Options After Recurrent Perinatal Loss
Recurrent Pregnancy Loss (RPL) is defined as two or more failed pregnancies. RPL can put women and families under tremendous stress, both physical and emotional. There are many treatment options for growing your family following RPL.
Many women have a miscarriage at one time or another. Women and families often grieve these losses deeply. About 15 to 20 percent of pregnancies end in miscarriage. Often, pregnancy loss is random, and does not mean there is any underlying genetic or reproductive issue. Approximately 2 percent of women experience two consecutive pregnancy losses, which could still be attributed to chance. However, about 0.5 percent of women experience a third consecutive loss, which might indicate a reproductive problem. If you have suffered two or more miscarriages, you should talk with your health-care provider about treatments to help reduce your risk of miscarriage.
Major advancements in reproductive medicine have helped identify the causes of RPL and an accurate diagnosis is possible in about 60 percent of cases. Common causes for recurrent pregnancy loss include:
Abnormalities in a woman’s uterus can cause problems during pregnancy and may be treated surgically. Uterine abnormalities could include fibroids, endometrial polyps or intrauterine adhesions. The most common uterine abnormality leading to pregnancy loss can be attributed to a septate uterus, in which there is a wall of tissue dividing the uterine cavity.
Hormonal disorders, including uncontrolled diabetes, thyroid disease or polycystic ovary syndrome (an estrogen imbalance), could contribute to recurrent pregnancy loss. Because proper hormone levels are needed for successful pregnancy, elevated prolactin levels can also contribute.
Women with autoimmune or clotting (thrombophilia) problems may be treated with low-dose aspirin and heparin. These medicines can be taken during pregnancy to lower the risk of miscarriage due to immunologic factors.
In about 50 percent of cases, pregnancy loss can be attributed to an abnormal number of chromosomes in the embryo. These issues usually occur spontaneously at the time of conception, but may occasionally be inherited from parents. If a genetic link is identified, a woman could undergo in vitro fertilization and screen embryos for the genetic problem.
There are other potential causes of recurrent pregnancy loss, including infections and sperm problems, although these are less well defined. Lifestyle factors such as smoking, drug use, caffeine and alcohol intake, toxin exposure and obesity should be addressed, as these can be contributing factors.
Almost two-thirds of women with RPL will eventually have a healthy pregnancy — often without any extra treatment. Multiple studies show that the very practice of monitoring this condition and receiving emotional support can improve the odds of having a successful pregnancy. Adoption is always an alternative to growing your family when medical treatments are not an option.
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