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Recurrent Pregnancy Loss
Recurrent Pregnancy Loss Care in Los Angeles
Being told to try again is not a plan. After more than one loss, evaluation is offered rather than waited for. It does not always find a cause — and what that means, and what happens next, deserves more than a sentence at the end of an appointment.
Your physician
Someone who has heard this history many times, and will hear yours properly.
Nearly thirty years in obstetrics and gynecology, over 7,000 deliveries, and fifteen years teaching OB/GYN residents at Cedars-Sinai Medical Center. Recurrent loss is a history that gets rushed in a short appointment. It is not rushed here.
- ExperienceNearly 30 years in obstetrics & gynecology
- DeliveriesOver 7,000
- Cedars-Sinai Medical Center15 years · OB/GYN residency faculty
- American Board of Obstetrics & GynecologyOral board examiner
Explained
Evaluation, and what it can and cannot tell you.
An honest account of what is looked for and what is often found.
When evaluation is offered
After two losses, evaluation is reasonable to ask for and reasonable to be offered.
The older convention of waiting for three is not a rule you have to accept, particularly if there are other factors — your age, how the losses happened, or how long you have been trying.
If you have been told to simply try again and that does not sit right with you, asking for an evaluation is a legitimate request and not an overreaction.
What the evaluation looks for
A defined list, worked through deliberately rather than one test at a time over months.
- Structural causes in the uterus, assessed by imaging.
- Hormonal and metabolic contributors, including thyroid function.
- Clotting and immune conditions associated with recurrent loss.
- Chromosomal factors in either partner.
- Where tissue was available from a loss, what its testing showed.
Which of these apply depends on your history, and the point of taking a history properly is to decide that rather than to test everything indiscriminately.
When no cause is found
This is the most common result, and the least well explained.
In a substantial share of cases a thorough evaluation does not identify a cause. That is not the same as nothing having been wrong, and it is not the same as nothing having been learned.
Outcomes in the next pregnancy after an unexplained evaluation are generally better than people expect, and that is worth hearing said out loud rather than inferred.
How the next pregnancy is followed
Earlier contact, earlier scans, and a plan agreed before you are pregnant rather than after.
Early ultrasound is arranged rather than waited for. See early pregnancy care. Where the evaluation found something treatable, treatment is in place before conception rather than started afterwards.
Setting the plan in advance is also what makes the first weeks bearable. Not knowing who to call is its own harm.
The part nobody schedules time for
Recurrent loss is a medical problem and a grief, and appointments tend to make room for only one of them.
You are allowed to bring the second one into the room. Being asked how you are, and having the answer taken seriously, is part of the care rather than a courtesy at the end of it.
If you would like support beyond the office, that can be arranged. It is a reasonable thing to want.
Questions
What patients ask first.
How many losses before an evaluation is offered?
Two is a reasonable point to start, particularly with other factors such as age or how the losses occurred. Waiting for three is a convention rather than a requirement.
Will the evaluation find a cause?
Often it does not. In a substantial share of cases a thorough evaluation identifies no cause, which is a recognised result rather than a failed workup.
Does no cause found mean I cannot carry a pregnancy?
No. Outcomes in a subsequent pregnancy after an unexplained evaluation are generally better than people expect.
What happens in the next pregnancy?
Earlier contact and earlier ultrasound, arranged in advance rather than requested when you are anxious. See early pregnancy care.
I have already been evaluated elsewhere. Is a second opinion reasonable?
Yes, and it is a common reason people come in. Bring the results you already have. See second opinion.
Where can I get recurrent pregnancy loss care in Los Angeles?
Yunella Women's Health is on San Vicente Boulevard in central Los Angeles, convenient to Beverly Hills, West Hollywood, Beverly Grove and the Miracle Mile.
General information about care at Yunella, not medical advice. What applies to you depends on your own history and examination.
Start here
Bring what you already know. We will start from there.
If you have results from an evaluation elsewhere, bring them. If you have none, we will begin at the beginning.
Or call (424) 404-8832 · 6330 San Vicente Blvd, Suite 418, Los Angeles, CA 90048 · delivery at Cedars-Sinai Medical Center