Recurrent Pregnancy Loss & Miscarriage

What is Recurrent Pregnancy Loss?

Recurrent pregnancy loss (recurrent miscarriage) affects approximately 5 percent of all reproductive age couples and is typically defined as having at least two consecutive miscarriages or three total over a woman’s individual reproductive history.

Causes of Miscarriage

There are many possible causes of recurrent pregnancy loss including the following:

• Genetic causes
• Uterine causes
• Ovarian causes
• Male factor causes
• Immunologic causes
• Blood clotting disorders
• Hormonal deficiencies

Our doctors use evidence-based medicine to diagnose and treat recurrent pregnancy loss.

Diagnosis

The evaluation of recurrent pregnancy loss typically involves one or more of the following tests:

• A transvaginal ultrasound to evaluate the uterus to rule out uterine fibroids
• A hysterosalpingogram (HSG) to rule out a uterine septum
• Ovarian reserve testing to look for a decreased number or decreased quality of eggs in the ovaries using ultrasound and hormonal testing
• Additional hormone testing may include prolactin and thyroid tests

We may also check for autoimmune problems such as antiphospholipid antibodies, a common cause of recurrent pregnancy loss that can be treated with a combination of aspirin and heparin. As long as your medical history is normal without a history of prior blood clots, further blood clot testing is not recommended.

A rare cause of recurrent pregnancy loss takes place when a man or woman has an underlying genetic abnormality resulting in a rearrangement of their chromosomes and abnormal eggs or sperm which can result in abnormal embryos. These abnormal embryos have a higher chance of miscarriage. Blood work can determine if there is any evidence of a genetic abnormality causing the recurrent pregnancy loss.

Treatment Options

Because miscarriages are so emotionally involved, patients frequently become determined to enter into any form of treatment which could theoretically improve their pregnancy rates. Our goal is to first help you identify the most likely causes for your recurrent pregnancy loss and explore treatment options that provide you a high chance of having a healthy pregnancy with a low chance of harm.

Progesterone replacement is frequently administered to help treat any progesterone deficiencies that a woman may have in her luteal phase – often referred to as a luteal phase defect.