Our team of pathologists, geneticists, and perinatologists uses a holistic approach and specialized care to help couples with recurrent pregnancy loss (RPL) and/or recurrent miscarriages. A multidisciplinary approach to diagnosing and treating any potential underlying cause(s) of the recurrent losses can be very effective, and also provide much-needed empathy and emotional support that couples who have experienced RPL require. Our program utilizes a team of providers, including reproductive endocrinologists, maternal fetal medicine specialists, a pathologist specializing in fetal loss, genetic counselors, a social worker, a dietitian, and a staff of experienced nurses to help couples with RPL navigate through the diagnosis and treatment of this disorder. We offer a comprehensive and individualized approach to couples with RPL, which is traditionally defined as the loss of three or more consecutive pregnancies prior to 20 weeks of gestation.While some definitions are limited to clinically identified pregnancies (those seen by ultrasound or under the microscope), biochemical pregnancies (those identified only by sensitive pregnancy tests) may also be included. The initial evaluation includes a visit with a perinatologist and a reproductive immunologist, with other consultants available as needed. Even when no specific cause for the repeated losses can be identified, very close monitoring and support of a subsequent pregnancy is likely to result in a favorable outcome. There are many types of assisted reproductive technologies available to RPL couples. In cases where there is a shortage of eggs or the majority of eggs are damaged—leading to increased miscarriage risk—egg donation can be considered.Alternatively, if the sperm is problematic, donor sperm can be utilized.Finally, in cases where the uterus is affected by congenital or acquired factors that cannot be reversed, a gestational carrier can be used to carry the pregnancy that is generated from the egg and the sperm of the couple with RPL.

The Yale Family Planning program’s vision is to provide reproductive health care rooted in dignity, equity, and science. Our mission is to provide exceptional care through evidence-based medicine, essential education, rigorous research, and advocacy focused on abortion and contraception. We provide compassionate and evidence-based care for people when they need birth control, as well as when they face unexpected or unhealthy pregnancies and need abortion care or miscarriage treatment. We support our patients’ journeys with respect. We know that all people deserve comprehensive information about their treatment options to make the best decision for themselves and their families. When it comes to reproductive health, we put our patients’ needs above all else. Our team includes subspecialty-trained physicians and dedicated nurses who provide compassionate care for our patients and their families. When our patients’ medical needs are complex, we partner with an interdisciplinary team of high-risk obstetricians, anesthesiologists, and medical specialists. Our services include: Pregnancy prevention with contraception: Contraceptive counseling and care Specialty contraceptive care for women with complex medical conditions (bleeding or clotting disorders, kidney failure, prior heart attack, organ transplant, or weight-loss surgery) Expertise with intrauterine devices and arm implants Pregnancy loss care: All options for management of early miscarriage Surgical management of second trimester pregnancy loss Bereavement support for pregnancy loss Abortion care: Medical abortion care in the first trimester Surgical abortion care through 23+6/7 weeks gestation Option of general anesthesia (to be “asleep“) for the procedure Bereavement support for ending a pregnancy Preoperative visit. This visit will include counseling, a medical history review, an exam (possible ultrasound and pelvic exam) and possible blood testing. The doctor will also review preoperative instructions (including arrival time for procedures), and consent forms will need to be signed. Patients should plan 1 to 1.5 hours for this visit. A support person is welcome. Before a preoperative visit, patients may need to have a separate ultrasound visit. Operative visit. Generally, the operative procedure will be the next day. Patients must not eat or drink for at least 8 hours before the procedure time, usually not after midnight the night before. Since patients will be affected by the anesthesia for the rest of the day after the procedure, they must have a ride home with someone who is at least 18 years old. They should plan to spend 5 to 6 hours at the hospital this day. Contraceptive visit. At this visit, we will review the patients’ medical history, counsel them on options for contraception, help them select a method that is right for them, and start that method. To prevent a concern for possible pregnancy at this visit, patients should not have unprotected sex for 15 days b