How to Assess the Prognosis after Recurrent Miscarriage

A patient with recurrent pregnancy loss (RPL) usually requires four answers, the cause of her miscarriages, the prognosis both for the next pregnancy and whether she will ever have a live child, and what treatment can be offered to prevent a recurrence. Various predictive factors have been reported to affect the prognosis, viz.: (i) The number of previous pregnancy losses. As the number of previous losses increases, the chance of a live birth decreases. (ii) Maternal age, (iii) The karyotype of previous miscarriage, (iv) Concurrent infertility, (v) Early or late pregnancy losses, as the patient with late losses tends to have a worse prognosis, and (vi) Primary, secondary, or tertiary aborter status has been reported to affect the prognosis, with the secondary aborter having a better prognosis than the primary or tertiary aborter. Parental karyotypic aberrations have been found in 3-10% of couples with recurrent miscarriage (RM).