Recurrent miscarriage is defined as the loss of at least two pregnancies before 28 weeks. Within the United States, approximately 1/4 of all pregnancies are lost during this timeframe. Data reveals that less than 10% of women experience two or more miscarriages, and less than 1% of women experience three or more miscarriages.
Recurrent miscarriage is very frustrating for individuals and couples attempting to have a child, but the vast majority is able to have a successful pregnancy with the right treatment.
What Causes Recurrent Miscarriage?
There are several causes of recurrent miscarriage. These causes include:
- Anatomic abnormalities
- Genetic abnormalities
- Infectious diseases
- Immunologic abnormalities
- Hormonal abnormalities
- Unknown reasons
Anatomic issues – Women with an abnormally shaped uterus can have a difficult time sustaining a healthy pregnancy. Anatomic issues can often be corrected with a minor outpatient surgery by a gynecologist Denver trusts. The common anatomic issues include uterine polyps, submucosal fibroids, and a uterine septum.
Genetic abnormalities – While most miscarriages are caused by being pregnant with a chromosomally abnormal baby, recurrent miscarriages often are not. Genetic Abnormalities only cause recurrent pregnancy loss about 7% of the time. Genetic abnormalities can be carried by either parent and can cause the baby to be chromosomally abnormal. Most of the genetic abnormalities that cause recurrent loss are balanced translocations. This is when the parent is physically normal but the chromosomes are arranged in a different order than usual.
Infectious conditions – Infections of the uterus can be associated with recurrent miscarriages. These conditions are discovered through cervical cultures and treated most often with antibiotics over the course of a few weeks. It is thought that mycoplasma and ureaplasma bacterial infections can lead to recurrent loss. It is rare that sexually transmitted diseases like Gonorrhea or Chlamydia lead to miscarriage.
Hormonal abnormalities – Many different hormonal imbalances can cause recurrent pregnancy loss. Women with recurrent pregnancy loss should have their thyroid tested, their prolactin level checked (this hormone makes breast milk but in low levels it can lead to miscarriages), their egg quality tested (FSH, estradiol, and antimullerian hormone levels on day 2, 3 or 4 of the menstrual cycle) and a serum progesterone level checked after ovulation has occurred. Sometimes a biopsy of the uterus is performed to check that the lining of the uterus is developing normally.
Immunologic disorders- Autoimmune disorders have been associated with recurrent pregnancy loss and pregnancy complications. The most common is Lupus. Sometimes woman can be positive for Lupus on blood test and not have any of the lupus symptoms except for recurrent miscarriages.
Blood clotting disorders- It is controversial whether blood clotting disorders can increase the risk for pregnancy loss. The most common blood clotting disorders are Factor V Leiden and a Prothrombin Gene Mutation. However some data suggests that Protein S and C abnormalities can lead to late pregnancy losses.
How is Recurrent Miscarriage Treated?
The treatment of recurrent pregnancy loss depends on the underlying issue causing the miscarriages. Anatomical issues are corrected with surgery, infectious conditions are treated with medication, and genetic abnormalities can be treated with preimplantation genetic diagnosis or the use of donor gametes.
Most Denver fertility doctors will also recommend lifestyle changes by the couple such as stopping the use of tobacco products, limited alcohol use, and a regimen of healthy eating and exercise. This is particularly useful when the reason for recurrent miscarriage is not known.
What is the Prognosis for a Successful Pregnancy?
The prognosis for a successful pregnancy occurring is still high despite repeated failures. About 70% of woman who are evaluated and treated for recurrent loss will have a baby. It is important to receive an accurate diagnosis with a fertility doctor in Colorado so the right treatment plan can be implemented. Even couples suffering from recurrent miscarriage where no known cause is found have a very good chance of having a successful pregnancy.
Rocky Mountain Fertility Clinic offers extensive infertility treatment for women who are having difficulty conceiving and/or making it through pregnancy. Dr. Deborah Smith has over 20 years experience as a top notch infertility doctor in Colorado, helping women achieve their goals through comprehensive treatment. Call (303) 999-3877 today for more information and scheduling!