Recurrent pregnancy loss (RPL) isn’t really a popular topic and not something I thought I would experience after having trouble getting pregnant. Who knew that getting pregnant was only a small step in the right direction?
Recurrent pregnancy loss is a distinct disease from infertility and is defined by two or more failed pregnancies. Some people experience both infertility and loss, like me, and others experience one or the other.
For me, recurrent pregnancy loss and infertility are one and the same. They are what kept me from bringing a baby home from the hospital for seven long years. I am infertile and while IVF helped me conceive, I miscarried every time. Recurrent loss is the ultimate problem for me.
Most miscarriages are due to an abnormal embryo — an unlucky accident, with no underlying medical issue, unless your specific issue is age-related or egg quality related. But, if you have miscarried three times, it is quite unlikely that this is due to three abnormal pregnancies, but rather one specific abnormality or underlying condition.
According to ASRM, although approximately 25% of all recognized pregnancies result in miscarriage, less than 5% of women will experience two consecutive miscarriages, and only 1% experience three or more.
I, of course, am that 1%.
I miscarried five times. We eventually moved on to gestational surrogacy.
In 50-75% of women with repeated miscarriages, doctors can find no cause for the losses. There may be clues, but no concrete answer. This was the case with me, as we had treated my clotting disorder and I still miscarried. Because our embryos were thought to be high quality, we could only assume that the problem was with my uterine environment and involved a highly complex reproductive immunological issue.
Testing
Sometimes, doctors or insurance companies will recommend testing after three losses, but I couldn’t disagree more. I highly recommend advocating for yourself to have the necessary testing done after two losses. Why risk another loss at this point if you could possibly avoid it?
For more information about possible reasons for RPL and available testing, check out the extensive post I wrote on recurrent miscarriage testing .
Dealing with Loss
Dealing with both infertility and recurrent pregnancy loss seemed cruel and unfair to me. While infertility was emotionally exhausting, dealing with loss after loss, along with infertility, was truly devastating. My worst triggers always are related to my losses. Don’t underestimate the emotional toll that recurrent loss will take on you. Take time to grieve and do it in your own time. Seek out support from others that have been through the same thing. A couple of good websites are Still Standing Magazine, Faces of Loss and Carly Marie Project Heal.
Learn More
I have written this post for RESOLVE’s “Resolve to know more” theme in honor of National Infertility Awareness Week (April 20 -27, 2014). If you know someone experiencing infertility or loss, consider taking it upon yourself to learn even more about the disease. You can go to RESOLVE’s Infertility 101 to find out more.
Resources + Connect
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9 Comments
Thank you for this informative post! I do not suffer RPL, but have had friends who do and I think it is just such a cruel blow. It doesn’t matter if you can get pregnant if the staying pregnant is an issue, and sometimes that is lost on people. I will definitely pass your links along and am so glad that gestational carrier resulted in your beautiful twins. Great post!
Thanks, Jessica! We always thought if we could just get pregnant, but we had no idea what was in store. But, the important thing is that it worked out for us in the end and we are very lucky.
Thanks Whitney for your post. After about 5 cycles of IUI’s/ drugs etc, I did my first IVF cycle in December, which resulted in mild OHSS, and then I miscarried at 6.5 weeks. I find out on Friday if my second round has been successful, but when I originally miscarried the Dr’s said that they’d test if it ever happened again, and for that I’m thankful.
You’re right – it’s a cruel blow. Women shouldn’t have to go through a third loss before investigating why it is occurring.
Robyn,
I’m so sorry for your loss. I’ll be thinking of you on Friday! Keep in touch and let me know how things turn out.
Thanks for thinking of me, Whitney. Test was negative. Bummer.
I’m so sorry. 🙁
Whitney thank you for touching on this topic and providing great information. Great post and perfectly written for #NIAW.
I was curious did they run the traditional RPL and the. The immune work up on you? I’ve had two miscarriages and had to call insurance on my own to figure out if they would cover my testing. I was told that it wouldn’t be covered til the third by the doctors office. Now almost a year after my miscarriage I’ve found out they would cover whatever needed to figure out the reason I’m losing babies. I’m waiting now to see what the doctor ordered. They seem a little frustrated with me for asking but honestly I don’t care.
I had both – RPL and immune workup, but RPL first. My doctor did suggest RPL workup after 2 miscarriages which was good and proactive. However, I had to advocate for the immune workup myself and find another doctor who would order it for me. You are right — who cares if they seem frustrated? Keep fighting for yourself. Nobody else will, unfortunately. Good luck.