Recurrent Pregnancy Loss (RPL)
At VCRM we see many women with RPL. A detailed investigation is key at finding the cause (s) of RPL. About 5% are due to genetic causes (such as balanced translocations or other genetic causes). Another 5% are due to hormonal imbalances such as thyroid disease, high prolactin levels, or PCOS. Others are due to immune problems such as lupus anticoagulant antibodies, anticardiolopin antobodies, factor V Leiden mutations, or heterozygous MTHFR gene mutations with low homocysteine levels. Anatomic causes are also important, and include uterine septum, bicornuate uterus, submucosal or other large fibroids impinging on the uterine cavity, and incompetent cervix. Some are caused by poor ovarian reserve with advancing age. Treatment is tailored to the cause of RPL, and in most cases a healthy pregnancy can be successfully achieved.
ASRM has recently released this fact sheet about the work-up of RPL: recurrent_preg_loss
ASRM does NOT recommend that women with RPL undergo PGS. Please see the section on PGD and PGS.