Guideline No. 464: Recurrent Pregnancy Loss

The object of this guideline is to provide clinicians with the most up to date evidence available for the evaluation and management of patients with recurrent pregnancy loss.

Patients with Recurrent Pregnancy Loss (defined as two or more pregnancy losses.) OPTIONS: Strategies for managing RPL includes lifestyle changes (reducing caffeine, smoking, alcohol), addressing obesity, screening for thyroid dysfunction, diabetes, antiphospholipid syndrome, and treating uterine anomalies like septate uterus or adhesions. Chronic endometritis may benefit from antibiotics. Genetic testing of gestational tissue and parental karyotyping can identify chromosomal issues. Treating acquired thrombophilias may be beneficial. Progesterone therapy may be helpful, especially if started in the luteal phase. Access to early pregnancy assessment clinics, emotional support, close monitoring, and trauma-informed care are essential, with empirical treatments used cautiously due to limited evidence.