The common characteristics between infertility and recurrent pregnancy loss

Currently, infertility and recurrent pregnancy loss (RPL) are two separate entities, evaluated and treated by different caregivers in different facilities. Infertility is defined as the inability to conceive after 1 year of unprotected intercourse while RPL's definition is more debatable and includes a history of 2 or 3 clinically documented pregnancy losses. A thin clinical border exists between infertility and RPL in the form of preclinically documented pregnancies, also known as chemical pregnancies or non-visualized pregnancies. In these cases a positive pregnancy test confirms the occurrence of fertilization, but neither an intrauterine nor an ectopic pregnancy is visualized before a decline in HCG levels is documented. In these pregnancies, because fertilization occurs, patients are not defined as infertile and because implantation was not completed, they are not considered to have pregnancy loss. This chapter aims to challenge the artificial separation between infertility and RPL. Not only do infertility and RPL patients share the same unfulfilled desire to deliver a baby, they also share common etiologic characteristics, evaluation pathways, as well as common management in some of the cases. In the chapter we briefly mention some of the common etiologic factors of both RPL and infertility. We suggest redefining infertility so that couples who cannot deliver babies will not be misjudged as fertile. Also, the conclusion of the chapter suggests implementing a multidisciplinary approach towards both the consistently infertile and RPL populations that will involve experts from both fields in the same evaluation and treatment facility.