Recurrent pregnancy loss (RPL) is a complex condition with multiple potential causes affecting couples trying to conceive. Understanding these causes helps guide evaluation and treatment options.
Key Causes of RPL Include:
- Unexplained Causes
About 50% of RPL cases remain unexplained despite thorough investigations. Some cases may involve thrombophilias other than antiphospholipid syndrome (APS), which affect blood clotting during pregnancy. - Endocrine Factors
Approximately 17-20% of women with RPL have endocrine abnormalities. Common endocrine causes include thyroid dysfunction, luteal phase defects, polycystic ovary syndrome (PCOS), hyperprolactinemia, obesity, and blood glucose abnormalities. - Autoimmune Causes
Antiphospholipid antibody syndrome (APS) is a well-recognized autoimmune cause of recurrent miscarriage. Other autoimmune factors may also contribute by disrupting placental function and maternal-fetal tolerance. - Anatomic Factors
Structural abnormalities of the uterus, such as septum, fibroids, polyps, adhesions, or congenital malformations can physically impair embryo implantation or growth. - Genetic Causes
Genetic abnormalities, such as parental chromosomal translocations or embryo aneuploidy, are significant contributors to RPL, especially with increasing maternal age. - Infections
Though less common, chronic infections of the reproductive tract may be a factor in some cases of recurrent miscarriage.
Understanding these multiple factors allows doctors to develop individualized treatment plans aiming to minimize pregnancy losses and improve the chance of a successful pregnancy.