Overview and Causes of Recurrent pregnancy loss (RPL)
A Pregnancy is clinically defined when it is visualized on an ultrasound. Pregnancy loss is when the pregnancy naturally gets terminated within 20 weeks after the formation of some foetal tissues. Approximately 8-15% of clinically recognized pregnancies end up in early pregnancy termination and around 1-2% of the women experience recurrent pregnancy loss.
According to the recent definition by the American Society of Reproductive Medicine (ACRM), recurrent pregnancy loss (RPL) is when a woman undergoes a pregnancy loss two or more times.
Causes of Recurrent pregnancy loss:
Consecutive loss of pregnancy may be due to a variety of reasons or due to unexplained reasons. However, some of the possible and potential causes of pregnancy loss can be:
- Genetic causes : Most pregnancy losses are a result of random chromosomal or genetic anomalies. These abnormalities may come in the egg, sperm, or during embryo formations and cell divisions. It is estimated around 50% of the total pregnancy losses have chromosomal abnormalities. Sometimes, genetic inheritance from the mother, father, or both can cause irregularities in the genes of the developing embryo. Thus, resulting in pregnancy loss.
- Advancing maternal age : Advancing age of the woman is associated with an increased risk of pregnancy loss. Increased age can lead to a decline in the egg quality resulting in chromosomal/genetic abnormalities in the egg.
- Uterine defects : Abnormalities of the uterus also can lead to recurrent pregnancy loss. The uterus or the womb provides a nurturing environment for fetal development. Women with congenital or developed uterine deformities, scarring, pelvic adhesions, uterine fibroids, can cause abnormal blood supply to the uterus or develop inflammation of the uterus leading to recurrent pregnancy loss.
- Immune factors : A woman’s immune system interacts with the fetus aiding its growth and development and so, auto-immune disorders such as Lupus, Antiphospholipid syndrome, can cause abnormal clotting of blood leading to loss of pregnancy.
- Hormonal defects: Hormones also play a role in pregnancy loss. Poorly controlled diabetes mellitus, thyroid disorders or even Polycystic ovary syndrome (PCOS) have an increased risk of recurrent miscarriages.
- Other causes : Environmental factors, stress, and occupational factors also can impact pregnancy loss to a certain extent.
- Unexplained RPL : Sometimes, the exact cause of recurrent miscarriages is not known or there is no proper reasoning/proof of the problem.
At OMYA Infertility Treatment Centre, a team of experienced specialists analyzes every angle of the fertility concern through a detailed medical history and genetic assessment. Recently, assisted reproductive techniques have been used to prevent further miscarriages in women with recurrent miscarriage. One approach uses either screening of embryonic chromosomes prior to embryo replacement (PGD/PGS).Range of diagnostic techniques such as Hysteroscopy, MRI scans and advanced genetic screening allows clear-cut analysis and helps devise a comprehensive treatment plan for all kinds of fertility problems.