Recurrent miscarriage (RPL)

Recurrent pregnancy loss (also known as "recurrent miscarriage" or "habitual abortion") is defined as three or more consecutive pregnancy losses. Miscarriage is a loss that happens prior to 20 weeks from the last menstrual cycle (a loss that happens after 20 weeks is known as a stillbirth). Recurrent pregnancy loss can be caused by genetic or chromosomal issues as well as structural problems of the uterus.

What is recurrent pregnancy loss (RPL)?

Recurrent pregnancy loss (RPL),also known as “recurrent miscarriage” or “habitual abortion,” is defined as two or more pregnancy losses prior to 20 weeks of gestation. The American Society of Reproductive Medicine (ASRM), however, has recently redefined this as two or more pregnancy losses.

Recurrent pregnancy loss is a rare condition affecting less than 5% of couples. RPL is typically caused by a genetic disorder, chromosomal issues, sperm or egg quality issues, or structural problems in the uterus.

How is a pregnancy confirmed?

A pregnancy is clinically confirmed through an ultrasound visualization of the gestational sac or heartbeat. A pregnancy can also be chemically confirmed by detecting higher levels of human chorionic gonadotropin (hCG), also known as the “pregnancy hormone.”

Symptoms of recurrent pregnancy loss

Common symptoms of miscarriage and RPL also include vaginal bleeding and spotting, white and pink mucus discharge from the vagina, weight loss, and painful contractions. After two or more consecutive miscarriages, however, a person can be diagnosed with RPL.

Treatment of recurrent pregnancy loss

The first step is diagnosing the root cause behind the loss itself, as RPL can be caused by a number of factors. If RPL is being caused by genetic or chromosomal abnormalities, a genetic specialist should be consulted to assess the odds of having a chromosomally normal pregnancy in the future. Structural uterine problems can be treated with surgery. IVF with embryo genetic testing (PGD) can help identify healthy embryos before they’re transferred into the uterus, decreasing the chances of miscarriage.

Dealing with one miscarriage, let alone RPL, can be incredibly challenging. Patients experiencing RPL may want to seek professional help to cope with their losses. 

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