Recurrent Pregnancy Loss: Assessment, Support and Treatment Options

Repeated pregnancy loss can be physically and emotionally difficult. An assessment may identify contributing factors, although an explanation is not always found. Treatment and future planning depend on the individual history; surrogacy is one possible consideration in selected circumstances, not a solution to every cause.

Common causes

• Chromosomal abnormalities in the embryo — more frequent with increasing maternal age
• Uterine problems — septum, fibroids, polyps, scarring (Asherman’s)
• Antiphospholipid syndrome (APS), an autoimmune condition — inherited thrombophilias are a separate group, assessed individually
• Hormonal factors — thyroid disease, poorly controlled diabetes, PCOS
• Parental chromosome rearrangements (balanced translocations)

Tests your doctor may consider

1. Pelvic ultrasound (ideally 3D) or hysteroscopy
2. Antiphospholipid antibodies
3. Thyroid function, HbA1c
4. Karyotype of both partners
5. Genetic testing of pregnancy tissue, if available

Treatment options

Depending on the cause and your doctor’s assessment, options may include surgery for a septum or polyps, anticoagulant treatment for confirmed APS, hormone treatment, or IVF with PGT in selected cases. There is no single plan that suits everyone.

When gestational surrogacy is considered

If losses continue despite treatment, or pregnancy poses a serious risk to the mother, gestational surrogacy may be discussed. It does not address every cause, such as chromosomal problems in the embryo. Armenian law requires a medical contraindication to pregnancy, which the doctors assess individually.

Looking after yourself

Grief after miscarriage is real. Counseling and support groups may help you decide on next steps at your own pace.

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