Recurrent Pregnancy Loss

Recurrent pregnancy loss (RPL) is a condition where a woman suffers two or more miscarriages before reaching the 20th week of pregnancy. The condition can be frustrating for both couples and fertility specialists.

Recurrent pregnancy loss causes

The majority of miscarriages occur as the result of a random chromosomal abnormality – typically a missing or duplicated chromosome. Less than 5 percent of these chromosomal problems are due to an inherited genetic disorder.

Although many women experience a single miscarriage, only about 1 percent goes on to experience recurrent pregnancy loss. In up to 50 percent of RPL cases, an exact cause cannot be determined.

When a cause is found, it is often linked to the following:

• Age – maternal age plays an important role in fertility. The risk of chromosomal abnormalities increases after age 35
• Congenital or acquired anatomical defects –uterine fibroids, adhesions or polyps; uterine septate; an abnormally shaped uterus and other defects can lead to miscarriage
• Endocrine factors – diabetes, thyroid disease, and luteal phase defects may be responsible for repeat miscarriages.
• Autoimmune disorders – clotting disorders caused by mutations of clotting factors can lead to pregnancy loss
• Infections – rarely, infection can be linked to recurrent miscarriage
• Environmental causes – lifestyle factors such as exposure to alcohol, cigarettes, and caffeine can contribute to pregnancy loss. Prolonged exposure to heavy metals, gases, and other agents has also been blamed for pregnancy loss

Treatment of recurrent pregnancy loss

Treatment of recurrent pregnancy loss depends on the cause. If a reason can be pinpointed, your gynecologist will discuss appropriate treatment options, which may include:

• Genetic counseling
• Surgery
• Medication

Even when women suffer multiple pregnancy losses of an undetermined cause, the majority goes on to have a successful pregnancy.

The impact of RPL can be devastating. If you have experienced recurrent pregnancy loss, psychological counseling may be helpful. Talk with your fertility specialist about options for dealing with this emotionally traumatic situation.