Recurrent pregnancy loss

Pregnancy loss, or miscarriage, is defined as the spontaneous demise of a pregnancy before the fetus reaches viability. In practice, this encompasses all losses from the time of conception until 24 weeks of gestation. Sporadic miscarriages are a common complication of early pregnancy and typically occur during the first trimester with an incidence of 10–50% in patients aged 20–45 years. Recurrent pregnancy loss (RPL) is less common and affects approximately 1% of couples. There is much uncertainty surrounding RPL. Patients are uncertain about the cause of miscarriages, the investigations and treatments available and how to access these services. Healthcare providers are uncertain about which investigations can positively impact future pregnancies and how to improve the chances of a successful pregnancy. Across the UK, the management of RPL varies significantly, due to contradictory and varying national and international guidelines.