Recurrent Pregnancy Loss

Even though miscarriages are considered common, fewer than 5% of women have two consecutive miscarriages. Only one percent have three or more miscarriages, but if a woman has three consecutive miscarriages, she is considered to suffer from recurrent pregnancy loss.

The fact that miscarriages are so common is little consolation for someone who achieves pregnancy only to lose it before 20 weeks. Whether you’ve suffered just one miscarriage or several, you should know that feelings of anxiety and sadness are to be expected but they should be addressed. Most fertility clinics offer counseling services or you can find assistance with online support groups.

Miscarriage risks increase as women age and every one you have increases risk for another. Yet, you should be encouraged by the fact that even after one or two miscarriages, you still have as much as a 70 percent chance of having a successful pregnancy. Even after five miscarriages, your chance of becoming pregnant are still greater than 50%.

Bringing a healthy baby into the world is a miraculous feat when you consider all that can go wrong. In fact, nearly 15 percent of all pregnancies end in miscarriage. As many as 70 percent of miscarriages occur before a woman realizes she is pregnant.

Once a patient in our care has two miscarriages, we initiate an evaluation so that we all can understand what her fertility challenges might be. In about half the cases, that initial evaluation tells us what we need to be addressing to help the patient through a successful delivery. For those whose solution is not so easy to determine, there is still much reason to hope. The factors we look at in cases of several miscarriages include:

Your family history of miscarriages, of birth defects or chromosomal abnormalities
Your mother’s age of menopause (51 years is the average in the US)
Whether you’ve had D & C’s or uterine surgery
Any personal history of thyroid dysfunction or diabetes

The most common causes of miscarriage include:

Genetics—As many as 90 percent of miscarriages can be due to genetic makeup. In these cases, something goes wrong during the first few cell divisions of an embryo. These miscarriages may be nature’s way of preventing a pregnancy that is not developing normally. Much less common is the situation where either parent carries a genetic abnormality that is passed on to the fetus.
Autoimmune--an autoimmune disorder occurs when your body rejects the developing embryo or fetus or something related to them. The most commonly assessed autoimmune causes of miscarriages are Lupus Anticoagulant Antibodies (LAC) and anticardiolin antibodies (ACL).
Hormonal (Endocrine)--Hormonal problems can thwart the development of an embryo. Thyroid dysfunction is a common cause of miscarriages. If your thyroid is either underactive or over-active, pregnancy may be difficult to sustain.
Anatomic—If the uterus is not properly formed recurrent pregnancy losses can occur. One of the most concerning is a uterine septum in which a ridge of tissue runs downs the middle of the uterus. Because it does not have a blood supply this ridge is not a good place for the embryo to implant. If an embryo implants on the ridge, an early miscarriage will occur. Other problems with the uterine cavity may include scars or benign fibroids or polyps.