Recurrent pregnancy loss (RPL) affects nearly 3% of reproductive-age couples. However, current standards for evaluating and managing this distressing disorder explain only half the RPL cases, leaving the other 50%, unexplained. This article presents a novel algorithm that explains the etiology in up to 90% of RPL cases and directs structured treatment regimens for RPL.
Recommendations General: All identified, prevalent, and potentially treatable anomalies in the first-trimester RPL cases, whether anatomic, immunologic, and/or endocrine, must be addressed regardless of the products of contraception (POC)-cytogenetic analysis results (Figure 1 Box 1). The proposed algorithm omits parental karyotype analysis from the currently followed initial work-up protocols and instead recommends systematic 24-chromosome microarray analysis (CMA) of the miscarriage tissue. Uterine cavity evaluation is…
