Abstract
Antiphospholipid syndrome (APS) is an autoimmune disease characterized by the presence of antiphospholipid antibodies (APAs). It is frequently associated with thrombotic and obstetric complications in women of reproductive age. This article reviews the main reproductive and obstetric complications related to APS, including primary infertility, embryonic implantation failure, recurrent miscarriages, fetal loss, preeclampsia, intrauterine growth restriction, and preterm birth. It addresses the pathophysiological mechanisms involved, such as placental dysfunction, alterations in spiral artery remodeling, and inflammatory processes mediated by APAs and the complement system. We conclude that early recognition of this clinical entity is essential, given its catastrophic clinical repercussions, precisely to improve reproductive and obstetric outcomes associated with high mortality rates.