We aimed to explore the role of Indium (In), Terbium (Tb), Yttrium (Y), and Lanthanum (La) in the serum of women with recurrent pregnancy loss (RPL) and compare them to controls. Additionally, the study aimed to examine the relationship between REE levels and oxidative DNA damage, to identify potential risk factors contributing to RPL. This case-control study included 30 RPL cases and 30 controls with uncomplicated pregnancy. Inductively Coupled Plasma Mass Spectrometer was used to evaluate levels of In, Tb, Y, and La in the serum samples in both groups. The relationship between REE levels, Total Antioxidant Capacity (TAC), and DNA damage was studied by correlation analysis. There was a significant increase in levels of In, Tb, Y, and La in the serum of the RPL group in contrast to the control group (P <
0.002). Furthermore, a negative correlation was observed between increased Y, Tb, La, and TAC in RPL cases (significant at P <
0.05), indicative of weakened antioxidant defenses. Moreover, increased levels of Y, Tb, and La exhibited a positive correlation with the DNA damage marker, statistically significant at P <
0.05. These findings highlight the potential role of oxidative stress-induced DNA damage and metal intoxication in the development of RPL, underscoring the importance of further research to clarify underlying mechanisms and develop preventive strategies.