Recurrent Pregnancy Loss Treatment

If you’ve experienced recurrent pregnancy loss, you may feel lost or uncertain about what comes next. At Pacific Reproductive Center, we offer compassionate care, advanced diagnostics, and personalized treatment options to help you achieve the healthy pregnancy you deserve.

What Is Recurrent Pregnancy Loss?

How Many Miscarriages Qualify as Recurrent?

According to the American Society for Reproductive Mediation (ASRM) and the American College of Obstetricians and Gynecologists (ACOG), recurrent miscarriage (recurrent pregnancy loss) refers to a woman who experiences two or more miscarriages before 20 weeks’ gestation.

How Common Is Recurrent Pregnancy Loss?

About 15-20% of all pregnancies end in miscarriage. Often, this loss is random and does not mean there is cause for concern. According to the American College of Obstetricians and Gynecologists, recurrent pregnancy loss occurs in about 1% of reproductive-aged women.

Causes of Recurrent Pregnancy Loss (RPL)

There are several reasons for multiple miscarriages, including:

Uterine Anomalies

Uterine Septum

Uterine septum is one of the most common causes of pregnancy loss. It is a wall of tissue that divides the uterus.

Because this tissue has limited blood supply, a fertilized egg may not get enough nutrients to grow if it attaches there, increasing the risk of miscarriage. Doctors often recommend removing a uterine septum if found.

Fibroids

Fibroids are non-cancerous growths in the uterus that can make it harder to achieve pregnancy and increase the risk of miscarriage. If fibroids grow in the area where a baby would develop, they can negatively affect pregnancy, especially if they are large.

Fortunately, both uterine septums and smaller fibroids can be removed using a minimally invasive outpatient procedure called hysteroscopy. Larger fibroids may require a procedure called a myomectomy.

Immune Issues

Sometimes, immune system malfunctions can lead to pregnancy loss. An overactive immune system attacks and damages your body’s tissues, including a developing fetus. A low-activity immune system can also contribute to recurrent miscarriage because it may fail to properly support implantation or protect the fetus from infections or other threats.

The most common immune conditions seen in patients with recurrent pregnancy loss include:

• Antiphospholipid Syndrome (APS)

APS is a rare medical condition where the immune system makes antibodies that cause blood clots. These clots can block blood flow to the placenta, increasing the risk of miscarriage or stillbirth. Doctors can prescribe blood thinners to lower this risk.

• Inherited Thrombophilia
  This is a genetic condition that affects blood clotting, but its link to pregnancy loss is unclear. Some doctors believe treatment with blood thinners does not improve pregnancy outcomes.

Hormonal Imbalances

Hormone imbalances can negatively impact fertility and increase the risk of miscarriage. Common issues include:

Thyroid Problems

• Hypothyroidism—too little thyroid hormone slows down body functions.
• Hyperthyroidism—too much thyroid hormone speeds up body functions.

Both conditions are linked to pregnancy loss but can often be managed with medication.

High Prolactin Levels

Prolactin is a hormone the pituitary gland produces. It that helps with breast milk production after childbirth. Having too much prolactin before pregnancy can affect estrogen and progesterone levels, two essential hormones for fertility, leading to infertility or pregnancy loss. Treatment may include medication or, in some cases, surgery if a tumor is present in the pituitary gland.

Polycystic Ovary Syndrome (PCOS)

PCOS affects more than 200,000 women in the U.S. each year. Women with this condition may have a higher risk of pregnancy loss due to elevated male hormones (testosterone) and high insulin levels. Managing blood sugar levels through diet or medication may help reduce your risk of miscarriage.

Hyperglycemia

When the body doesn’t respond to insulin properly, glucose (sugar) can’t be absorbed from the blood. This can lead to prediabetes or diabetes. High blood sugar has been linked to a higher risk of early pregnancy loss.

At Pacific Reproductive Center, we often check blood sugar levels with a fasting blood glucose test and review insulin levels and HgbA1C (a test that shows your average blood sugar over the past 3 months).

We typically recommend diet and lifestyle changes to correct these issues, but medications like Metformin may also be prescribed to help manage blood sugar levels.

Chromosomal Imbalances

Chromosomes carry essential genetic information that guides a baby’s development. A woman can suffer a miscarriage when there is too much, too little, or misplaced genetic material. The most common types of chromosomal imbalances include:

• Balanced Translocation
  This is a genetic variation where a piece of one chromosome breaks off and attaches to another. A person with this condition (carrier) usually has no symptoms. However, during pregnancy, a baby may inherit too much or too little genetic material, leading to congenital abnormalities or miscarriage.

  A karyotype test can diagnose it, but there is no available treatment.

• Chromosomal Abnormalities in the Embryo
  This is a condition in which the embryo has an abnormal number of chromosomes (either missing or extra copies). It can lead to developmental issues, early miscarriage, or congenital abnormalities, depending on the specific abnormality.

