Australia's first Australasian guidelines for recurrent pregnancy loss have been published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, offering clinicians and patients a locally relevant framework that reflects Australian legal and clinical context.
Critically, the new guidelines redefine recurrent pregnancy loss as two or more pregnancy losses before 20 weeks gestation with the same partner. This is a significant shift from most international guidelines, which require three consecutive losses before 24 weeks. Genea's Dr Anthony Marren, a Sydney-based fertility specialist and reproductive surgeon who contributed to the guidelines, said GPs should not feel bound by older international thresholds.
"If someone's had two losses, they should be offered the investigations and patients can make a choice regarding whether or not they want to go through the testing," Dr Marren said.
The guidelines cover nine contributing factor categories including chromosomal, anatomical, thrombophilia, endocrine, autoimmune, infective, environmental, lifestyle, and male factors. Aneuploidy (an abnormal number of chromosomes) is identified as the leading cause of both sporadic and recurrent pregnancy loss, with karyotyping of both partners unanimously recommended. Anatomical investigations including sonohysterography and ultrasound are recommended for uterine anomalies, which occur in up to 15% of patients with recurrent pregnancy loss. Thyroid function tests, antiphospholipid screening, and endometrial biopsy are also among the recommended investigations.
Between half and three-quarters of recurrent pregnancy loss cases remain unexplained after investigation. In these cases, progesterone supplements, IVF, and supportive counselling are recommended management options.
A plain language patient version of the guidelines is being finalised and will be freely available for GPs to download.
Read the full article for a detailed breakdown of the guidelines and their clinical implications.
Dr Anthony Marren
Dr Anthony Marren understands the emotional journey couples endure when they have difficulty conceiving or experience recurrent pregnancy loss. He appreciates the importance of dedicating sufficient time during consultations to listen to his patients’ concerns and provide support. Anthony strives to offer clear, helpful information in order to empower couples to make informed decisions regarding fertility treatment.
Dr Danielle Robson
Dr Danielle Robson is an experienced gynecologist who has worked and trained in hospitals in Sydney, Brisbane, and Darwin. She provides compassionate personalised care. Danielle understands every fertility journey is unique, and it can be both an overwhelming and confusing time for patients. She provides clear and concise management plans that are evidence based, so that patients can make an informed decision. She prides herself on her ability to provide empathetic care and she takes the time to listen to and be available for her patients.
Dr Ying Li
Dr Ying Li provides a compassionate and personalised approach to fertility treatment. Ying invests time in understanding his patients and developing the most appropriate plan to address their specific fertility issues to maximise their chance of having a baby.
Ying’s unwavering focus is testament to his passion for women’s health. A leader in obstetrics, gynaecology, and fertility treatment, he can support patients at all points of their fertility journey. Ying believes in partnering with patients to explain and then develop an effective management plan. He understands fertility treatment can be overwhelming and collaboration with a Fertility Specialist is imperative.
