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Recurrent Pregnancy Loss Research

We regularly conduct research on recurrent pregnancy loss, ensuring that the care we provide is the most advanced, effective, and evidence-based care possible.
Recurrent pregnancy loss has a significant emotional impact on patients and their partners, and additionally poses an economic burden on the healthcare system. Numerous risk factors associated with RPL and its major causes, including genetic, endocrinologic, anatomic, and autoimmune, have been identified, but further research is still needed to better understand this complex condition and its diagnosis and treatment. 

Up to 50% of recurrent pregnancy loss cases do not have a clearly defined case. That is why we have decided to create a RPL Data Registry to help improve the treatment patients receive. 

What is the purpose of the RPL Data Registry? 

The RPL data registry collects data on how and whether patients improve after being seen at the recurrent pregnancy loss clinic. This will help with future research on causes, treatment and long-term prognosis of recurrent pregnancy loss. Whether you consent or decline to participate in this research will have no effect on your clinical care at the RPL Clinic.

If you are interested in learning more, or would like to opt out of this research, please feel free to contact the research team at: RPLresearch@cw.bc.ca or 604-875-2000 ext 5686.

Research Highlights

Chronic intervillositis of unknown etiology (CIUE) is a placental inflammatory process associated with pregnancy loss and high recurrence risk. The pathogenesis is unclear but involves aberrant maternal inflammation. This study assesses expression of inflammatory mediators by placenta and intervillus macrophage using digital spatial profiling. This study demonstrates that CIUE is associated with a specific profile of inflammatory mediators expressed by placenta villi that is dominated by IFN signaling, suggesting that uncontrolled IFNγ signaling may play a primary role in the pathogenetic mechanism underlying CIUE.

 
This was a retrospective cohort study that aimed to answer if initiating levothyroxine treatment based on thyroid-stimulating hormone (TSH) >2.5 mIU/l or thyroid autoimmunity improved pregnancy continuation rates in recurrent pregnancy loss (RPL) patients. It was found that treatment of hypothyroidism in pregnancy should be initiated based on a TSH >4 mIU/l. Treatment initiation based on thyroid autoimmunity or a TSH >2.5 mIU/l may result in overtreatment.

 
The objective of this study was to evaluate the incidence of Chronic Intervillositis of Unknown Etiology (CIUE) at our institution and to report on the pregnancy outcomes based on severity of lesions. It was found that CIUE prevalence is low at 0.17%, CIUE is associated with pregnancy loss, particularly in the first trimester, and high grade CIUE may be associated with worse pregnancy outcomes than low grade CIUE. Currently, there is insufficient data to support use of empiric treatment for CIUE.

 
This study evaluates the prevalence and treatment choices of couples with structural chromosomal rearrangement, such as reciprocal or Robertsonian translocations, referred to a tertiary care RPL clinic. In addition, it compares the two methods of management, IVF with preimplantation genetic diagnosis (PGD) and prenatal diagnosis, in terms of live birth rate. It was found that parental carriers of structural chromosomal rearrangement and history of RPL are more likely to pursue natural conception over IVF with PGD. With regards to reproductive outcomes, no significant difference in miscarriage rate, time to live birth, or live birth rate was observed between couples who pursued PGD compared with expectant clinical management.

 
 

SOURCE: Recurrent Pregnancy Loss Research ( )
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