What is recurrent loss of pregnancy? Three or more repeat miscarriages or pregnancy loss are considered recurrent. Recurrent miscarriages are a sign that a woman is at risk. A thorough physical exam and testing may be recommended.
What Causes Repeated Miscarriages
Recurrent miscarriages are extremely rare. About 1% of women will experience repeated miscarriages. About 60% of miscarriages occur randomly. This occurs when an embryo receives an abnormal number of chromosomes in fertilization. This is a natural phenomenon and there aren’t any medical conditions that could be attributed to it. Recurrent miscarriages are more common in mature women.
However, miscarriages are quite common. These miscarriages occur in 15% to 20% of all pregnancies. They usually occur in the first three months or the first 13 weeks. These miscarriages do not define a woman’s fertility. More than half the time, healthy children are born to these couples. Even after two miscarriages.
It may be worth looking at the possible causes behind your recurrent miscarriages beyond two or three miscarriages.
What causes repeated pregnancy loss
Many patients have a third successful pregnancy despite miscarriage being not always obvious. There is a 65% chance that your third pregnancy will be a live birth even after having two miscarriages.
It is possible to find the cause of your miscarriage and fix it if you are able to. This will help prevent future losses and emotional stress. You may have recurrent pregnancy loss after two miscarriages. This is when you can benefit from the diagnostic testing mentioned above to determine if there is a cause.
Although the purpose of the studies was to identify the cause of miscarriages in the cases, up to 50%-75% of the cases show that the testing is normal.
Different types of miscarriage
Miscarriage can be caused by many factors, but most often they fall into one of two categories: early or late.
Early miscarriages that occur in the first trimester are usually due to genetic chromosomal problems. Between 50 and 80% of spontaneous deaths have abnormal chromosomal numbers. Early miscarriage can also be caused by structural problems in the uterus.
Late miscarriage may be caused by uterine abnormalities or autoimmune issues, incompetent cervical surgery, premature labor, or a combination of these.
Management and evaluation are required for any history of repeated miscarriages. A variety of tests can be performed on the father and mother to determine the cause. If necessary, even fetal tissue. One of these tests could include:
- Blood clotting studies are indicated only if there is a family history of venous embolism.
- Sonography/anatomical testing (ultrasound test, HSG /X-ray).
- Tests for auto-immune diseases (in the case of 3 or more losses).
- If you have had a miscarriage, we can do chromosome testing to determine if your products are still viable.
- Tests for insulin resistance, diabetes, or other endocrinopathies relating to the thyroid glands and pituitary glands
- Parents looking for balanced translocations should test their chromosomes
Sometimes, even with testing, the cause of a miscarriage may not be fully understood. However, 65% of miscarriages are resolved by the time a third pregnancy is attempted.
It can be difficult to determine the cause of recurrent pregnancies. In 50-75% of cases, the tests are negative. There is no way to know what the cause might be. It is possible to fix the problem once the cause has been established.
Recurrent miscarriages can be caused by these causes.
Recurrent miscarriages can be caused by endocrine problems. These problems could be caused by diseases such as thyroid disease, pituitary, polycystic-ovarian syndrome, or diabetes.
LPD (Luteal phase Defect) could indicate that the woman’s womb may be suboptimal. This could also lead to miscarriage. LPD treatment can begin with ovulation-inducing medication such as clomiphene citrate.
Progesterone therapy was once used to treat similar endocrine problems. However, research has shown that it offers few benefits if any. To properly evaluate endocrine issues and devise a plan to address them, it is necessary to do so.
Autoimmune conditions: Antiphospholipid antibody syndrome
When antibodies are produced by the mother or the carrier, they can indirectly cause blood vessel clotting that leads to an immunological problem. A miscarriage occurs when the fetus dies in utero and is deficient in nutrients.
If you have suffered three or more losses, a variety of blood tests can be performed to check for the problem. This condition can be treated with aspirin (an anticoagulant) or heparin (an antibiotic). You will likely use an aspirin dose of 81 mg per day if your doctor recommends it.
Heparin is an anticoagulant that is often prescribed to prevent blood clotting problems. Discuss with your doctor all the potential risks and benefits of heparin use during pregnancy. Only use this therapy if it is absolutely necessary.
Recurrent pregnancy loss is not caused by blood clotting disorder. However, patients who have a family history of blood clots (in their extremities and lungs) should be tested for these clotting conditions. This can be a complicated and confusing problem and specialists will help you decide on the right testing.
Gene (embryo or parent)
The most common genetic or chromosomal abnormalities in an embryo are 50-80% of repeat miscarriages in the first three months. This can lead to a lot of miscarriages if it is repeated. It is recommended that you and your partner discuss karyotype if there is more than one loss.
This is to ensure a balanced translocation. There’s a chance of approximately 4% for each parent. Translocation patients don’t usually show symptoms or exhibit any physical signs. However, some eggs and sperm may have abnormal chromosomes. Miscarriage can occur when an embryo has too little or too many genetic materials.
In vitro fertilization can be used in certain situations. Preimplantation genetic testing may also be possible. This allows you to choose a normal embryo and reduce the risk of having a chromosomally defective embryo. This is a highly individualized procedure and should be discussed with your doctor.
Blood clotting disorders
Systemic lupus, antiphospholipid Syndrome, and systemic lupus are two examples of blood clotting disorders that can lead to sticky blood’ or recurrent miscarriages. These rare disorders may affect the flow and function of the placenta. This could lead to miscarriage by denying the baby essential nutrients and oxygen.
