Most women are joyous when they conceive and give birth to a healthy baby. But sometimes, for some women, certain complications derail this process not just once but many times, and it takes an emotional toll on them. Miscarriages are common, with nearly 15% of pregnancies ending in this manner, and the majority of them happen in the first trimester. For some women, it happens more than once and is caused by various factors. Continue reading to learn why it happens and what treatment options are available.
Recurrent miscarriage or pregnancy loss is the loss of pregnancy two or more times. It can happen at any time spontaneously in the initial stages of pregnancy, but typically, most miscarriages occur in the first 12 weeks or the first trimester. This is not an uncommon occurrence, and despite having recurrent miscarriages, women can hope to complete their full term. However, the risk of miscarriage increases if there are more than two such instances, and the chances rise with every loss. What's more, the chances of recurrent pregnancy loss increase as women age, with those over 40 and who have had a previous history of it, are more at risk than younger women.
Genetics: A genetic condition that affects both or one parent or a genetic problem with the embryo may cause recurrent pregnancy loss. Most of these losses are due to chromosomal abnormalities in the embryo, where errors occur in egg maturation. In some cases, both or a single parent has a chromosomal abnormality, resulting in a defective embryo.
Condition Impacting the Uterus: Progesterone controls the implantation process, and the embryo and the endometrium should be in sync. But certain factors alter this and cause pregnancy losses.
Anatomical problems with the uterus: Fibroids, polyps or congenital defects may cause miscarriage.
Problems of the immune system: A special unknown relationship between the immune system and the uterus is present. Problems with the immune system may cause recurrent miscarriages. Antibodies like ACA (anticardiolipin antibodies), beta-II-glycoprotein and lupus anticoagulant (LAC) may cause miscarriage by creating clotting in the placenta or preventing implantation.
Hormonal disorders: Certain endocrine system disorders like thyroid disease and uncontrolled diabetes are known to cause recurrent pregnancy loss.
Male factors: Some data suggest that the DNA fragmentation of sperm may cause recurrent pregnancy loss.
A pelvic exam, medical history and one or a few of the below tests are needed to diagnose the cause of recurrent miscarriage:
This is the first treatment option most healthcare providers recommend. It includes limiting alcohol consumption and stopping the use of drugs and smoking. Women who are obese or overweight may be asked to reduce weight as this helps in the reduction of pregnancy-related issues. Women may be advised to limit excessive caffeine consumption. While there is no proof that stress and anxiety lead to miscarriage, expectant women should look at ways to reduce it and stay positive during this difficult time.
Thyroid dysfunction, diabetes and other immune system conditions are among the leading causes of recurrent miscarriages. Medications help in such cases. However, patients should follow the doctor’s prescription when taking medicines for these issues and not change dosage without the healthcare provider’s consent.
In conditions like thrombophilia (autoimmune blood clotting) or antiphospholipid antibody syndrome, your healthcare provider may prescribe low-dose heparin and aspirin. These blood thinners for recurrent miscarriages should be taken during pregnancy to reduce the risk. However, talk to your doctor before using them, as they can cause bleeding problems.
Uterine abnormalities like the presence of septum or fibroids in the uterus are among the common recurrent pregnancy loss causes. Surgery may have to be a treatment option to correct the abnormality and prevent recurrent miscarriage. The surgery helps correct the uterine anatomy so the fetus can grow and develop. Hysteroscopy is the procedure used to do such surgeries.
In some recurrent miscarriages, at least one parent has faulty chromosomes, which causes fetal chromosomal abnormalities. This results in recurrent pregnancy losses. A blood test can check for this. If confirmed, fertility treatments for recurrent miscarriages like IVF and genetic counselling are recommended. This fertility treatment helps to choose embryos without abnormalities and increases the probability of a successful pregnancy and childbirth.
Despite comprehensive medical tests, some women may have a diagnosis where the root cause cannot be determined. This diagnosis of unexplained recurrent miscarriages may be frustrating, but there are treatment options available that reduce miscarriage risks. These options include:
Having more than two miscarriages is called recurrent pregnancy loss and can be caused by many factors. However, in half of these cases, the cause is unknown. Many of the early miscarriages are because of congenital uterine abnormalities, polyps, fibroids, immune disorders or age-related reasons. If you experience miscarriage, consult a specialist, as there are recurrent miscarriage treatment options which can prevent further such losses. Work with a specialist so you can carry and deliver a healthy child.
During fertility treatments like IVF, the eggs and the sperm are fertilised in the lab. Before it is implanted in the uterus, the embryos are tested, and those without any chromosomal abnormality are selected and implanted, increasing the chances of a successful pregnancy.
Women who undergo IVF for recurrent miscarriage have a PGS (preimplantation genetic screening) and a PGD (preimplantation genetic diagnosis), which help test for chromosome and genetic problems in an embryo that causes miscarriage.
Yes. Research indicates that blood thinners (a combination of medicines to prevent blood clots) may boost pregnancy outcomes in women with recurrent miscarriages.
