Recurrent Pregnancy Loss2019-04-05T22:55:50+00:00

Recurrent Pregnancy Loss

It is a condition in which a woman has 2 or more clinical pregnancy losses. This means pregnancies that were seen by ultrasound. This condition affects 5% of couples.

Genetic causes

Up to 70% of pregnancy losses are due to chromosomal errors in the embryo. Normally there are 46 chromosomes which encompass genes for normal development., however, sometimes embryos can have an extra chromosome (47) or less chromosomes (45). These embryos usually result in pregnancy losses. As women age, the risk of having a loss due to chromosomal imbalances increases significantly.

Anatomical causes

In some cases, birth defects in the shape of the uterus can be present (uterine septum, bicornaul uterus, among others) that can result in pregnancy losses. Other common causes are: fibroids and even polyps have been associated with pregnancy losses.

Causes related to lifestyle

Cigarrette use, alcohool and drugs have all been associated with recurrent pregnancy losses. Having a sedentary lifestyle or being obese can also be realted to this condition. Excessive caffeine use (>2 cups per day) has also been linked to pregnancy losses.

Medical causes

Medical conditions such as diabetes or hypothyroidism can increase the chances of having a pregnancy loss. Immunological or hematological (thrombophilia or antiphospholipid syndrome) have been associated with recurrent pregnancy loss.

A thorough evaluation needs to be performed, starting by bloodwork which include a genetic analysis to the couple (karyotype), specialized immunologic testing and coagulation testing (thrombophilia and antiphospholipid antibodies). A hysterosalpingogram (x-ray) or a saline sonogram (3D ultrasound) can detect uterine anomalies that may be causes the pregnancy losses. Genetic studies can be performed directly to the fetus after a loss which can provide extra information.

It is important to note that even after two losses there is a 70% chance that the third pregnancy will be successful, however, after evaluating the couple, your doctor may recommend medical or surgical treatments that can maximize your chances of having a live birth. These treatments will aim to correct or treat hematologic conditions such as thrombophilias or antiphospholipid antibodies, immunologic conditions like hypothyroidisim or elevated antibodies. If needed, your doctor can recommend lifestyle changes, supplements, IVF with Preimplantation Genetic Testing and surgical corrections.