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Recurrent pregnancy loss (RPL) is typically defined as two or more pregnancy losses, whether or not they occur consecutively. Traditionally, RPL referred only to clinical pregnancies confirmed by ultrasound, but many specialists now also consider biochemical pregnancies (very early pregnancy losses detected only by hormone testing).
Pregnancy loss is more common than many people realize:
Age plays a major role:
There is no single cause of recurrent miscarriage. In many cases, RPL is linked to genetic abnormalities, but several other biological, hormonal, anatomical, and immunologic factors may contribute.
Most early miscarriages occur because the embryo has an abnormal number of chromosomes.
Age-related risk: As female age increases, the chance of aneuploid embryos—and therefore miscarriages—increases. Aneuploidy is also a major reason infertility rises with age.
Issues with the uterus can increase miscarriage risk, including:
These conditions may affect implantation or growth of a pregnancy.
Imbalances in thyroid hormones, prolactin, or other reproductive hormones may contribute to pregnancy loss. Treating the underlying hormonal disorder often improves pregnancy outcomes.
Certain autoimmune or clotting disorders—especially antiphospholipid syndrome (APS)—can increase miscarriage risk. APS is a well-documented, treatable cause of RPL.
While RPL is often approached from the woman’s medical history, sperm quality also plays a role. DNA fragmentation, oxidative stress, or other male-factor abnormalities may contribute.
A thorough evaluation looks at both partners and focuses on the most common factors associated with miscarriage.
Typical RPL testing includes:
This comprehensive approach helps identify potential causes and guide individualized treatment.
Treatment depends entirely on what the evaluation uncovers—there is no single universal protocol.
Examples of targeted treatment include:
The most encouraging fact is that most individuals with recurrent pregnancy loss ultimately achieve a healthy, successful pregnancy, even without major medical interventions. With proper evaluation, personalized treatment, and supportive care, outcomes are often very positive.
