Editing Recurrent miscarriage (section)

{{short description|Spontaneous loss of multiple pregnancies}}
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| synonyms        = Habitual abortion, recurrent pregnancy loss (RPL)
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'''Recurrent miscarriage''' or '''recurrent pregnancy loss''' ('''RPL''') is the [[Miscarriage|spontaneous loss]] of 2-3 [[pregnancies]] that is estimated to affect up to 5% of women. The exact number of pregnancy losses and [[Gestational age|gestational weeks]] used to define RPL differs among medical societies.<ref name="Giouleka-2023">{{Cite journal |last1=Giouleka |first1=Sonia |last2=Tsakiridis |first2=Ioannis |last3=Arsenaki |first3=Elisavet |last4=Kalogiannidis |first4=Ioannis |last5=Mamopoulos |first5=Apostolos |last6=Papanikolaou |first6=Evangelos |last7=Athanasiadis |first7=Apostolos |last8=Dagklis |first8=Themistoklis |date=May 2023 |title=Investigation and Management of Recurrent Pregnancy Loss: A Comprehensive Review of Guidelines |url=https://journals.lww.com/10.1097/OGX.0000000000001133 |journal=Obstetrical & Gynecological Survey |language=en |volume=78 |issue=5 |pages=287–301 |doi=10.1097/OGX.0000000000001133 |pmid=37263963 |s2cid=258358167 |issn=1533-9866|url-access=subscription }}</ref> In the majority of cases, the exact cause of pregnancy loss is unexplained despite genetic testing and a thorough evaluation. When a cause for RPL is identified, almost half are attributed to a [[Chromosome abnormality|chromosomal abnormality]] (ie. [[aneuploidy]]). RPL has been associated with several [[Risk factor (epidemiology)|risk factors]] including parental and genetic factors (ie. advanced maternal age, chromosomal abnormalities, [[DNA fragmentation|sperm DNA fragmentation]]), [[Birth defect|congenital]] and acquired anatomical conditions, lifestyle factors (ie. cigarette smoking, caffeine, alcohol, stress), [[endocrine disorder]]s, [[thrombophila]] (clotting disorders), immunological factors, and infections. The [[American Society of Reproductive Medicine]] recommends a thorough evaluation after 2 consecutive pregnancy losses; however, this can differ from recommendations by other medical societies.<ref name="Giouleka-2023" /><ref>{{Cite journal |date=November 2012 |title=Evaluation and treatment of recurrent pregnancy loss: a committee opinion |journal=Fertility and Sterility |language=en |volume=98 |issue=5 |pages=1103–1111 |doi=10.1016/j.fertnstert.2012.06.048|pmid=22835448 |doi-access=free |author1=Practice Committee of the American Society for Reproductive Medicine }}</ref> RPL evaluation can be evaluated by numerous tests and imaging studies depending on the risk factors. These range from cytogenetic studies, blood tests for [[Coagulopathy|clotting disorder]]s, hormone levels, [[diabetes]] screening, [[thyroid]] function tests, sperm analysis, antibody testing, and imaging studies. Treatment is typically tailored to the relevant risk factors and test findings. RPL can have a significant impact on the psychological well-being of couples and has been associated with higher levels of depression, anxiety, and stress. Therefore, it is recommended that appropriate screening and management (ie. pharmacologic, counseling services) be considered by medical providers.