Recurrent Pregnancy Loss (RPL)
When a woman has three or more clinical pregnancy losses she is considered to have recurrent pregnancy loss (RPL). Biochemical pregnancies are not included in the definition. Below is some general information on this condition and what to expect if it occurs.
Causes of Recurrent Pregnancy Loss
There can be many causes of RPL, but in about 50 percent of couples with RPL no cause is found.
Causes include genetic etiology such as if one partner is a carrier of a balanced translocation or the woman is of advanced maternal age which increases the chances of a genetic issue with the conceptus. Other causes can be abnormal anatomy such as a uterine septum or congenital malformation or large uterine fibroid. Another proven cause for recurrent miscarriage is an acquired syndrome called antiphospholipid antibody syndrome which can make a woman more susceptible to developing blood clots and miscarriages. This syndrome is diagnosed via clinical history and some blood tests. Other less common causes include inherited thrombophilas (clotting disorders), immunologic disorders and infections.
Treatment of Recurrent Pregnancy Loss
In couples where the cause of RPL is diagnosed to be due to a balanced translocation, they can undergo in vitro fertilization (IVF) with pre-implantation genetic diagnosis (PGD) to identify and transfer only normal embryos during the IVF process. Anatomic causes of RPL can often be surgically corrected. For antiphospholipid antibody syndrome and thrombophilias the treatment is usually baby aspirin and heparin started when pregnancy is diagnosed. For immunologic causes the treatment is still controversial and therapy with immunoglobulins such as IVIG cannot be recommended to be of benefit based on the data at this time. Infectious causes may be amenable to treatment with antibiotics.
The good news is that in many couples with RPL, if no specific cause is found, they have a high likelihood of successful pregnancy with the next conception. Even after 3 miscarriages, there is a greater than 60 percent chance that the next pregnancy will be viable.
All of our four board certified Reproductive endocrinologists have experience and expertise in the diagnosis and treatment of couples with RPL. Appointments with our doctors are available in both the Bedford and Frisco locations.
Our Bedford office is close to Fort Worth, Dallas, Irving, Las Colinas, and the DFW airport. Our Frisco office is close to Plano, Richardson, McKinney, Lewisville, Allen, Denton, and Dallas. We encourage you to learn more about this condition and treatment options by scheduling a consultation without our Dallas / Fort Worth fertility specialists and doctors.