Recurrent Pregnancy Loss: Frequently Asked Questions
- What is a miscarriage?
- How common is miscarriage?
- What is recurrent pregnancy loss (RPL)?
- What is recurrent miscarriage?
- What causes recurrent miscarriage?
- Is RPL more common in older mothers?
- If tests determine a cause, how likely is it for a woman to have a successful subsequent pregnancy?
- What if the cause remains a mystery?
- What is intravenous immunoglobulin (IVIG)?
- What is secondary recurrent miscarriage?
- How else can a woman try to prevent recurrent pregnancy loss?
Q. What is a miscarriage?
A. A miscarriage is a pregnancy loss before five months gestation.
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Q. How common is miscarriage?
A. At least one in six clinical pregnancies ends in clinical miscarriage. Many more miscarriages may occur before a woman even knows she is pregnant. Most of these preclinical miscarriages are due to a random chromosome error.
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Q. What is recurrent pregnancy loss (RPL)?
A. RPL is the loss of two or more pregnancies at any gestational age. About 5 percent of women suffer RPL. For example, a couple may have a history of a six week miscarriage, successful pregnancy, and then another miscarriage at eight weeks of gestation.
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Q. What is recurrent miscarriage?
A. Recurrent miscarriage is defined as three or more miscarriages in a row. About 1 to 2 percent of women suffer recurrent miscarriage.
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Q. What causes recurrent miscarriage?
A. Recurrent pregnancy loss may result from:
- Genetic abnormalities
- A hormonal imbalance, such as luteal phase deficiency or thyroid disease
- A metabolic disorder, such as polycystic ovary syndrome or diabetes
- Uterine abnormalities, such as septate uterus and intrauterine scarring
- An autoimmune factor, such as antiphospholipid syndrome
- An inherited blood clotting disorder
At least half the time, no cause for recurrent miscarriage can be found.
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Q. Is RPL more common in older mothers?
A. Yes. As a woman ages, the number of her eggs decreases, and the remaining eggs are more likely to have chromosomal errors, such as trisomy 21, commonly known as Down syndrome. In addition, age can also negatively affect the uterine lining, which needs to be healthy in order to maintain a pregnancy
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Q. If tests determine a cause, how likely is it for a woman to have a successful subsequent pregnancy?
A. It depends on many determinants, including the woman's age, her obstetrical history, and the factors identified by the RPL specialist.
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Q. What if the cause remains a mystery?
A. Our RPL specialist may suggest reasonably safe forms of therapy that may prove helpful, such as low-dose aspirin and/or progesterone. Or, a patient may qualify for a research study in which participants receive the chance to try a promising investigational treatment. The trial is to determine whether intravenous immunoglobulin (IVIG)--a drug used to treat many immune disorders--is effective in preventing pregnancy loss.
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Q. What is intravenous immunoglobulin (IVIG)?
A. IVIG is a treatment for many immune disorders. Preliminary research suggests that it may help maintain pregnancy in women who have experienced secondary recurrent miscarriage by improving the mother’s immune response to this pregnancy. Currently, Dr. Stephenson is conducting an international trial to test whether IVIG helps promote successful pregnancies in women who have suffered secondary recurrent miscarriage.
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Q. What is secondary recurrent miscarriage?
A. Secondary recurrent miscarriage is the loss of at least three pregnancies to miscarriage following one successful pregnancy.
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Q. How else can a woman try to prevent recurrent pregnancy loss?
A. A pregnant woman should not:
- Smoke
- Drink alcohol
- Use illegal drugs
- Be exposed to high levels of radiation and toxic agents
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