Recurrent Pregnancy Loss (RPL) is one of the most heartbreaking experiences a woman may face on her journey to motherhood. According to the World Health Organization, recurrent miscarriage is defined as two or more consecutive pregnancy losses before the 20th week of gestation. This issue not only presents physical challenges but also brings significant emotional stress to couples.
Fortunately, with advances in modern medical science, many cases of recurrent miscarriage are now diagnosable and treatable.
But what is the most common cause of recurrent miscarriage? And how can it be diagnosed and managed effectively?
Let’s explore the answers in this comprehensive article.
Approximately 50–60% of miscarriages in the first trimester are caused by chromosomal abnormalities in the embryo. These abnormalities often occur randomly during cell division. However, in some couples, one of the parents may carry a structural chromosomal issue (such as a balanced translocation) that leads to nonviable embryos.
📌 Diagnosis: Parental karyotyping and, when possible, genetic analysis of the miscarried fetal tissue
🩺 Treatment: IVF with preimplantation genetic testing (PGT)
Congenital uterine malformations such as a septate uterus, bicornuate uterus, or intrauterine adhesions (Asherman’s syndrome) may interfere with proper embryo implantation or growth, making them one of the common causes of miscarriage.
📌 Diagnosis: 3D ultrasound, hysterosonography, or hysteroscopy
🩺 Treatment: Corrective hysteroscopic surgery
Some recurrent miscarriages are due to immune system disorders, such as antiphospholipid syndrome (APS) or inherited thrombophilias. These conditions can cause excessive blood clotting, leading to placental thrombosis and disrupted blood supply to the fetus.
📌 Diagnosis: Coagulation and thrombophilia screening (e.g., APLA, Protein C/S, Factor V Leiden, etc.)
🩺 Treatment: Low-dose aspirin, heparin, IVIG, or immunotherapy if needed
Hormonal and Metabolic Imbalances
Hormonal disruptions, including hypothyroidism, uncontrolled diabetes, or low progesterone levels, may impair the endometrium’s ability to support pregnancy.
📌 Diagnosis: Thyroid function tests, blood sugar levels, progesterone and prolactin levels
🩺 Treatment: Thyroid hormone replacement, blood sugar control, and progesterone supplementation during the luteal phase or pregnancy
Certain bacterial or viral infections—such as Listeria, Toxoplasma, CMV, or STDs—can lead to miscarriage. In addition, exposure to toxic chemicals, smoking, severe stress, and nutritional deficiencies (e.g., vitamin D or folic acid) are contributing factors.
📌 Diagnosis: Vaginal cultures, TORCH panel, lifestyle evaluation
🩺 Treatment: Antibiotics, lifestyle modifications, and supplements such as folic acid and vitamin D
✅ Comprehensive evaluation by a fertility specialist
✅ IVF with genetic testing (PGT) in cases of chromosomal abnormalities
✅ Hysteroscopic surgery for uterine anomalies
✅ Hormonal treatment and regulation
✅ Medication for immune and clotting disorders with close pregnancy monitoring
✅ Advanced therapies like IVIG or lymphocyte immunotherapy in selected cases
If you or someone close to you is facing recurrent miscarriage, the most important step is identifying the exact cause. Many couples who have suffered multiple losses have gone on to experience successful pregnancies after thorough evaluation and appropriate treatment.
Consulting with a fertility or reproductive specialist and undergoing personalized diagnostic testing can open the door to effective treatment—and restore hope along the path to parenthood.
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