support, emotional support, or, most likely, some combination of all of these together.

My story cannot predict yours. I won't tell you that if I did this, you can too. That isn't something anyone can honestly promise another person. But I can tell you that a difficult beginning does not necessarily determine the ending, and that you deserve a plan built around your actual body and your actual story, not fear, and not silence either.

How Health Hatch can help

Everything in this article points to the same conclusion: this is genuinely complex, it deserves the right medical team, and it also deserves real attention to the nutrition and lifestyle factors within your influence not instead of medical care, but alongside it.

That's the work Health Hatch does. We work with women, men, and couples on personalised preconception and fertility nutrition. Nutritional adequacy, metabolic health, PCOS, thyroid health, the nutrition side of autoimmune and reproductive health, male fertility and sperm health, and pregnancy nutrition. Always working alongside your medical care, never in place of it. We don't treat autoimmune disease, and we don't prevent miscarriage; no one honestly can promise that. What we can do is help you optimise the factors that nutrition and lifestyle genuinely influence, personalised to your body, your labs, and your history.

If you've been through a miscarriage, or you're trying to conceive again and feel scared about what comes next, you don't have to figure it all out alone.

Frequently asked questions

Can I have a healthy pregnancy after a miscarriage?

Yes, in most cases. A single miscarriage does not mean your next pregnancy is unlikely to succeed — most women who experience one early loss go on to have a healthy subsequent pregnancy. That said, every situation is individual, and speaking with your doctor about your specific history is worthwhile, especially if you have other risk factors.

Does one miscarriage mean I will miscarry again?

No. One early miscarriage, on its own, does not predict a future loss. The majority of early miscarriages are one-off events caused by random chromosomal abnormalities, not a pattern that's likely to repeat. Recurrent pregnancy loss (generally defined as two or more losses) is what typically prompts a fuller medical evaluation.

What causes recurrent miscarriage?

Recurrent pregnancy loss can have several possible contributing causes, including genetic factors, uterine structural issues, hormonal or thyroid conditions, and antiphospholipid syndrome, though in a meaningful proportion of cases no single cause is identified. Because the causes vary so much, evaluation needs to be individualised rather than based on one test.

Can autoimmune conditions cause miscarriage?

Certain autoimmune conditions, most clearly antiphospholipid syndrome, are associated with increased pregnancy loss risk and can be treated with a specific evidence-based protocol. Other autoimmune markers, including a positive ANA, show some association with adverse outcomes in research, but this is not the same as a confirmed cause in an individual case.

What does a positive ANA mean for pregnancy?

A positive ANA is a nonspecific marker found in various autoimmune conditions and in a meaningful number of people without any diagnosed condition at all. On its own, it does not diagnose antiphospholipid syndrome or predict miscarriage. It's a reason for a fuller conversation with a specialist, not a standalone diagnosis.

Does a positive ANA mean I cannot get pregnant?

No. A positive ANA does not mean you cannot conceive or carry a pregnancy. Many women with a positive ANA go on to have healthy pregnancies, sometimes with additional monitoring, sometimes with no treatment at all, depending on the complete clinical picture.

Do blood thinners prevent miscarriage?

Not universally. In confirmed antiphospholipid syndrome, aspirin combined with heparin is associated with improved pregnancy outcomes in the evidence base. In unexplained recurrent miscarriage or inherited thrombophilia without APS, large trials have not shown that adding heparin improves live birth rates. This is a decision that belongs with a specialist, based on your specific diagnosis.

What should I eat after a miscarriage?

There's no specific "post-miscarriage diet," but a nutritionally adequate, minimally processed eating pattern — adequate protein, plenty of vegetables and fruit, healthy fats, and key nutrients like folate, iron, and vitamin D — supports your overall health while you recover and, if and when you choose, try again. Personalised guidance matters more than a generic list.

Can a vegan diet be healthy during pregnancy?

Yes, if it's well-planned. Research shows outcomes can be affected when key nutrients aren't deliberately addressed, so a vegan pregnancy diet needs specific attention to vitamin B12, iron, iodine, DHA (usually via an algae-based supplement), and choline, alongside adequate protein and calcium.

Should my partner be tested after recurrent miscarriage?

Yes. A complete evaluation after recurrent pregnancy loss should include the male partner. Research has found an association between sperm DNA fragmentation and recurrent pregnancy loss, which is one of several reasons male fertility assessment shouldn't be skipped.

When should I see a fertility specialist after miscarriage?

After a single miscarriage, most women can try again without a formal work-up, though it's reasonable to check in with a doctor, especially with any additional risk factors. After two or more losses, or if you have a known condition such as an autoimmune disorder, formal evaluation is recommended sooner rather than later.