Recurrent miscarriage is a sign that a woman should be tested for antiphospholipid antibodies before she gets pregnant. Aspirin or heparin therapy can be used to thin the blood. Recurrent miscarriage is a sign that the blood of women with recurrent miscarriages has a higher tendency to clot, which can block the flow of nutrients to the baby.
Certain autoimmune diseases are caused by antibodies produced by the mother. These antibodies cause blood vessels to clot and can lead to the death of the developing fetus. This results in the loss of vital growth nutrients for the fetus. This causes the fetus to die in utero. This can also lead to miscarriage.
If you have suffered from three or more losses in pregnancy, blood tests can be done to check for autoimmune conditions. Your doctor may recommend aspirin therapy to help combat these autoimmune diseases.
Anticoagulant medications like Heparin can be prescribed to prevent blood clotting. Talking to your doctor about the long-term and short-term effects of medications such as heparin during pregnancy is a good way to determine if this treatment is really necessary.
These are complicated issues. Although blood clotting disorders do not cause recurrent loss of pregnancy, it is recommended that patients with a family history or personal history of blood clots be tested before they can affect their chances of getting pregnant. It is especially important if it affected the extremities or the lung.
Antibodies to the thyroid
Thyroid antibodies are small molecules found in the bloodstream which can attack the thyroid and cause it to stop working properly. High levels of thyroid antibodies can increase miscarriage risk. Women who have antibodies should be screened for thyroid dysfunction, especially if they are pregnant.
Problems with the uterine system
An abnormally shaped womb could increase your chances of having a recurrent miscarriage or premature birth. An ultrasound scan is used to diagnose this condition. There are many ways to examine the shape of your uterus. Depending on the results, surgery may be recommended.
About 15% of miscarriages are caused by uterine structural problems. These uterine abnormalities may be congenital or acquired at birth. A disorder called septate uterus is most commonly associated with miscarriage. This condition causes the uterus to be separated by a wall made of tissue.
Some women may experience problems from growths such as fibroids or polyps. These can occur anywhere in the uterus and can cause many problems.
Miscarriages can also be caused by scarring in the uterus or intrauterine. This is not always a major problem. Most of these problems can be addressed before conception by surgery.
These procedures can increase your chances of having a healthy baby. Discuss the possibility of a problem such as this with your healthcare provider.
Multiple miscarriages may be linked to syndromes such as Ashman syndrome. This is when scarring and adhesions form in the uterus. These can happen long before a woman realizes she is pregnant.
Our environment can have a significant impact on many risk factors. Particularly during pregnancy. There is always a higher chance of miscarriage if a mother is exposed to x-rays, drugs, alcohol, or cigarettes. Lifestyle factors such as excessive caffeine intake, smoking, and alcohol consumption can have an impact on the outcome of a pregnancy.
Lifestyle factors such as obesity are also important. Some things are unavoidable, such as the working relationship and chemicals or toxins in the environment.
You may be eligible for a scan starting at 14 weeks if you have had a history of miscarriages or are at high risk for cervical weakness. This will allow you to determine the length of your cervical cervix. You may be recommended to have a cervical cerclage (cervical sewing) depending on your pregnancy, medical history, and scan results.
Natural killer cells
Experts believe natural killer cells found in the uterus may play a role in miscarriage and infertility. You can have tests done to determine your level of NK cells. It is not offered by the NHS. Not all fertility clinics offer to test, but some do. You will need to pay if they offer it. These can be costly and the costs will vary from one clinic to another. Learn more about testing and investing.
Also, it is very common for repeated miscarriages to not be diagnosed. Repeated miscarriages occur in between 50-75% of women. There is no known cause. You may have a few clues but there is no one-for-all answer.
To assess the cause, your healthcare provider might ask you about your medical history and pregnancies. A complete physical exam including a pelvic examination may also be done.
You may also need blood tests to detect any genetic or other disorders, as well as problems in the immune system. Also, imaging tests can be used to determine if there is a uterine issue.
Your healthcare provider might recommend specific treatment if you can identify repeated miscarriages.
Multiple miscarriages can be increased by certain medical conditions. Certain medical conditions can increase the risk of repeated miscarriages.
Miscarriages can also be caused by other diseases, such as diabetes mellitus. High levels of glucose or sugar in the blood can cause miscarriages. This disease is more common in women who are not well-controlled. Women with Polycystic Ovarian Syndrome are also at risk.
Recurrent miscarriage is caused by an infection in between 0.5 to 5% of cases. Mycoplasma and ureaplasma are the main suspect pathogens. An infectious evaluation may be warranted in people with immunodeficiency, or with signs of chronic endometritis/cervicitis on examination.
There is no evidence to suggest that routine infectious testing is productive or appropriate. Common bacteria can cause chronic endometritis (CE). This condition is common in women who have had a history of repeated miscarriages. A study showed that 71% of the women who were positive for the condition could be successfully treated with an antibiogram-based antibiotic therapy. 78% of these women became pregnant within the first year after treatment.
According to the study, “CE is common in women who have recurrent miscarriages.” “Antibiotic treatment appears to be associated with improved reproductive outcomes.” The study authors conclude that hysteroscopy should also be part of the diagnostic process for infertile women who experience unexplained recurrent miscarriages.
A recent study found that women suffering from chronic endometritis are more likely to experience miscarriage than those without it. This is despite the difficulties in diagnosing the condition.