UT Health Physicians

Recurrent Pregnancy Loss

Related to: Recurrent Miscarriage , Recurrent Pregnancy Loss (RPL)

The Reproductive Health and Fertility Center at UT Health San Antonio has been helping families grow for more than 40 years. Our expert team of board-certified reproductive endocrinologists and fertility specialists offer comprehensive evaluation and treatment options.

What is recurrent pregnancy loss or RPL?

Pregnancy loss or miscarriage happens to 15-20% of couples with most losses occurring before 12 weeks of pregnancy.  Recurrent pregnancy loss is defined by the American Society of Reproductive Medicine (ASRM) as two or more failed pregnancies.  Sadly, about 5% of couples will experience two consecutive miscarriages and fewer than 1% of couples will have three or more miscarriages. 

Causes of recurrent pregnancy loss:

There are various known causes of recurrent pregnancy loss such as problems with the structure of the uterus, hormonal issues (e.g., thyroid disorders), clotting issues (e.g., antiphospholipid syndrome), and genetic problems.  However, with your second pregnancy loss, you can request your provider to send your miscarriage to be chromosomally tested, as this is the most common cause for a miscarriage.  If the chromosomes of your baby are abnormal, this will give you the most likely answer for why this happened.  If the chromosomes are normal, other testing can be performed to understand the other reasons for pregnancy loss.  

Diagnosis of recurrent pregnancy loss:

The standard testing that will be offered is chromosomal testing for you and your partner, testing for antiphospholipid syndrome, testing for hormones from your thyroid, routine pelvic ultrasound, a special ultrasound where we inject saline into your uterus to look for structural issues of your uterus, sampling of your lining of your uterus and sperm analysis for your partner. 

Treatment of recurrent pregnancy loss:

After a comprehensive work up, we will try to identify a cause for your recurrent pregnancy loss and establish a personalized treatment plan.  However, after testing, about 40-50% of couples will not find a reason for their miscarriages and are called unexplained recurrent pregnancy loss.  In these cases, we offer supportive care with weekly ultrasounds during pregnancy to couples. 

New research in recurrent pregnancy loss:

Our faculty are involved in several research projects trying to find new causes for RPL.  Our faculty are participating in a NIH funded multicenter study on investigating new genetic causes for recurrent pregnancy loss called the Genomic Predictors of RPL (GPRPL study) alongside other studies.  Please ask your doctor about these studies. 

Make an Appointment

For appointments or more information call (210) 450-9500.