What is recurrent pregnancy loss (RPL)?
Recurrent pregnancy loss has been traditionally defined as three consecutive first-trimester losses, but we now recommend a workup and possible treatment after two early miscarriages. There are numerous possible causes of recurrent miscarriage (RPL), yet the majority of cases reveal no definitive cause. Many repeat miscarriages may be due to the incidental loss of a chromosomally abnormal embryo found in 20-50% of early pregnancies depending upon the women’s age.
Common causes of RPL
- Uterine anomalies (congenital malformations) such as septate uterus
- Fibroids affecting the uterine cavity including uterine scarring
- Genetic abnormalities such as chromosomal translocations in either the male or female partner
- Immunologic disorders such as the anti-phospholipid syndrome
- Uncontrolled diabetes and other endocrine or medical disorders
- Uterine infections
- Male or sperm-related factors
Once a woman has had two miscarriages, it is wise to undergo a thorough evaluation to discover and treat any of the known and preventable causes of miscarriage. Even if the problem is not easily treated, the workup allows our team to calculate a patient’s risk of future miscarriage, and often simply offer reassurance that the patient is safe to try to conceive again.