For anyone who has experienced the heartbreak of a pregnancy loss, the pain can be immense. When those losses happen multiple times in a row, it can feel even more overwhelming and confusing. This is known as Recurrent Pregnancy Loss (RPL), a condition where someone experiences two or more consecutive miscarriages.

 But there is hope—many causes of RPL can be found and treated, allowing for a positive pregnancy outcome in the future.

Let’s explore the reasons behind RPL, how they can be addressed, and ways to cope both emotionally and physically.
 

What is Recurrent Pregnancy Loss?

RPL is defined as two or more miscarriages in a row, often before 20 weeks of pregnancy. Miscarriages can occur for many reasons, and a single loss is common (with up to 20% of pregnancies ending this way). But RPL may point to a specific underlying issue.

Pregnancy requires a careful balance of physical, genetic, and hormonal factors. If something disrupts this delicate process, recurrent losses can occur. Understanding the cause is the first step toward finding answers.
 

Common Causes of Recurrent Pregnancy Loss (with Examples)

1. Chromosomal Abnormalities

• What It Means: These occur when there are issues with the baby’s genetic material, such as too many or too few chromosomes. This often happens randomly during the formation of the egg or sperm.
• Example: Imagine a couple who has had two miscarriages around eight weeks of pregnancy. Genetic testing of the miscarried tissue reveals an extra chromosome (trisomy). This explains why the pregnancy couldn’t continue naturally.
• Actionable Step: Couples can undergo karyotype testing, which checks their chromosomes. For future pregnancies, IVF with genetic testing (PGT) may be an option to select embryos with healthy chromosomes.

2. Uterine Abnormalities

• What It Means: Problems with the shape or function of the uterus can disrupt pregnancy. A common cause is a septate uterus, where the uterus is divided by a thin wall of tissue. Other issues include fibroids or scar tissue.
• Example: A woman has RPL with pregnancy losses at around 10 weeks. An imaging test like an MRI reveals a fibroid (a non-cancerous growth) pressing into the uterine cavity, preventing the fetus from fully developing.
• Actionable Step: Procedures like a hysteroscopy can be used to correct structural issues (e.g., removing fibroids or fixing a septate uterus), significantly improving the chance of carrying a baby to term.

3. Hormonal Problems

• What It Means: Hormones play a key role in maintaining a healthy pregnancy. Issues like thyroid disorder, PCOS (polycystic ovary syndrome), or even low levels of the hormone progesterone can lead to early miscarriages.
• Example: A woman with irregular periods and frequent miscarriages finds out she has an underactive thyroid (hypothyroidism). The condition is affecting her ovulation and the ability to sustain pregnancy.
• Actionable Step: Simple blood tests can identify hormonal problems. Treatment might include thyroid medication, progesterone supplements, or managing PCOS through lifestyle changes and medication.

4. Autoimmune Disorders

• What It Means: Sometimes, the immune system mistakenly attacks the pregnancy. A condition like antiphospholipid syndrome (APS) increases the risk of blood clots, which can block blood flow to the developing baby.
• Example: A couple has multiple miscarriages despite normal genetic and uterine testing. A blood test reveals the presence of antibodies related to APS. Treatments, including blood-thinning medications like aspirin or heparin, help prevent future losses.
• Actionable Step: Blood work can identify autoimmune-related causes, and targeted treatments can help ensure a healthy pregnancy.

5. Infections

• What It Means: Certain infections in the uterus or bloodstream can increase the likelihood of miscarriage.
• Example: A woman with repeated early pregnancy losses tests positive for Ureaplasma, a bacterial infection in her reproductive tract. Antibiotic treatment eliminates the infection, and her next pregnancy progresses normally.
• Actionable Step: Testing for infections and prompt treatment can improve outcomes. Ask your doctor about any possible infection risks if you’re experiencing RPL.

6. Lifestyle Factors

• What It Means: External factors like smoking, drinking, obesity, or even excessive stress can make pregnancy more challenging.
• Example: A woman with a BMI (body mass index) above 35 is advised to lose weight before trying to conceive again. She begins a healthier lifestyle, loses 10% of her body weight—and her next pregnancy is a success.
• Actionable Step: Quitting smoking, reducing alcohol, managing stress, eating nutritious foods, and maintaining a healthy body weight can all improve pregnancy success.

Taking Action Against RPL

When to See a Doctor

You should consider seeking medical advice if:

• You’ve had two or more consecutive miscarriages.
• You experience symptoms like fever, severe abdominal pain, or heavy bleeding during pregnancy.
• You have a known condition (e.g., PCOS, thyroid issues) that can affect fertility.
  
  Consult Dr. Vaishali Chavan, Pune’s best lady high-risk pregnancy specialist, for expert care and guidance.

Diagnostic Tests to Explore:

• Genetic testing for both partners to check for chromosomal issues.
• Ultrasound or hysteroscopy to evaluate the uterus.
• Blood tests for autoimmune or hormonal disorders.
• Screening for infections.

Treatment is highly personalized. Based on the results, your doctor will recommend strategies tailored to your needs.
 

Emotional Support and Coping with RPL

The emotional impact of RPL is profound, but support is available.

• Find a Therapist who understands fertility challenges.
• Join Support Groups (in-person or online) to connect with others who’ve had similar experiences.
• Talk Openly with your partner, as RPL affects both individuals emotionally.
• Take Time to Heal before trying again—both physically and emotionally.

Example: A woman who joined a local RPL support group found comfort in knowing she wasn’t alone. She learned about options like genetic testing from other members, empowering her to take the next steps in her fertility journey.
 

Frequently Asked Questions (FAQs)

1.Is Recurrent Pregnancy Loss Preventable?

Sometimes. If a treatable cause is found (like a hormonal imbalance or uterine issue), addressing it can prevent future losses. Work with a specialist to improve your chances.

2.What if No Cause is Found?

This happens in about 50% of RPL cases. However, people in this situation still have a strong chance of successful pregnancy with proper care and monitoring.

3.Does Stress Cause RPL?

Stress alone isn’t a direct cause of RPL, but prolonged stress can affect overall fertility and health. Prioritizing mental well-being during this time is important.

4.How Long Should I Wait Before Trying Again?

Doctors generally recommend waiting 2-3 months after a miscarriage to allow physical healing. Always consult your healthcare provider for personalized advice.

5.Can Age Play a Role?

Yes. Women over 35 are at higher risk of RPL due to an increased likelihood of chromosomal abnormalities and reduced egg quality.
 

A Note of Hope

Recurrent pregnancy loss can feel isolating, but you’re not alone. With medical advancements, many of the causes of RPL can be treated effectively. No matter where you are on this journey, there’s hope—and resources to guide you.

Reach out to a high risk pregnancy doctor who can offer personalized care, support, and solutions to help you move closer to your dream of growing your family. Remember, every step forward brings you closer to hope and healing.