About 1 in 4 pregnancies end in miscarriage. And if we count recurrent chemical pregnancies -- those that have not yet been detected on a pregnancy test -- as many as 75% of fertilized eggs never become an embryo. Many women worry that a single miscarriage means they'll have another miscarriage. In reality, one miscarriage doesn't increase your odds of subsequent miscarriages, but the odds of another miscarriage slightly increase after two miscarriages, and greatly increase after three.
There is perhaps nothing more heartbreaking than hoping for a baby, getting excited about a positive test, forming a bond with your baby and planning for the future, only to suddenly lose the child you longed for. Many people don't understand the pain of a miscarriage. But no matter how early you lost your pregnancy, that was your baby; you have a right to grieve.
The Center of Reproductive Medicine will honor your losses and your feelings. We also understand that recurrent miscarriage is a serious medical issue. We don't want to see you continue to suffer, so let us help you figure out what's behind these recurrent miscarriages.
What Causes Miscarriages?
Most miscarriages are caused by genetic abnormalities in the developing embryo that would have made it impossible for the baby to live a normal life. This is nature's way of preventing serious defects from making their way into the gene pool, so take heart; the miscarriage is not your fault, and there is nothing you could have done to prevent it.
After you have a miscarriage, particularly if the miscarriage is later on in the first trimester, you may be able to request genetic testing of the embryo. Your doctor may also conduct tests on you to evaluate whether an infection or some other issue contributed to the miscarriage.
Understanding Recurrent Miscarriage
Because miscarriages are so common, doctors won't diagnose a woman with recurrent miscarriage until she has had three or more miscarriages in a row. When this happens, it suggests a chronic issue -- not a one-time genetic anomaly -- is at play.
Understanding what's behind recurrent miscarriage is not always easy. That's why it's so important to partner with a fertility specialist, since your regular doctor may not have the skill or experience necessary to properly diagnose or treat your condition.
So what's behind recurrent miscarriage? Some common issues include:
- Hormonal imbalances; if your body does not produce enough progesterone, you won't be able to sustain the pregnancy. Thyroid disorders, some cancers, some chronic illnesses, and a host of other issues can throw your hormones out of whack.
- Autoimmune disorders; sometimes your body attacks the embryo as if it is a foreign invader.
- Maternal medical conditions; some issues may produce mutations in the egg that cause genetic defects.
- Advanced maternal or paternal age; older women and men are more likely to produce sperm and eggs that contain genetic defects, increasing the odds of repeat miscarriages.
- Uterine abnormalities; issues with the blood supply to your uterus, growths in the uterus, or problems with your uterine lining can interfere with your ability to sustain a pregnancy.
- Lifestyle issues; you don't have to have a perfectly healthy life to get or remain pregnant. But if you use drugs or alcohol to excess -- particularly if you have another risk factor, such as advanced age -- you may suffer from repeat miscarriages.
- Blood clotting disorders.
- Some medications, particularly immunosuppressants, chemotherapy, and medications that affect the functioning of your endocrine system.
Rarely, recurrent miscarriage is just a fluke. Some women have three or more miscarriages, but then go onto have a successful pregnancy. Sadly, this outcome is relatively rare. Moreover, miscarriages can be difficult on your body. You might not ovulate for several months after a miscarriage. Your hormones may be thrown out of balance. And rarely, a miscarriage can leave behind scar tissue or cause structural damage. So if you've suffered recurrent miscarriages, don't force yourself to continue suffering. Seek the expert insight of a fertility specialist.
Solutions for Recurrent Miscarriage
The solutions for recurrent miscarriage are as diverse as the women who experience this heartbreaking issue. Treatment begins with a comprehensive workup that may include lab work, tracking your menstrual cycles, a detailed medical history, and scans of your reproductive organs to assess the cause. From there, treatment options may include:
- Lifestyle changes such as weight loss, eliminating alcohol, or quitting drugs.
- Hormonal treatments before or after you get pregnant.
- Medications to treat endocrine disorders.
- Antibiotics and other treatments for infections or chronic health conditions.
- In vitro fertilization: when the cause is unclear, or when there is no immediate treatment for the cause, this approach may be best. In vitro fertilization allows your doctor to select a quality egg, fertilize it outside of your body, then implant the embryo directly into your uterus, thereby circumventing a number of the issues that lead to recurrent miscarriages.
- Surgery to remove scar tissue or address structure abnormalities.