Recurrent abortion, also known as recurrent pregnancy loss (RPL), is a condition where a woman experiences multiple consecutive miscarriages, typically defined as the loss of two or more consecutive pregnancies before 20 weeks of gestation. This condition can be emotionally and physically challenging for those affected.

Causes:

Recurrent abortion can result from a variety of factors, including:

Genetic Factors:

• Chromosomal abnormalities in either the parents or the embryo can lead to miscarriage. These can be due to random errors during cell division or inherited genetic disorders.

Anatomical Issues:

• Uterine abnormalities, such as a septate uterus (a partition in the uterine cavity), fibroids, or scar tissue, can interfere with the implantation and growth of the embryo.

Hormonal Imbalances:

• Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, and luteal phase defects can contribute to recurrent pregnancy loss by disrupting the hormonal environment needed to support a pregnancy.

Immune System Disorders:

• Autoimmune conditions like antiphospholipid syndrome (APS) can cause the immune system to attack the developing embryo, leading to miscarriage.
• Other immune responses, such as natural killer (NK) cell activity, may also be implicated.

Blood Clotting Disorders:

• Thrombophilias, which are inherited or acquired conditions that increase the risk of blood clots, can affect the blood supply to the placenta and lead to pregnancy loss.

Infections:

• Certain infections, including those caused by bacteria, viruses, or parasites, can increase the risk of miscarriage. These infections might be asymptomatic in the mother but can still impact pregnancy.

Diagnosis:

Diagnosis typically involves a combination of tests, including:

• Genetic Testing: To identify chromosomal abnormalities in either partner.
• Ultrasound or Hysteroscopy: To detect anatomical abnormalities in the uterus.
• Hormonal Assays: To check for hormonal imbalances.
• Blood Tests: To identify autoimmune disorders or blood clotting issues.
• Infection Screening: To rule out infections that might contribute to pregnancy loss.

Treatment:

Treatment depends on the underlying cause and may include:

• Genetic Counseling: If a genetic issue is identified, genetic counseling and possibly preimplantation genetic testing (PGT) during IVF can be considered.
• Surgery: To correct uterine abnormalities, such as a septate uterus or fibroids.
• Medications: Hormonal treatments, such as progesterone supplementation, or anticoagulants like aspirin and heparin for blood clotting disorders.
• Lifestyle Changes: Recommendations to improve diet, reduce stress, and avoid harmful substances.
• Immune Therapy: For conditions like APS, treatment may include low-dose aspirin and heparin, and in some cases, other immunomodulatory treatments.