Recurrent pregnancy loss
After three early pregnancy losses a work-up is offered. In a substantial share of cases it comes back normal. That is where internal medicine works alongside gynaecology.
What it is
Recurrent early pregnancy loss is usually defined from three losses before fourteen weeks of amenorrhoea, sometimes two depending on the learned society. The recommended work-up looks for uterine, hormonal and parental chromosomal causes, and for antiphospholipid syndrome. When it finds nothing, the situation is called unexplained — which means unexplained by validated tests, not unexplainable.
His work on this subject
The approach is to treat these situations as an internal medicine problem: systematic search for a latent autoimmune or inflammatory disease, placental pathology where available, discussion at a multidisciplinary board, rather than as a failure of reproduction alone. It draws on the FALCO registry and on the FaCIL-2 and CERTIFY trials.
Where care is organised
Saint-Antoine Hospital (AP-HP); a day hospital dedicated to recurrent pregnancy loss opened at Trousseau Hospital (AP-HP) in February 2025; national multidisciplinary board on infertility.
What is not known
No immunomodulatory treatment has demonstrated, in a controlled trial of sufficient size, an improvement in live birth rate in unexplained recurrent pregnancy loss. That is precisely the object of the ongoing trials.
References
- FALCO registry — Human Reproduction, 2024. DOI 10.1093/humrep/deae146cité 11 fois