Age and Lifestyle Factors

Several factors can increase the risk of recurrent pregnancy loss, including:

• Age: Women over 35 have a higher risk of RPL due to declining egg quality.
• Weight: Being overweight or underweight can negatively impact hormone levels and pregnancy health.
• Tobacco, Alcohol, and Drug Use: These substances can reduce fertility and increase the risk of miscarriage.
• Caffeine: According to the American Journal of Obstetrics and Gynecology, pregnant women who consume more than 200 mg of caffeine per day are more than two times as likely to have a miscarriage than pregnant women who consume less than 200 mg per day.
• Chronic Stress: Severe stress may affect hormonal levels and uterine health.

Environmental Factors and Health Conditions

Environmental factors, chronic illnesses, and certain infections can also increase a woman’s RPL risk. Examples include:

• Exposure to pesticides, heavy metals, and radiation.
• Long-term exposure to poor air quality and air pollution.
• Conditions like diabetes, high blood pressure, or autoimmune diseases.
• Several bacterial or viral infections.
• Some prescription or over-the-counter medications.

How Recurrent Pregnancy Loss Is Diagnosed

RPL is diagnosed after two or more failed clinical pregnancies. A thorough evaluation can help identify potential causes, and personalized recurrent pregnancy loss treatment can increase the chance of a successful pregnancy.

Tests for Recurrent Pregnancy Loss

Diagnostic tests for recurrent miscarriage may include:

Imaging Tests

• Ultrasound to look for uterine abnormalities or conditions.
• Sonohysterogram (saline ultrasound) to examine uterine health and structure.
• Hysterosalpingogram (HSG) to identify abnormalities, blockages, or issues with the fallopian tubes or uterus.

Genetic Testing for Both Partners

• Karyotyping to analyze the number and structure of the chromosomes and identify abnormalities.
• Chromosomal Microarray Analysis (CMA) to detect smaller genetic abnormalities.
• Preimplantation Genetic Testing (PGT) (in vitro fertilization only) to identify genetic abnormalities before embryos are transferred to the uterus.

Comprehensive Medical History Review

• Detailed review of past pregnancies (e.g., timing and characteristics of each loss).
• A complete physical and pelvic exam to identify underlying medical issues.
• Sperm analysis.

Treatment Options for Recurrent Pregnancy Loss

Treatment options for recurrent pregnancy loss include:

Hormonal Therapy to Support Pregnancy

Common hormone therapy treatments for RPL include:

• Progesterone supplementation.
• Estrogen supplementation.
• Hypothyroidism (underactive thyroid) management.
• Diabetes management.
• Hyperprolactinemia (overactive pituitary gland) management.

Surgery for Uterine Issues

• Hysteroscopy: Minimally invasive procedure to assess and treat uterine abnormalities (e.g., polyps and fibroids).
• Uterine Fibroid Embolization: Minimally invasive procedure to block blood supply to the fibroids.
• Myomectomy: Fibroid removal that preserves the uterus.

Immune Therapy (for Autoimmune Conditions)

A healthy pregnancy requires a delicate balance between the mother’s immune system and the developing fetus. If a woman has an autoimmune condition, immune therapy, like intravenous immune globulin (IVIG), can help modulate the immune system and potentially improve pregnancy outcomes.

Genetic Counseling and Testing

Genetic counseling and testing can help identify underlying causes (e.g., chromosomal abnormalities) and guide treatment options, potentially including in vitro fertilization (IVF) with preimplantation genetic testing.

Blood Thinners or Anticoagulation Therapy

Doctors may prescribe blood thinners or anticoagulation therapy to help women with blood clotting disorders reduce their risk of miscarriage.

Fertility Medications for Ovulation Support

Depending on the cause of RPL, fertility specialists may prescribe medications to regulate ovulation and support hormone levels that are critical for implantation and sustaining a healthy pregnancy.

Steps to Begin Your Recurrent Pregnancy Loss Treatment Journey

Schedule a Consultation With Our Experts

If you’ve had two or more miscarriages, our experts are here to help. We’ll help identify the root cause of your fertility issues and create a personalized treatment plan to support a healthy pregnancy.

Initial Assessment and Diagnostic Tests

We start with a thorough assessment of your health and pregnancy history, using specialized diagnostic tests to pinpoint potential causes of pregnancy loss.

Designing Your Customized Treatment Plan

Once understand the root cause of your fertility issues, our fertility specialists will design a tailored treatment plan to improve your chances of a successful pregnancy.

Continuous Monitoring and Support

We closely monitor your progress and adjust treatments as needed to give you the best possible chance of carrying a healthy pregnancy.

Get Recurrent Pregnancy Loss Treatment at PRC

Pacific Reproductive Center is a licensed and accredited fertility clinic specializing in diagnosing and treating a wide range of fertility challenges.

We’ve helped thousands of couples fulfill the dream of creating families or their own using our fertility practices—and we’re ready to help you, too. Contact us today to take the first step.