Recurrent miscarriage

The exact number of pregnancy losses and gestational weeks used to define RPL differs among medical societies.

advanced maternal age, chromosomal abnormalities, sperm DNA fragmentation), congenital and acquired anatomical conditions, lifestyle factors (ie.

RPL can have a significant impact on the psychological well-being of couples and has been associated with higher levels of depression, anxiety, and stress.

[6][7] Fifteen percent of women who have experienced three or more recurring miscarriages have some anatomical reason for the inability to complete the pregnancy.

Women with polycystic ovary syndrome also have higher loss rates possibly related to hyperinsulinemia or excess androgens.

Infections known to increase the risk of miscarriage include bacterial vaginosis (M. hominis and U. urealyticum), syphilis, CMV, dengue fever, malaria, brucellosis, and HIV.

There is mixed evidence regarding the risk of miscarriage with Chlamydia trachomatis, HPV, Hepatitis B, Toxoplasma gondii, HSV1/HSV2, and parvovirus B19.

[44] However, each additional loss worsens the prognostic for a successful pregnancy[citation needed] and increases the psychological and physical risks to the mother.

[46] In certain chromosomal situations, while treatment may not be available, in vitro fertilization with preimplantation genetic diagnosis may be able to identify embryos with a reduced risk of another pregnancy loss which then would be transferred.

[citation needed] Experiencing pregnancy loss can have a significant and at times prolonged psychological impact, including higher levels of stress anxiety, and depression.

This can particularly be seen in women that developed maladaptive coping mechanisms following a miscarriage, isolated themselves as a result of the cultural and societal stigma, or received inadequate social support from medical providers, partners, families, and other personal relationships.

This decision should be made with the guidance of a medical provider given the teratogenicity and potential adverse effects of antidepressants on the fetus.

[47][49] In addition to psychotherapy, psychological care for people experiencing recurrent pregnancy loss can include counseling and other supportive services.

There is some evidence to support that women that received bereavement counseling (based on the Guidelines for Medical Professionals Providing Care to the Family Experiencing Perinatal Loss, Neonatal Death, SIDS, or other Infant Death) after pregnancy loss were able to cope better, with women reporting 50% less despair than those that did not receive this intervention.