ESHRE guideline: recurrent pregnancy loss.

Area of Science:

• Reproductive Medicine
• Clinical Guidelines
• Evidence-Based Medicine

Background:

• Recurrent pregnancy loss (RPL) management guidelines require updating from the previous 2006 iteration.
• ESHRE (European Society of Human Reproduction and Embryology) developed this guideline to address current gaps in RPL care.

Purpose of the Study:

• To provide recommended management strategies for women experiencing recurrent pregnancy loss (RPL).
• To consolidate the best available evidence for investigations and treatments in RPL.
• To offer guidance on organizing care for couples with RPL.

Main Methods:

• A systematic literature search was conducted for papers published up to March 2017.
• Key questions on RPL investigations, treatments, and care organization were formulated by experts.
• Recommendations were developed through consensus within the guideline group and stakeholder review.

Main Results:

• The guideline includes 77 recommendations (38 on risk factors/investigations, 39 on treatments).
• Most recommendations (60) are evidence-based, but the evidence quality is predominantly low to moderate.
• A significant number of recommendations advise against certain investigations and treatments due to insufficient evidence.

Conclusions:

• Many investigations and treatments for RPL are not well-supported by scientific evidence.
• The guideline provides clinicians with best practice advice for RPL management.
• Future research is recommended to strengthen the evidence base for RPL interventions and definitions.