About this article

This article shares the personal experience of Niharikka Budhwani, Co-Founder of Health Hatch, alongside published research on miscarriage, recurrent pregnancy loss, autoimmune markers, and pregnancy nutrition. It is intended for education, not as individual medical advice, and does not replace evaluation by a qualified obstetrician, maternal-fetal medicine specialist, or reproductive immunologist. Niharikka's personal experience — including her specific diagnoses, treatment, and outcomes — is her own story and should not be read as a prediction, recommendation, or guarantee for any other individual. Any decision about anticoagulation, medication, or treatment for autoimmune or pregnancy-related conditions should be made with a qualified treating physician.

Author: Niharikka Budhwani, Co-Founder, Health Hatch
Medical/evidence review: Health Hatch Fertility Nutrition Team
Date published: August 29, 2026
Date reviewed: August 29, 2026

Related reading on Health Hatch

• Recurrent Miscarriage: What Actually Needs Investigating
• Autoimmune Conditions and Reproductive Health: The Nutrition Connection
• PCOS and Fertility: A Nutrition-First Approach
• Thyroid Health and Fertility: What Every Woman Trying to Conceive Should Know
• Male Fertility and Sperm Health: Why Both Partners Matter
• Egg Quality: What the Evidence Actually Shows
• Preconception Nutrition: Preparing Your Body Before You Try to Conceive
• Pregnancy Nutrition, Trimester by Trimester
• Do Fertility Supplements Actually Work? A Look at the Evidence
• Insulin Resistance and Fertility: Why Metabolic Health Matters

References

1. Practice Committee of the American Society for Reproductive Medicine. Recurrent pregnancy loss: a committee opinion. Fertility and Sterility. 2026.
2. ESHRE Guideline Group on RPL. ESHRE guideline: recurrent pregnancy loss: an update in 2022. Human Reproduction Open. 2023;2023(1):hoad002. PMID: 36873081
3. de Jong PG, Kaandorp S, Di Nisio M, Goddijn M, Middeldorp S. Aspirin and/or heparin for women with unexplained recurrent miscarriage with or without inherited thrombophilia. Cochrane Database of Systematic Reviews. 2014. PMID: 24995856
4. Middeldorp S, et al. (ALIFE2 investigators). Heparin for women with recurrent miscarriage and inherited thrombophilia (ALIFE2): an international open-label, randomised controlled trial. The Lancet. 2023. PMID: 37271152
5. Kaandorp SP, Goddijn M, van der Post JA, et al. Aspirin plus Heparin or Aspirin Alone in Women with Recurrent Miscarriage. New England Journal of Medicine. 2010;362(17):1586–1596.
6. Ticconi C, Inversetti A, et al. Antinuclear antibodies positivity in women in reproductive age: From infertility to adverse obstetrical outcomes — a meta-analysis. Journal of Reproductive Immunology. 2023. PMID: 36621091
7. The association between dietary patterns and risk of miscarriage: a systematic review and meta-analysis. Fertility and Sterility. 2023.
8. Muffone ARMC, de Oliveira Lübke PDP, Rabito EI. Mediterranean diet and infertility: a systematic review with meta-analysis of cohort studies. Nutrition Reviews. 2023;81(7):775–789. PMID: 36346903
9. Meulenbroeks D, Otten E, Smeets S, Groeneveld L, Jonkers D, Eussen S, Scheepers H, Gubbels J. The Association of a Vegan Diet during Pregnancy with Maternal and Child Outcomes: A Systematic Review. Nutrients. 2024;16(19):3329.
10. Papadopoulou T, Sarantaki A, Metallinou D, Palaska E, Nanou C, Diamanti A. Strict vegetarian diet and pregnancy outcomes: A systematic review and meta-analysis. Metabolism Open. 2024.
11. Rashid S, et al. Review of Vitamin B12 deficiency in pregnancy: a diagnosis not to miss as veganism and vegetarianism become more prevalent. European Journal of Haematology. 2021. PMID: 33341967
12. Derbyshire EJ. Choline in Pregnancy and Lactation: Essential Knowledge for Clinical Practice. Nutrients. 2025;17(9):1558.
13. Sperm DNA fragmentation and recurrent pregnancy loss: a systematic review and meta-analysis. Fertility and Sterility. 2019. PMID: 31056315
14. Agarwal A, Aponte-Mellado A, Premkumar BJ, Shaman A, Gupta S. The effects of oxidative stress on female reproduction: a review. Reproductive Biology and Endocrinology. 2012;10:49. PMID: 22748101