Recurrent Early Pregnancy Loss (RPL) Program

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Helping You Fulfill Your Dreams of Having a Baby

Recurrent early pregnancy loss (also known as RPL) can be devastating. If you have had 2 or more consecutive miscarriages, you may worry if you will ever have the baby of your dreams — or whether you should keep trying.

The treatment for recurrent early miscarriages is unique from other fertility approaches. It requires an unparalleled level of expertise that comes from decades of experience, specialized training, and advanced monitoring protocols.

That’s where TRIO’s RPL program comes in.

We understand the pain that you have gone through while trying to grow your family. With 40 years of combined experience and over 6,000 patient cases, TRIO offers the most comprehensive RPL program in the country.

Dr. Sony Sierra leads our caring and compassionate reproductive team as we provide hope to more RPL patients than any other clinic in Canada.

Why Choose TRIO’s RPL Program?

There are many underlying reasons why recurrent pregnancy loss occurs. In most cases, there is nothing that you should or could have done differently. Unfortunately, with each subsequent miscarriage, the risk of having another loss increases. What you need is a respected clinic to conduct a thorough investigation, determine a diagnosis, and provide a detailed fertility plan.

Our RPL program uses a systematic approach to assess every individual or couple. We look deeper at the reproductive, hormonal, and autoimmune factors that can contribute to pregnancy loss. This involves personalized testing, monitoring, and treatment to optimize your chances of having a healthy pregnancy.

You receive care from the top RPL specialists in the country. Dr. Sony Sierra has dedicated much of her career to giving RPL patients hope and helping them grow their families. Alongside her is a hand-picked team of reproductive endocrinologists, fertility nurses, preconception naturopaths, and counsellors.

You benefit from an industry-leading RPL program. It is based on the Treatment and Evaluation of Recurrent Miscarriage (TERM) program, founded by Dr. Carl Laskin. The program has contributed to multiple peer-reviewed articles, the development of standards of care, well-established research, and a solid track record of success.

If you’re a candidate, our RPL program aims to support you in your future pregnancy working towards an excellent chance to take home a baby.

A photograph of a doctor speaking with a woman in an office.
A photograph of a screen with photographs of stages of development of an embryo.

From Our Team

A photograph of Dr. Laskin.
“We look at elements that are standards of practice in other areas of medicine and apply them in new and innovative ways to find answers for our patients who experience recurrent pregnancy loss.”
Dr. Carl Laskin MD, FRCPC
Managing and Founding Partner, TRIO

How Our RPL Program Works

You don’t want to give up on becoming a parent — and we believe you shouldn’t have to. After your initial assessment and thorough testing, your treatment plan may include:


Early Supportive Care

We provide a thorough evaluation, investigations, and the formulation of a personalized treatment plan to monitor your next pregnancy. This can include but is not limited to, cycle monitoring, timed intercourse, hormonal support, and monitoring, In Vitro Fertilization (IVF), and PGT-A, if appropriate. Above all, we do everything with care and compassion.


Ongoing Monitoring

We provide close surveillance of your early pregnancy, such as frequent ultrasounds and ongoing access to your medical support team. If you have a history of 2 or more pregnancy losses, you will benefit from early monitoring, regardless of how the pregnancy is conceived.


Other Approaches

We are actively involved in evaluating the use of experimental approaches which may be helpful to couples with a history of recurrent early pregnancy loss. This could include a more detailed fertility evaluation and alternative treatments.


Access to multiple specialties

Having a large medical team working together means access to unique expertise in a variety of subspecialties within the field of fertility medicine. These include but are not limited to: recurrent pregnancy loss, reproductive immunology, world-class fertility research and clinical trials, and LGBTQ+ family building.

Patient Stories

"There are no words that could truly express our gratitude to Dr. Sierra and her team. It was because of their support, expertise, and innovative treatment that our family dreams finally became a reality. After having 3 heartbreaking miscarriages, one failed IVF, and countless medicated cycles we had almost given up. It wasn’t until we got referred to Dr. Sierra and her team at TRIO Toronto that we finally began to see hope. Thanks to Dr. Sierra and her team at TRIO we were given the biggest miracle gift of our life...our daughter, Ainsley. We are so grateful that we did not give up our fertility battle before being referred to Dr. Sierra."
A photograph of a baby.
Melissa & Tim, Patients

Frequently Asked Questions

At TRIO, RPL refers to a history of 2 or more pregnancy losses during the first trimester.
This can somewhat depend on your history. Pregnancy loss can be a chemical pregnancy loss (occurring shortly after implantation) or a clinical miscarriage during the first trimester (confirmed by ultrasound).

Most of the time, miscarriages are due to random genetic errors that can not be controlled. Risk factors can include genetics, structural issues (i.e. uterine), hormonal imbalances, autoimmune/blood clotting issues, male factor infertility, infection, lifestyle, or maternal age.] However, if you have had 2 or more losses, we recommend you book an appointment at TRIO to be evaluated by an RPL specialist.

In many cases, we find a treatable cause that can increase your odds of having a successful and healthy pregnancy. In those cases where we don’t find a specific cause, we will evaluate all of the tools and treatments available and create a plan that is best suited to your needs.
Yes, important factors need to be screened in both patients who are contributing their genetics to the pregnancy.
If you are not already a TRIO patient, call your doctor and request a referral to our clinic. You can also ask your family physician if it’s possible to collect the pregnancy loss tissue for cytogenetic analysis. This will help our RPL specialists determine the next steps in your investigation and management.

There is strong evidence that detailed monitoring and early medical care, coupled with emotional support, can dramatically improve the prognosis for a live birth — by up to 70%. For patients with a history of recurrent pregnancy loss, this kind of ongoing monitoring from the very first stages of pregnancy, combined with a high level of medical support, can make all the difference.