Recurrent pregnancy loss, or RPL, is a heartbreaking condition defined as two or more consecutive miscarriages occurring before 20 weeks of pregnancy. Understanding the causes can guide diagnosis and treatment, helping hopeful parents navigate this difficult path.
Unexplained Causes
Around half of RPL cases remain unexplained, even after detailed evaluation. Some of these may be due to subtle blood clotting disorders other than antiphospholipid syndrome which are hard to detect but can affect pregnancy.
Endocrine Factors
Hormonal imbalances contribute to 17-20% of RPL cases. Conditions like thyroid dysfunction, polycystic ovary syndrome (PCOS), diabetes, and luteal phase defects disrupt the hormonal support needed for pregnancy maintenance.
Autoimmune Causes
Autoimmune diseases, especially antiphospholipid antibody syndrome (APS), can attack blood proteins, leading to clot formation and placental issues that increase miscarriage risk. Other immune factors may also play roles.
Anatomic Abnormalities
Structural uterine problems such as fibroids, polyps, septa, or scarring can impair embryo implantation or growth, resulting in recurrent losses.
Genetic Factors
Genetic issues affecting the parents or embryo, such as chromosomal translocations or aneuploidies, are common reasons for RPL. These abnormalities hinder embryo development and increase miscarriage risks.
Infections
Reproductive tract infections, though less frequently, may cause inflammation and contribute to pregnancy losses.
Conclusion
Recurrent pregnancy loss results from a mix of unexplained, endocrine, autoimmune, anatomic, genetic, and infectious causes. Identifying the underlying factors through comprehensive evaluation helps tailor treatment and improves chances of a successful pregnancy. If you’ve experienced RPL, consulting a fertility specialist early can provide guidance, support, and hope for the future.