13 Apr Possible Causes of Recurrent Miscarriage
While statistics may say that approximately one-in-five (20%) or more pregnancies end in miscarriage, that’s no consolation for women who have experienced the grief of a pregnancy loss. That grief and personal devastation is compounded when miscarriages occur one after the other – called recurrent miscarriage or recurrent pregnancy loss.
First and foremost, you need to take gentle care of your emotional wellbeing, so make sure you’re getting the infertility support you need. Then, it’s time to identify the possible causes of your recurrent miscarriage.
Recurrent Miscarriages Should Be Evaluated by a Fertility Specialist
Recurrent miscarriage indicates that there is some kind of glitch in the reproductive system, and it takes expert investigation to find the cause. Once you’ve had three or more miscarriages in succession, it’s time to find a fertility specialist to figure out the potential cause(s).
Here are some of the most common reasons your body is struggling to have a healthy full-term pregnancy:
The body tries its best to ensure all pregnancies are full-term and result in the birth of a healthy baby. When it notices any type of anomaly, like chromosomal/genetic abnormalities or erroneous cell division, it will shed the uterine lining in an effort to begin anew.
These abnormalities can occur for a few different reasons:
- You and/or your husband carry a chromosomal/genetic abnormality (genetic testing should verify whether or not this is the case)
- There are issues with sperm quality (sperm analysis determines whether sperm are a factor)
- There are issues with egg quality (we can’t test directly for egg quality yet, but maternal age is certainly a factor here, as is medical/treatment history.
In all of the above cases, we can speak to you about options such as sperm or egg donation, or using a donor embryo, which immediately corrects the genetic or sperm/egg quality issue.
Hormone imbalance or thyroid issues
Any undiagnosed or underlying medical condition can disrupt a pregnancy. However, two of the most common are hormone imbalances and thyroid issues. Disruptions in your fertility hormone balance can prevent an embryo from remaining implanted. Examples include elevated prolactin or low levels of progesterone. Thyroid or adrenal malfunctions can also play a negative role in fertility cycles.
These will all be evaluated and tested for by your physician.
Fibroid tumors (non-cancerous masses in the uterus/uterine lining) are interesting. Some women have horrendous symptoms with tumors that don’t affect fertility, some women have zero to very mild symptoms with tumors that compromise fertility. High-quality imaging is the only way to tell whether these masses are compromising the implanted embryo from “staying the course” or preventing it from developing fully.
When they impact certain regions of the uterine lining or cavity, fibroid tumors can complicate things, but careful surgery to remove them may make the uterus a more welcoming place for the next fertilized egg to call home.
Similarly, uterine abnormalities can have the same effect as fibroids, compromising everything from a fertilized egg from being able to attach correctly, being undernourished by a weak lining or to preventing your embryo from being able to grow properly.
Any anatomical abnormalities in the uterus is evidenced by infertility testing, using a combination of ultrasound imaging as well as a test called a hysterosalpingogram, which helps to illuminate any anatomical issues or blockages in the uterus and fallopian tubes.
If you’re diagnosed with uterine abnormalities surgical treatment may be an option, or your fertility specialist may recommend using a gestational carrier.
Maternal age and/or egg quality
We mentioned this in the section above about genetic/chromosomal abnormalities, but maternal age and/or egg quality are a factor. The older you are, the more likely your eggs are to have diminished quality as a result of fragmenting/breakdowns of the DNA.
Also, women who have had medical treatments that compromise the eggs (chemotherapy, radiation, certain medications, etc.) or women with a history of alcohol/drug addiction or unhealthy lifestyle choices are at higher risk for compromised egg quality.
If egg quality is an issue, your doctor may recommend considering an egg donor.
Overzealous immune system
Sometimes the woman’s immune system is the issue. A “healthy” immune system can mistakenly interpret everything as a “foreign invader,” and attack. Unfortunately, this suspected “invader” can include your partner’s sperm, a fertilized egg, or an implanted embryo.
Immunology is a newer frontier in the world of fertility treatments, but once immune system issues are identified as a potential, there are promising treatments in this realm that you can discuss with your doctor.
Testing Miscarriage Material Provides Important Information
When we meet with women or couples experiencing recurrent miscarriage, we remind them that the good news is that they’re able to get pregnant. For many of our patients, conception is the struggle. In your case, conception is happening as it should (hurray) but something else is getting in the way of the next steps.
We highly recommend you capture as much of the miscarried material as you can so you can bring it to us or the lab for analysis. This is no easy feat, and we absolutely understand what tender and excruciating process that can be for many women. However, the ability to test the miscarried tissue can provide valuable clues that point us in the right direction as we work to find the best fertility treatment for you.
Are you looking for answers about the causes of your recurrent miscarriages? Please schedule a consultation with us here at Virginia Fertility & IVF. Our compassionate team of fertility specialists are dedicated to finding solutions.