eng Oriental Scientific Publishing Company Biomedical and Pharmacology Journal 0974-6242 2025-09-30 18 3 1953 1961 10.13005/bpj/3228 67851 article Asaad Babker 1 Hanan Khalid Fadul Ahmed 2 Salaheldein Elzaki 2 Shawgi Elsiddig 3 Sarah Elsiddig Dafallah 4 Tagwa Yousif Elsayed Yousif 5 Department of Medical Laboratory Sciences, College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates Department of Molecular Epidemiology, Tropical Medicine Research Institute, National Center for Research, Khartoum, Sudan Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia. Departrment of Family Medicine, Faculty of Medicine, Gadarif University, Gadarif, Sudan Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University. Gizan,45142, Saudi Arabia Department of Medical Laboratory Technology, College of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia This study aimed to investigate the prevalence of ACE I/D and PAI-1 4G/5G polymorphisms in Sudanese women experiencing recurrent pregnancy loss (RPL), and to explore their possible relationship with this condition. A retrospective study was carried out at Omdurman Maternity Hospital in Sudan. The study involved 125 participants: 64 RPL cases (defined as women with a history of at least three unexplained spontaneous abortions) and 61 healthy controls with normal success pregnancies and. A 5 mL EDTA blood sample was taken from each participant, and demographic, personal, and family medical information was collected using a questionnaire. Genomic DNA was extracted from blood leukocytes utilizing the GF-1 Blood DNA Extraction Kit. The polymorphisms of the PAI-1 4G/5G and ACE I/D genes were examined through polymerase chain reaction (PCR). Data analysis was conducted employing SPSS version 24. The ACE I/D polymorphism was found to have a notable association with recurrent pregnancy loss (RPL), with the I/D and D/D genotypes linked to an increased risk (odds ratio 1.29). Although the 4G allele and the 4G/4G genotype showed statistical significance, they were more prevalent in the control group (2.8% and 45.9%, respectively) compared to the cases (6.2%, p < 0.001). Homozygosity for the D allele of ACE, when combined with the PAI-1 4G/4G genotype, significantly raised the likelihood of RPL (p < 0.001). Despite a higher occurrence of the 4G/4G genotype in controls (17% versus 44.7%), these findings suggest complex interactions with other genetic factors. Overall, the homozygous D allele of ACE and the PAI-1 4G/4G genotype are more frequently observed among Sudanese women suffering from recurrent miscarriage, highlighting the commonality of these genetic variations within this population. https://biomedpharmajournal.org/vol18no3/frequency-of-ace-i-d-and-pai-1-4g-5g-polymorphisms-in-women-with-recurrent-pregnancy-loss-in-sudan/ ACE I/D Polymorphism Abortion Genetic Risk Factors PAI-1 4G/5G Recurrent Pregnancy Loss Sudanese Women Thrombophilia