Recurrent Pregnancy Loss (RPL)

Recurrent pregnancy loss (RPL) affects approximately 1–2% of couples trying to conceive. The American Society for Reproductive Medicine (ASRM) now defines RPL as two or more failed clinical pregnancies (confirmed by ultrasound or histology), moving away from the older three-loss threshold to allow earlier investigation and treatment.

Evaluation includes parental karyotyping, uterine anatomy assessment (sonohysterogram, hysteroscopy), antiphospholipid antibody panel, thyroid function, and in some cases thrombophilia testing. Identifiable causes are found in roughly half of couples; in the rest, the losses are attributed to random embryo chromosomal errors. Even without a specific cause identified, 65–75% of couples with RPL achieve a live birth with their next pregnancy.