The investigation and management of recurrent early pregnancy loss: a Canadian Fertility and Andrology Society clinical practice guideline.
Sony Sierra, Jason Min, Julio Saumet, Heather Shapiro, Camille Sylvestre, Jeff Roberts, Kimberly Liu, William Buckett, Maria P Velez, Neal Mahutte
Author Information
Sony Sierra: IVIRMA Global Research Alliance, TRIO Fertility, Toronto, Ontario, Canada; Women's College Hospital, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Toronto, Toronto, Ontario, Canada. Electronic address: ssierra@triofertility.com.
Jason Min: The Regional Fertility Centre, Calgary, Alberta, Canada; Department of Obstetrics and Gynecology, University of Calgary, Alberta, Canada.
Julio Saumet: Miacleo Fertility, Montreal, Quebec, Canada; Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, University of Montreal, Montr��al, Qu��bec, Canada.
Heather Shapiro: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Toronto, Toronto, Ontario, Canada; Mount Sinai Fertility, Sinai Health System, Toronto, Ontario, Canada.
Camille Sylvestre: Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, University of Montreal, Montr��al, Qu��bec, Canada; CHU Ste-Justine, Montreal, Quebec, Canada; Clinique OVO Fertilit��, Montreal, Quebec, Canada.
Jeff Roberts: Pacific Centre for Reproductive Medicine, Vancouver, British Columbia, Canada; Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of British Columbia, Vancouver, British Columbia, Canada.
Kimberly Liu: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Toronto, Toronto, Ontario, Canada; Mount Sinai Fertility, Sinai Health System, Toronto, Ontario, Canada.
William Buckett: Department of Obstetrics and Gynecology, McGill University, Quebec, Canada.
Maria P Velez: Department of Obstetrics and Gynecology, Queen's University, Ontario, Canada.
Neal Mahutte: The Montr��al Fertility Centre, Montr��al, Quebec, Canada.
This guideline defines recurrent early pregnancy loss (REPL) as two or more losses that occur before 10 weeks gestational age and includes non-consecutive and biochemical losses. Investigations should be considered on an individual basis and may include an evaluation of genetic, anatomical, endocrinological, structural and male-associated factors. Based on the findings and available resources, options for management may include preimplantation genetic testing (PGT) for aneuploidies or PGT for chromosomal structural rearrangements, progesterone supplementation and supportive care. This guideline emphasizes a personalized approach to the problem of REPL, recognizing an overall promising prognosis for this patient population and the avoidance of treatment options that have not been shown to be of benefit.
