The occurrence of three or more consecutive pregnancy losses is traditionally defined as recurrent pregnancy loss. A pregnancy loss is defined as a clinically recognized pregnancy that ends involuntarily before 20 weeks of gestation. A medically recognized pregnancy is one in which the pregnancy was viewed on an ultrasound or pregnancy tissue was identified after a miscarriage.

What Are The Causes Of Recurrent Pregnancy Loss?

miscarriage recurrent pregnancy loss

  • The majority of pregnancy losses are caused by chromosomal, or genetic, abnormalities and occur at random. The abnormality could be caused by the egg, the sperm, or the early embryo.
  • Maternal age raises the risk of miscarriage, which is usually caused by poor egg quality, which results in chromosomal abnormalities. 
  • Miscarriage can occur when there is an abnormality in the uterus (the womb). The miscarriage could be caused by a lack of blood supply to the pregnancy or by inflammation.
  • The immune system of a woman may also play a role in recurrent pregnancy loss. Thyroid disease and diabetes, for example, can both cause pregnancy loss due to hormonal imbalances. Pregnancy loss may also be affected by abnormalities in a mother's blood clotting.

The cause of recurrent pregnancy loss is frequently found in one of four areas:

The Uterus

Fibroids, polyps, or scar tissue inside your uterus, as well as an abnormally shaped uterus, can cause pregnancy loss.

Genetics

Genetic testing may reveal that you and your partner have a chromosomal mutation that is passed down to the baby each time you become pregnant.

Hormones

hormones recurrent pregnancy loss

A blood test may reveal hormonal imbalances that affect your ability to carry a full-term pregnancy.

Clotting Disorders

If you have a blood clotting disorder, your body will struggle to properly nurture and grow your baby, increasing the risk of miscarriage.

Recurrent Pregnancy Loss Can Be Overcome By The Following Treatments

By Dr. Y. Swapna, Fertility Consultant, Nova IVF Fertility, Vijayawada shares some of the ways to overcome recurrent pregnancy loss.

Surgery 

Some uterine difficulties, such as extra tissue that divides the uterus, fibroids (benign tumours), and scar tissue, can be surgically treated. Correcting the shape of the uterus's interior can reduce the risk of miscarriage. 

Blood-thinning drugs

blood thinners recurrent pregnancy loss

Low-dose aspirin and heparin may be used to treat women who have autoimmune or clotting issues (thrombophilia). These medications can be used during pregnancy to reduce the chances of miscarriage.

Other Medical Issues Must Be Addressed

Recurrent pregnancy loss may be linked to a variety of medical issues. These include abnormal blood sugar levels, an overactive or underactive thyroid gland, and high prolactin levels. Diabetes, thyroid dysfunction, and high prolactin levels can all be treated to increase the chances of having a healthy, full-term pregnancy.

Genetic Testing

genetic test recurrent pregnancy loss

One of the parents has a chromosome rearrangement (translocation) in approximately 5% of RPL couples. If one parent has a translocation, foetuses with chromosome imbalances are more likely to miscarry. The blood of the parents can be studied (karyotyped) to see if they have a translocation. If a chromosomal problem is discovered, the doctor may advise genetic counselling. Although many couples eventually conceive a healthy pregnancy on their own, some doctor may recommend fertility treatments such as in-vitro fertilization (IVF) where the eggs and sperm are mixed in a laboratory outside of the body.

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Other Treatments Include Changes In Lifestyle 

•Smoking cigarettes and avoiding illicit drugs such as cocaine will reduce the risk of miscarriage

•Limiting your intake of alcohol and caffeine may also help. 

•Overweight can also lead to an increased risk of miscarriage; weight loss may also improve pregnancy outcomes. 

Controversial treatments

There is no evidence that intravenous (IV) infusions of blood products such as intravenous immunoglobulin [IVIG]) or medicines such as soybean oil infusion reduce the risk of miscarriage.

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There is no evidence that Recurrent Pregnancy Loss is caused by stress, anxiety, or mild depression. However, these are significant issues that arise as a result of RPL. Couples can benefit from psychological support and counselling to help them cope with the emotional pain of miscarriage and create a healthy environment for a pregnancy.

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