Bill Rancic, Giuliana Rancic Bill Rancic, Giuliana Rancic

Giuliana and Bill Rancic started the new year by learning the devastating news that their surrogate suffered a miscarriage while she was pregnant with their last embryo.

The couple, who have spoken candidly about their fertility issues on their reality show Giuliana & Bill, had a baby boy named Duke via surrogate in 2012. Last year, their surrogate became pregnant again with two of their three remaining embryos and miscarried within weeks. After she became pregnant with their third and final embryo, the E! News host tells People in a new interview that the couple was told on New Year's Eve that she lost that pregnancy as well.

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The third strike was "the toughest blow," Giuliana tells the magazine. "We were so optimistic with this last embryo. We thought, 'This is definitely going to work. This is our last shot.'"

The Rancics turned to surrogacy after Giuliana's breast cancer diagnosis in 2011. Because she is still on cancer-suppressing medication, Giuliana, 40, getting pregnant herself has been ruled out, but the couple is looking at other options.

"We're open to everything," Giuliana says. "I think adoption is a beautiful gift you're giving each other. ... I'm even more open to [adoption] than I was before. Because I think to myself, 'I love Duke so much, if I couldn't take care of him, I hope there would be someone else who would love him.'"

Giuliana Rancic's memoir, Going Off Script, will be released April 7.