Ep 305: Why Am I Having Miscarriages: A Deep Dive into Recurrent Pregnancy Loss

 Fertility Docs Uncensored is hosted by Dr. Carrie Bedient from the Fertility Center of Las Vegas, Dr. Susan Hudson from Texas Fertility Center, and Dr. Abby Eblen from Nashville Fertility Center. In this episode, the docs welcome visiting physician Dr. Shelley Dolitsky from Shady Grove Fertility in Towson, Maryland, for an in-depth conversation about recurrent pregnancy loss. Dr. Dolitsky begins by reviewing how different professional organizations define recurrent pregnancy loss. The American Society for Reproductive Medicine considers two or more losses—including very early biochemical losses—to be recurrent pregnancy loss, while the American College of OB/GYN defines it as two clinical losses under 20 weeks. The docs discuss how age dramatically affects miscarriage risk, with up to 75% of women over 40 experiencing miscarriages, compared with an overall rate of three to five percent. They walk through the full evaluation, which includes assessing the uterine cavity for abnormalities such as scar tissue, polyps, or congenital malformations; ensuring the fallopian tubes are normal and ruling out tubal damage; and performing chromosome analysis on both partners. Testing for antiphospholipid antibodies and lupus anticoagulant is also essential, as these can contribute to placental clotting issues. The conversation highlights the importance of screening for chronic medical issues that might be undiagnosed. About half of patients with recurrent pregnancy loss will have an identifiable and often treatable cause. Finally, the team discusses recommendations for patients whose workup is normal but who continue to experience losses. This podcast was sponsored by Shady Grove Fertility.