Uterine factors in recurrent pregnancy losses

Congenital and acquired uterine anomalies are associated with recurrent pregnancy loss (RPL). Relevant congenital Mullerian tract anomalies include unicornuate, bicornuate septate, and arcuate uterus. Recurrent pregnancy loss has also been associated with acquired uterine abnormalities that distort the uterine cavity such as, notably, intrauterine adhesions, polyps, and submucosal myomas. Initial evaluation of women with RPLs should include an assessment of the uterine anatomy. Even if proof of efficacy of surgical management of certain uterine anomalies is often lacking for managing RPLs, surgery should be encouraged in certain circumstances for improving subsequent pregnancy outcome. Uterine anomalies such as uterine septa, endometrial polyps, intrauterine adhesions, and submucosal myomas are the primary surgical indications for managing RPLs. ((C) 2020 by American Society for Reproductive Medicine.)

Automated summary

Both congenital and acquired uterine anomalies are associated with recurrent pregnancy loss. Initial evaluation of uterine anatomy is crucial for women with RPL. Surgical management of certain uterine anomalies, such as uterine septa, endometrial polyps, intrauterine adhesions, and submucosal myomas, may improve subsequent pregnancy outcomes in specific circumstances.