Recurrent Miscarriage and Treatment Options
Recurrent miscarriage, or recurrent pregnancy loss (RPL), is defined by the American Society of Reproductive Medicine (ASRM) as two or more consecutive pregnancy losses before the 20th week of fetal development. If you’ve experienced RPL, the expert fertility specialists at NYU Langone Fertility Center (NYULFC) can assess your condition and develop a customized treatment plan to help you grow your family.
Causes of Recurrent Pregnancy Loss
In most cases, miscarriages result from random chromosomal or genetic abnormalities coming from the egg, the sperm, or the early embryo. Common causes of recurrent pregnancy loss include:
- Uterine abnormalities, such as fibroids, polyps, or adhesions
- Hormonal disorders, including uncontrolled diabetes and thyroid disease
- Advanced maternal age
- Abnormal number of chromosomes in the embryo
- Infections
- Problems with the sperm
In some cases, RPL is unexplained.
Diagnosing Recurrent Miscarriage
At NYULFC, our fertility specialists will take a detailed medical, surgical, family, and genetic history and perform a physical examination. We may evaluate the uterus using an ultrasound, saline ultrasound, hysterosalpingogram X-ray, MRI magnetic resonance imaging (MRI), or hysteroscopy. It’s also important to evaluate the male partner’s sperm.
Recurrent Loss Treatment Options
In vitro fertilization (IVF) with preimplantation genetic testing (PGT) may be the best course of care for individuals who have experienced multiple miscarriages. These treatments allow our fertility team and genetic counselors to test each embryo for specific genetic and chromosomal issues that may cause miscarriage. That way, we transfer only healthy, chromosomally normal embryos to the uterus, significantly reducing the chance of miscarriage.
Recurrent Miscarriage FAQs
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Recurrent pregnancy loss is uncommon, with only about two percent of pregnant women experiencing two consecutive miscarriages.
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After a miscarriage, many couples want to attempt to conceive again. However, it’s important to try and determine whether the cause of the miscarriage was due to structural issues within the reproductive system, chromosomal irregularities, or hormonal imbalances. Your doctor will likely run a series of diagnostic tests before giving you the green light to try and conceive again. If medical treatment is necessary, your physician will work with you to determine a personalized treatment plan.
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Surgery may be recommended for individuals with structural issues within the reproductive system. Occasionally, the removal of fibroids is necessary, although not all women with fibroids require surgery. Surgery may also be a helpful avenue to diagnose uterine conditions that may be causing recurrent miscarriage. Common surgeries include hysteroscopy, laparoscopy, and hysteroscopic metroplasty. Most surgeries diagnosing or treating recurrent miscarriage are performed under general anesthesia, with patients typically returning home on the same day.
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Unexplained pregnancy loss accounts for 50% of RPL cases, meaning that even after thorough testing, doctors can’t identify a specific cause for the losses. Treatment options include IVF, but you may be able to get pregnant without any intervention at all.
Get Top-Rated Treatment for Recurrent Miscarriage
Experiencing recurrent pregnancy loss can be physically and emotionally challenging. At NYU Langone Fertility Center, our world-class team of fertility specialists and embryologists collaborate with nurses, psychologists, and wellness experts to treat families who experience recurrent miscarriage. Contact us today for more information or to schedule your first patient appointment.