What is Recurrent Pregnancy Loss?
Recurrent pregnancy loss is when a woman experiences at least two or three consecutive miscarriages before the 20th week. If these losses occur before the 12th week, it is called "recurrent premature pregnancy loss".
• 20–30 yaş arası kadınlarda düşük ihtimali yaklaşık %15’tir.
• 40 yaşında bu oran %40’a, 45 yaşında ise %85-90’a kadar çıkar.
• Recurrent miscarriages occur in the general population at a rate of %1–3.
Causes of Recurrent Miscarriages
Düşüklerin %50’sinden fazlası embriyodaki genetik bozukluklardan kaynaklanır. Bunun dışında:
• Immune system problems (autoimmune diseases)
• Hormonal and metabolic disorders (thyroid diseases, diabetes, vitamin deficiencies, anemia)
• Uterine problems (structural abnormalities, polyps, fibroids, adhesions)
• Genetic factors (chromosomal abnormalities in the mother or father)
• Coagulation problems (especially acquired thrombophilia such as antiphospholipid syndrome)
👉 Hastaların yaklaşık %20–25’inde herhangi bir sebep bulunamaz.
What tests are done in cases of recurrent miscarriage?
• Uterine evaluation: HSG, 3D ultrasound, MRI
• Genetic testing: Karyotype analysis of the mother and father.
• Hormonal tests: Thyroid function tests, antithyroid antibodies
• Metabolic examination: Diabetes screening, vitamin levels
• Assessment of luteal phase insufficiency
• Immune system tests: Lupus anticoagulant, anticardiolipin antibodies
💡 Note: Genetic coagulation tests are not necessary for patients without a history of venous thromboembolism.
Does IVF Treatment Have a Place?
The success of IVF treatment is debatable in patients who can conceive naturally but have experienced miscarriages.
• İlk 2 gebeliği düşükle sonuçlanan bir kadının 3. gebeliğinde canlı doğum ihtimali ortalama %65 civarındadır.
• Studies show that in-vitro fertilization (IVF) treatment does not generally increase this rate.
However, since a significant portion of miscarriages are caused by genetic abnormalities in the embryo, success rates can be increased when embryos with normal chromosomal structures are selected using PGT-A (genetic screening IVF).
It is particularly useful in the following situations:
• Women over 42 years of age
• In cases of recurrent miscarriages where no other cause can be found
Conclusion
For couples experiencing recurrent miscarriages, the process is challenging both psychologically and medically. Each patient's situation is different, so treatment options should be planned through a joint discussion between the patient and the doctor.
