Recurrent Pregnancy Loss

The definition of ‘recurrent pregnancy loss’ or ‘recurrent miscarriage’ or ‘habitual abortion’ is still a dilemma but most frequently accepted as having three consecutive pregnancy losses, which is documented by ultrasonography or histopathologic examination. Pregnancy loss one of the most frustrating and difficult areas in reproductive medicine because the etiology is often unknown and there are few evidence-based diagnostic and treatment strategies.

But in most of clinics after 2 miscarriages, clinicians start to investigate. Approximately 15 percent of pregnant women experience sporadic loss of a clinically recognized pregnancy. Just 2 percent of pregnant women experience two consecutive pregnancy losses and only 0.4 to 1 percent have three consecutive pregnancy losses. One of the most important concerns is the cause of recurrent miscarriage. But unfortunately, the cause can be determined in only 50 percent of patients. Some of the reasons we know are uterin anomalies, leiomyomas, endometrial polyps, intrauterine adhesions; cervical insufficiency; defective endometrial receptivity which cause rejection of embryo; immunologic factors such as antiphospholipid syndrome; endocrine factors such as diabetes mellitus, thyroid disorders, polycystic ovary syndrome, hyperprolactinemia, luteal phase defect; genetic factors such as aneuploidy, chromosomal rearrangement; thrombophilia and fibrinolytic factors; environmental chemicals and stress such as anesthetic gases (nitrous oxide), arsenic, aniline dyes, benzene, ethylene oxide, formaldehyde, pesticides, lead, mercury, and cadmium; some infections.

If the clinician finds a possible cause that can be treated, he or she will treat it. Treatment might help improve your chances of having a successful pregnancy. For example, problems in the uterus can sometimes be treated with surgery. Certain medical, immune, or hormone problems can sometimes be treated with medicines.