Ying Hong Li1, Anthony Marren2. 1. BSc(Med), MBBS, MBA, FRANZCOG, RPA Fertility Unit, RPA Hospital, Camperdown, NSW; consultant, Genea Fertility, Sydney; VMO, St George Private Hospital, Waratah Private Hospital and Hurstville Private Hospital, NSW. 2. BMed(Hons), MMed(RHHG), FRANZCOG, CREI, RPA Fertility Unit, Camperdown, NSW; consultant, Genea Fertility, Sydney; VMO, Northshore Private Hospital and Mater Hospital, NSW.@Anthony@marrencampbellmackie.com.au.
Abstract
BACKGROUND: Recurrent pregnancy loss (RPL) is defined as two or more pregnancy losses. It affects <5% of couples. There are many proposed causes; however, in a significant proportion of cases, the cause is unknown. OBJECTIVE: The aim of this paper is to provide a summary of the aetiology, investigations and management of RPL, which is based on the three most recent international guidelines on RPL (European Society of Human Reproduction and Embryology, 2017; American Society for Reproductive Medicine, 2012; and the Royal College of Obstetricians and Gynaecologists, 2011). DISCUSSION: Management of RPL should occur in a specialised clinic. Appropriate investigations include karyotyping of parents and products of conception, two-dimensional/three-dimensional ultrasonography with sonohysterography, thyroid function tests, and antibodies and testing for acquired thrombophilias. Management options encompass some lifestyle modifications for smoking, alcohol, illicit drug use and caffeine consumption. Acquired thrombophilias should be treated with unfractionated heparin and low-dose aspirin.
BACKGROUND: Recurrent pregnancy loss (RPL) is defined as two or more pregnancy losses. It affects <5% of couples. There are many proposed causes; however, in a significant proportion of cases, the cause is unknown. OBJECTIVE: The aim of this paper is to provide a summary of the aetiology, investigations and management of RPL, which is based on the three most recent international guidelines on RPL (European Society of Human Reproduction and Embryology, 2017; American Society for Reproductive Medicine, 2012; and the Royal College of Obstetricians and Gynaecologists, 2011). DISCUSSION: Management of RPL should occur in a specialised clinic. Appropriate investigations include karyotyping of parents and products of conception, two-dimensional/three-dimensional ultrasonography with sonohysterography, thyroid function tests, and antibodies and testing for acquired thrombophilias. Management options encompass some lifestyle modifications for smoking, alcohol, illicit drug use and caffeine consumption. Acquired thrombophilias should be treated with unfractionated heparin and low-dose aspirin.
Authors: Lindsey N Block; Brittany D Bowman; Jenna Kropp Schmidt; Logan T Keding; Aleksandar K Stanic; Thaddeus G Golos Journal: Biol Reprod Date: 2021-01-04 Impact factor: 4.161
Authors: Hubert Wolski; Grażyna Kurzawińska; Marcin Ożarowski; Aleksandra E Mrozikiewicz; Krzysztof Drews; Tomasz M Karpiński; Anna Bogacz; Agnieszka Seremak-Mrozikiewicz Journal: Sci Rep Date: 2021-02-25 Impact factor: 4.379