Recurrent pregnancy loss (RPL) can be an emotionally and physically challenging experience for couples trying to conceive. Understanding the right time to begin evaluation and investigations is key to identifying underlying causes and planning appropriate treatment strategies.
When Should Evaluation Begin?
Medical guidelines recommend starting investigations after two consecutive failed clinical pregnancies. This includes both pregnancies confirmed by ultrasound (clinical) and biochemical pregnancies, especially in women undergoing assisted reproductive techniques like IVF.
The rationale for early evaluation includes:
- Allowing timely identification of possible genetic, anatomical, immunological, or hormonal issues that could contribute to losses.
- Providing psychological support and counseling to couples during a stressful period.
- Optimizing chances for a future successful pregnancy through targeted interventions.
What Does Evaluation Involve?
Typical assessments during evaluation may include:
- Genetic testing of parents and products of conception
- Screening for antiphospholipid syndrome and other autoimmune disorders
- Imaging studies to check uterine structure (ultrasound, hysterosalpingogram)
- Hormonal and metabolic evaluations (thyroid, prolactin)
- Lifestyle and environmental factor assessments
Conclusion
Starting investigations after two consecutive pregnancy losses balances the need for early diagnosis with avoiding unnecessary tests. It enables healthcare providers to personalize care and offer evidence-based treatments that improve outcomes for couples facing recurrent pregnancy loss. Consulting a fertility specialist promptly after repeated losses helps in navigating this complex condition with expertise and compassion.