Recurrent Pregnancy Loss (RPL)

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Are you Eligible?

At TRIO, we work with patients who have a history of two or more consecutive pregnancy losses in the first trimester, or any pregnancy loss after 15 weeks gestation. Our program is unique because it offers a systematic approach to the evaluation and treatment of recurrent pregnancy loss, including a personalized management strategy for each patient or couple to optimize the probability of a successful pregnancy.

The Recurrent Pregnancy Loss Program at TRIO is a comprehensive program that focuses on all aspects of recurrent pregnancy loss. 

The medical definition of recurrent pregnancy loss (RPL), sometimes referred to as recurrent miscarriage, is the occurrence of three or more consecutive pregnancy losses before 20 weeks of pregnancy.

Our program, which is the largest in Canada devoted to studying and treating unexplained miscarriage, is built on the original research, history, and success of its predecessor, The TERM Programme. TERM was known for its successful medical interventions, promoting live births and experience with more than 5,000 cases of recurrent pregnancy loss over the past 30 years.

Recurrent Pregnancy Loss

Hover over sections for details.

First Appointment

First Appointment

We need to know your situation better. At your first appointment, we’ll take a complete medical history for you and your partner, if you have one. This will include an evaluation of any known genetic, hormonal or anatomic causes of recurrent pregnancy loss. This visit is covered by OHIP.

Testing Phase

Testing Phase

We will do our own medical evaluation, including a clinical assessment and further testing that may include but is not limited to:

- Hormonal testing -
- Endometrial lining evaluation -
- Coagulation and immune testing -
- Pre-implantation genetic screening (PGS) -

Follow up with MD

Follow up with MD

Your doctor will review your test results with you and recommend an individualized treatment plan that may involve one or more of the following:



In addition to medical interventions, the program provides support and counselling by professionals with specific expertise in reproductive issues. These counsellors are well trained to provide couples and individuals the support they need as well as the opportunity to work through the psychological issues inherent in this specific challenge.

Follow Up Three Options

1. Monitoring

If your treatment plan involves trying to conceive naturally, you will have a pregnancy test to confirm this. If you are pregnant, your TRIO doctor and their team will work closely with you to monitor your early pregnancy. You will continue to be followed beyond your first trimester.

2. Re-Evaluation

If your pregnancy test is negative, you and your physician will re-evaluate your treatment plan. This could include a more detailed fertility evaluation and alternative treatments such as

3. Other Approaches

We are actively involved in evaluating the use of a range of elements that may be helpful to couples with a history of recurrent pregnancy loss:

- New technologies -
- Clinical trials -
- Research studies -
- Experimental modalities -

The RPL Team

Heading up the program is a highly experienced and compassionate group of specialists, including Dr. Carl Laskin, Dr. Sony Sierra, and Karen Spitzer, as well as the whole TRIO team of reproductive medicine specialists.

Drs. Sierra and Laskin and their team have unparalleled expertise in treating this group of patients, including Dr. Sierra’s specialized training and dedication of half of her practise to the issue; and Dr. Laskin’s extensive clinical and research work in recurrent pregnancy loss and reproductive medicine.


“We look at elements that are standards of practise in other areas of medicine and apply them in new and innovative ways to find answers for our patients who experience RPL.”

Dr. Carl Laskin


“The gynecologic, endocrinology and autoimmune perspectives that are brought to the treatment of recurrent pregnancy loss in this program make it the only one of its kind in Canada.”

Dr. Sony Sierra




Main Location:
TRIO Fertility
655 Bay Street
Toronto, Ontario
11th and 18th floors