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By definition, recurrent miscarriages (also known as recurrent pregnancy loss) is the loss of two or more pregnancies. A single miscarriage may be devastating for hopeful parents-to-be, and this emotional toll usually increases as more losses occur.

After a woman experiences a miscarriage, many questions tend to swim through her mind. “Why did this happen to me? Will it happen again? Am I to blame?” Despite trying to stay logical and level-headed, many women are left feeling a combination of sad, guilty, angry, and hopeless.

The most common cause of miscarriages is genetics; that is, something went awry during development when the egg or sperm were formed, or when fertilization occurred. Usually this is because the incorrect number of chromosomes were present at the time of development. This actually accounts for about 60 percent of miscarriages, but becomes more common as a woman (and her eggs) get older.

For the most part, the chance that a woman who has had a miscarriage will have another is about 1 percent. That number increases, however, if the reason for the miscarriage was a different type of genetic problem called a translocation. This is when a woman’s eggs or a man’s sperm have an extra or a missing piece on a certain chromosome. This can be detected by testing the chromosomes of the parents.

Not all miscarriages are related to these genetic problems, however. Others may be caused by medical conditions such as immune disorders that make a woman prone to blood clots, such as antiphospholipid syndrome. Problems with diabetes and thyroid disorders can also cause pregnancy loss.

Unfortunately, most of the time (up to 75 percent) a reason for repeated miscarriages cannot be discovered. Things that are often done to try to find a diagnosis include going through a thorough medical history, physical exam, blood tests, and genetic testing (both for the parents and the pregnancy tissue). An ultrasound or other imaging may also be done to see if the shape of the uterus may be part of the problem as well.

Treatment for recurrent pregnancy loss depends on what may be causing it. Some women may need surgery to correct the shape of their uterus, while others may be placed on blood thinners if antiphospholipid syndrome is present. Fertility treatments, such as in vitro fertilization, or the use of donor eggs, sperm, or a gestational carrier may also be part of the treatment plan.

Overall, about 65 percent of women go on to have healthy babies after experiencing recurrent pregnancy loss. It is important that throughout this process women (and their partners) get the support they need, since so many times they blame themselves or have to deal with well-meaning but unhelpful advice from families and friends.

Takeaways

  • Recurrent pregnancy loss is the loss of two or more pregnancies.
  • More than half the time, a cause is not found.
  • The most common reason for recurrent pregnancy loss is a genetic or chromosomal problem.
  • It is important to have good emotional support while dealing with recurrent miscarriages.

References

  1. The American Congress of Obstetricians and Gynecologists. FAQ 100: Repeated miscarriages. May 2016.

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