Recurrent Pregnancy Loss (RPL)

Recurrent-Pregnancy-Loss

What Is Recurrent Pregnancy Loss?

Recurrent Pregnancy Loss (RPL) is defined as two or more consecutive miscarriages.
It affects approximately 1–2% of couples, and although emotionally challenging, many causes are treatable once properly identified.

At Saga Clinic Tirana, Dr. Eser Agar performs a comprehensive evaluation to uncover the reasons behind pregnancy loss and develops a personalized plan to help couples achieve a healthy pregnancy.

Why Do Recurrent Pregnancy Losses Happen?

Multiple factors can contribute — sometimes more than one at the same time.

1. Genetic Causes

  • Chromosomal abnormalities in embryos
  • Parental balanced translocations
  • Gene mutations

PGT-A or PGT-M during IVF may be recommended when genetic risk is present.

2. Anatomical (Uterine) Causes

Structural issues can impact implantation or fetal development:

  • Uterine septum
  • Fibroids
  • Polyps
  • Intrauterine adhesions (Asherman syndrome)
  • Congenital uterine anomalies

These can often be corrected with hysteroscopic surgery.

3. Hormonal and Endocrine Disorders

  • Thyroid dysfunction
  • Uncontrolled diabetes
  • High prolactin
  • Luteal phase defects
  • PCOS-related hormonal imbalance

Correcting these increases the chance of a healthy pregnancy.

4. Immune and Thrombophilia Factors

Some women may have:

  • Antiphospholipid syndrome (APS)
  • Blood clotting abnormalities
  • Autoimmune issues affecting implantation

Treatment may include low-dose aspirin, heparin, or immune-modulating therapies when clinically indicated.

5. Lifestyle Factors

  • Smoking
  • Alcohol
  • Obesity
  • High stress
  • Nutritional deficiencies

These can reduce egg quality and implantation potential.

6. Unknown Causes

In about 40–50% of cases, no clear cause is found.
Even then, supportive treatment and careful monitoring significantly improve outcomes.

Symptoms and When to Seek Help

You should seek evaluation if you have had:

  • Two or more consecutive miscarriages
  • One miscarriage after age 35
  • A history of ectopic or molar pregnancy
  • A miscarriage with abnormal genetic testing

Early investigation helps guide treatment.

How We Diagnose Recurrent Pregnancy Loss at Saga Clinic

1. Detailed Medical & Pregnancy History

Understanding previous pregnancies, cycle patterns, symptoms, and risk factors.

2. Ultrasound and Hysteroscopy

To identify structural abnormalities, fibroids, polyps, or adhesions.

3. Genetic Testing

  • Karyotype analysis of parents
  • PGT testing for embryos (if undergoing IVF)

4. Hormonal Testing

  • Thyroid panel
  • Prolactin
  • Ovarian reserve and cycle evaluation

5. Immunology & Thrombophilia Testing

APS and clotting gene mutations when indicated.

6. Semen Analysis (Male Evaluation)

Sperm DNA fragmentation can also contribute to pregnancy loss.

Treatment Options

1. Correcting Anatomical Problems

Hysteroscopic surgery for septum, polyps, fibroids, or adhesions.

2. Hormonal & Metabolic Management

  • Thyroid and prolactin correction
  • Progesterone support
  • PCOS management

3. Blood Thinning Therapy

For thrombophilia or APS:

  • Low-dose aspirin
  • Heparin injections

4. IVF with PGT Testing

Improves outcomes by transferring genetically normal embryos.

5. Lifestyle Optimization

  • Smoking cessation
  • Weight management
  • Stress reduction
  • Nutritional support

6. Supportive Early Pregnancy Care

Close monitoring of:

  • Hormone levels
  • Early ultrasounds
  • Early pregnancy viability

This significantly improves confidence and outcomes.

Prognosis

Even after several pregnancy losses, over 70–80% of couples eventually achieve a successful pregnancy with appropriate treatment and monitoring.

Why Choose Saga Clinic for RPL Care?

  • Comprehensive and empathetic evaluation
  • Advanced diagnostic testing
  • Personalized treatment plans
  • Expertise in hysteroscopy and fertility surgery
  • Access to IVF + PGT when needed
  • Supportive follow-up during early pregnancy
  • Dedicated care by Dr. Eser Agar

Our goal is to provide clarity, reassurance, and an evidence-based plan that gives you the best chance for a healthy pregnancy.

Appointments and Contact

If you have experienced repeated miscarriages, we are here to guide you with care, expertise, and compassion.
Contact Saga Clinic Tirana to schedule your evaluation.

Contact & Appointments

For appointment requests or medical inquiries, please contact us using the options below.

📞 Clinic Phone (Office Hours)
+355 69 836 1565
Available Monday–Saturday, 09:00–16:00.

💬 WhatsApp (Outside Office Hours)
+355 69 362 0838
Available outside office hours via WhatsApp Message only.