The majority of women will have a smooth pregnancy, however, some will suffer a miscarriage at some point during pregnancy. But some women experience recurrent pregnancy loss (RPL), i.e., more than once or twice. 

Several factors can cause a pregnancy loss, and if a woman has a miscarriage once, it does not necessarily mean that she will never become pregnant again or that she will have another miscarriage if she conceives. 

Many people consider RPL to be a natural process. Problems causing recurrent pregnancy loss are always treatable in nearly half of the cases. Most women who have suffered multiple miscarriages can still have a healthy pregnancy with proper medical care.

Definition of recurrent pregnancy loss (RPL)

A woman who suffers two or more consecutive miscarriages, or recurrent miscarriages or abortions, is defined as recurrent pregnancy loss. According to a study, about 15% of pregnancies end up with miscarriages before the 20th week of pregnancy. Pregnancy losses or miscarriages are most common in the first 12 weeks of conception.

Causes of recurrent pregnancy loss (RPL)

Several studies claim that genetic abnormalities are responsible for recurrent miscarriages. Moreover, as women get older, the likelihood of these recurrent miscarriages increases. Women who are around 35 years of age have a 15% to 20% chance of developing genetic abnormalities; those over 40 years of age have a 50% chance of developing abnormalities. Genetic abnormalities refer to embryos with an abnormal number of chromosomes formed during the fertilization of an egg.

  • There can be miscarriages due to anatomical abnormalities like the irregularly shaped uterus or an abnormally shaped septum. 
  • Miscarriage may be caused by an incompetent cervix or a weak cervix that is incapable of supporting the fetus.

Medical conditions

Recurrent pregnancy losses may also be caused by certain medical conditions, including:

  • Antiphospholipid syndrome (APS) 
  • Thyroid problems
  • Asherman’s syndrome
  • Hormonal issues 
  • Fibroids
  • Polyps
  • Lupus (SLE) and antiphospholipid syndrome (Blood clotting disorders)

Medication or surgery can be used to treat most of these conditions. The only thing you need to do when you have a miscarriage is to contact a gynaecologist. They recommend the best treatment for recurrent pregnancy loss based on the results of some diagnostic procedures. 

Recurrent Pregnancy Loss Treatment 

In order to improve your chances of a healthy pregnancy and treat recurrent pregnancy loss, lifestyle modification, prescription medications, and surgery to eliminate certain conditions are very effective. Even after three consecutive miscarriages, women still have a 60% to 80% chance of conceiving and carrying a full-term pregnancy.

It is common for miscarriage survivors to attempt to become pregnant again naturally, but before that certain health conditions causing miscarriages need to be treated.

Surgical treatment can be used to treat medical conditions like septate uterus, abnormal shape of uterus, fibroids, and scar tissue, which reduce the likelihood of miscarriage. Surgical correction of anatomical problems enhances the live birth rate.

Doctors may recommend blood-thinning medications like aspirin and heparin to treat autoimmune diseases like Antiphospholipid syndrome (APS). High blood sugar, thyroid problems, and hormonal imbalances can be treated with the help of medicines that trigger dopamine receptors or progesterone supplements.

A doctor might recommend genetic screening if they diagnose chromosomal defects like translocations. Though many couples with this condition can have healthy & natural pregnancies, but to reduce the risks of complications, doctors may recommend fertility treatments like ICSI (intracytoplasmic sperm injection) or IVF (in-vitro fertilization). 

The advantage of fertility treatments is that embryos are genetically tested before implantation by an advanced procedure called preimplantation genetic diagnosis (PGD). In order to ensure a healthy pregnancy outcome, only healthy embryos are transferred to the uterus.

Likewise, both female and male partners should commit to a healthy lifestyle and avoid excessive consumption of alcohol, cigarettes, illegal drugs, and excessive caffeine consumption etc., to reduce the chances of recurrent pregnancy loss.

It is also important to maintain a healthy weight to prevent recurrent miscarriages. Although stress, anxiety, and depression aren’t proven to cause recurrent miscarriages, experts believe that they may have a role in RPL.

If you have had miscarriages or are looking for RPL treatment, consult our top gynaecologist in Hyderabad, Dr. Susmitha Reddy at Matrusri Hospital. She has vast experience of recurrent pregnancy loss.