Recurrent Pregnancy Loss
What is recurrent pregnancy loss or RPL?
Pregnancy loss or miscarriage happens to 15-20% of couples and most happen before 12 weeks of pregnancy. Recurrent pregnancy loss is defined by the American Society of Reproductive Medicine (ASRM) as a condition defined by two or more failed pregnancies. Sadly, about 5% of couples will experience two consecutive miscarriages and less than 1% of couples will have three or more miscarriages.
There are various known causes of recurrent pregnancy loss, including:
- Problems with the structure of the uterus
- Hormonal issues such as thyroid disorders
- Clotting issues such as antiphospholipid syndrome
- Genetic issues
However, most cases of RPL are caused by chromosomal abnormalities that prevent the embryo from developing normally. Chromosomal abnormalities can happen at random but are also more likely to occur when the aspiring parents are over the age of 35 or if the mother has an underlying condition, such as polycystic ovary syndrome (PCOS).
Diagnosing and Treating Recurrent Pregnancy Loss
With your second pregnancy loss, you can request your ob-gyn to send your miscarriage to have a chromosome analysis as this is the most common cause for a miscarriage. If the chromosomes of your baby are abnormal, this will give you the most likely answer to why this happened. If the chromosomes are normal, other testing can be performed to understand the other reasons for pregnancy loss. These may include:
- Genetic testing for parents (carrier screening)
- Hormonal tests (thyroid function, progesterone levels)
- Blood clotting disorders screening
- Uterine cavity evaluation
- Immunological tests
- Infectious disease testing
- Assessment of structural abnormalities
- Endocrine evaluations (PCOS, diabetes)
- Assessment of cervical factors
Once the underlying causes are understood, your fertility care team will develop a treatment protocol to address the specific issues, which may include one or a combination of the following:
- Hormone therapy to address hormonal imbalances
- In vitro fertilization (IVF) with preimplantation genetic testing (PGT)
- Blood thinners for individuals with clotting disorders
- Immunotherapy for autoimmune conditions
- Antibiotic or antiviral medications for infectious causes
- Surgery to correct structural abnormalities
- Lifestyle changes, including weight management and diabetes control
- Antioxidant supplements
- In some cases, donor eggs
For those who are experiencing recurrent pregnancy loss due to chromosomal abnormalities, the most highly recommended treatment protocol is IVF using preimplantation genetic testing for aneuploidy (PGT-A). With this method, embryos are created outside of the body and then evaluated for the number of chromosomes. Only embryos with 23 pairs of chromosomes (a total of 46 altogether) are then selected for embryo transfer.
Schedule a Consultation for Recurrent Pregnancy Loss
At Aspire Fertility, our fertility specialists will perform a comprehensive fertility diagnostic workup for your recurrent pregnancy loss and provide supportive, compassionate care every step of the way. We invite you to learn more about our fertility clinic locations in Austin, Dallas, Houston, McAllen, and San Antonio, get five-star patient support, or request an appointment to get started.
