An Integrative Approach to Recurrent Pregnancy Loss

Lora Shahine, M.D., F.A.C.O.G.
Lecture Type: 
Breakout Session
Lecture Day: 
Day 2
Segal Conference Room

Course Description:

Recurrent pregnancy loss can be a clinically frustrating and emotionally charged challenge for patients and their care providers alike. Patients can leave their medical providers with more questions than answers and search the internet, their friends, and other sources for why they are having miscarriages. In this course, learn how Western medicine currently approaches evaluation and treatment for recurrent pregnancy loss.  Review evidence on different care approaches from expectant management and supportive care to using IVF technology to decrease miscarriage risk.  Learn the limitations of technology and the benefits of an integrative approach to care for recurrent pregnancy loss. 

Learning Objectives

  1. Understand the current Western approach to evaluation for recurrent pregnancy loss
  2. Understand evidence for treatment options for recurrent pregnancy loss from expectant management to IVF with chromosomal screening
  3. Understand the benefits of an integrative approach to care for recurrent pregnancy loss


  1. Introduction
  2. Definition of miscarriage and RPL
  3. Incidence of miscarriage and RPL
  4. Evaluation of RPL
    1. Evidence-based  approach
    2. Differences in recommendation from different societies: ASRM, ACOG, Royal College
    3. Definition of unexplained RPL
    4. Other testing available/controversies
  5. Treatment for RPL
    1. Cause for RPL – treatment options
    2. Lifestyle changes that can impact RPL


ii.Toxins – smoking, caffeine alcohol, BPA, environmental toxins

  1. No cause for RPL – unexplained RPL treatments

i.Expectant management

ii.Supportive care

  1. Emotional well being
  2. Empiric treatment

iii.IVF with chromosomal screening of embryos – benefits, risks, limitations

  1. Benefits of an integrative approach to care
    1. East and West bringing their strengths together to benefit the patients
    2. Team approach to care


Lora Shahine, M.D., F.A.C.O.G.

Lora Shahine, M.D., F.A.C.O.G. is a board certified Reproductive Endocrinologist currently practicing at Pacific NW Fertility and IVF Specialists in Seattle.

As a Clinical Instructor at the University of Washington and Director of the Center of Recurrent Pregnancy Loss at PNWF, she is committed to providing excellence in patient care, teaching the next generation of women’s health providers, and continuing research in the fields of fertility and recurrent miscarriage.

She has published over 20 peer-reviewed research papers and is an active member of the American Society of Reproductive Medicine, Pacific Coast Reproductive Society, and Seattle Gynecology Society. Dr. Shahine is committed to an integrative approach to care and co-authored the book, “Planting the Seeds of Pregnancy: An Integrative Approach to Fertility Care.”

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Symposium Location

Simon Fraser University at Harbour Centre
515 West Hastings Street
Vancouver, BC