Can Genetics Explain Repeated Pregnancy Loss?

Experiencing a miscarriage can be deeply emotional and difficult, and it’s important to remember that you’re not alone. While every loss is personal, miscarriage is more common than many people realize, affecting approximately 15% of recognized pregnancies, most often during the first trimester.

While genetics might play a factor in pregnancy loss, the answer is actually more complicated. 

What is Repeated Pregnancy Loss? 

Historically, recurrent pregnancy loss (RPL) was defined as experiencing three consecutive miscarriages. However, medical guidelines and clinical practice have evolved, and many physicians now begin evaluating patients after two pregnancy losses. This earlier evaluation can help identify potential underlying factors and ensure that patients receive appropriate guidance, support, and care without having to experience another loss before seeking answers.

Age is also an important factor when evaluating recurrent pregnancy loss. A woman’s age, particularly when comparing someone in her 20s with someone in her 30s or beyond, can influence how physicians approach an evaluation and understand the potential causes of pregnancy loss. Factors such as egg quality, chromosomal abnormalities, and overall reproductive health may change with age, making individualized evaluation especially important.

What Factors Do Eggs Play? 

As women age, both the number and quality of their remaining eggs naturally decline. For some women, however, this process may begin earlier than expected, a phenomenon often referred to as premature ovarian aging. Research suggests that approximately 10% of women may experience accelerated ovarian aging.

As egg quality declines, the likelihood of chromosomal abnormalities in embryos increases, which can increase the risk of miscarriage. For this reason, recurrent pregnancy loss may sometimes be an early sign of ovarian aging or diminished egg quality.

However, genetics and egg quality are only one piece of the puzzle. Researchers are increasingly recognizing that pregnancy loss can have many contributing factors, including reproductive aging and other potentially treatable conditions. Understanding the underlying cause is an important step toward determining the most appropriate care and next steps.

To learn more about recurrent pregnancy loss and the potential role genetics may play, listen to Dr. Gleicher’s newest episode of The Egg Factor here.