Evaluation of Recurrent Pregnancy Loss.

Area of Science:

• Reproductive Medicine
• Genetics
• Immunology

Background:

• Recurrent pregnancy loss (RPL) affects about 5% of couples, with varying definitions.
• Evaluation is advised after a second pregnancy loss, with established links to chromosomal issues, uterine anomalies, and antiphospholipid syndrome (APS).

Purpose of the Study:

• To outline the recommended evaluation and management strategies for recurrent pregnancy loss.
• To clarify the evidence base for various contributing factors and treatments.

Main Methods:

• Review of current evidence linking parental factors, uterine anomalies, and APS to RPL.
• Analysis of treatment recommendations including anticoagulant therapy, aspirin, progesterone, and surgical correction.
• Emphasis on individualized comorbidity management and psychological support.

Main Results:

• Strong evidence supports links between RPL and parental chromosomal rearrangements, uterine anomalies, and APS.
• Anticoagulant therapy and low-dose aspirin are recommended for RPL with APS.
• Vaginal progesterone and surgical correction are options for specific cases.

Conclusions:

• Management of RPL should be individualized, addressing identified risk factors and comorbidities.
• Most individuals with RPL achieve a live birth within five years.
• Compassionate and supportive care is crucial throughout the process.