Recurrent Pregnancy Loss
The loss of a pregnancy through miscarriage can be traumatic and extremely distressing. About 5% of couples will experience two or more pregnancy losses, while 1% will experience three or more losses. Though the exact definition of recurrent pregnancy loss differs between international professional bodies, the most recent consensus has defined it as two or more pregnancy losses prior to 24 weeks of gestation with the same partner.
Though the causes of recurrent miscarriage are not always clear, if you have experienced two or more consecutive pregnancy losses, a fertility specialist with an interested in recurrent pregnancy loss can help you to overcome these challenges towards growing your family.
Causes of Recurrent Miscarriage
Roughly half of recurrent miscarriages have no known underlying cause. This can be frustrating but it may still be possible to have children through natural conception or assisted reproductive technologies (ARTs) such as IVF.
For cases where a reason can be identified, the most common causes of recurrent miscarriage are:
- Genetic anomalies, where abnormal chromosomes are passed from the parent(s) to the embryo, leading to an increased risk of miscarriage
- Abnormalities of the uterus, such as fibroids, polyps, or adhesions, or a condition known as a septate uterus
- Hormonal imbalances, including from conditions such as PCOS, diabetes, and thyroid disease
- Other medical concerns such as antiphospholipid syndrome, blood clotting disorders, and severe infections
Over half of recurrent miscarriages with an identifiable cause will be related to chromosomal abnormalities. The rate of miscarriage increases with the age of both you and your partner, as genetic faults in eggs and sperm become more prevalent with older age. This is something that can be tested and addressed through the use of IVF with preimplantation genetic testing.
Certain lifestyle choices for both you and your partner can impact your risk of experiencing a miscarriage. Both men and women can contribute to a healthy pregnancy through:
- Avoiding smoking, alcohol, and recreational drugs
- Maintaining a healthy body weight
- Eating a well-balanced diet
- Limiting caffeine intake
- Engaging in regular moderate-intensity exercise
Treatment for Recurrent Miscarriage
Effective management of recurrent miscarriage relies on identifying the underlying cause. Your fertility specialist will organise certain tests, such as medical imaging, blood tests, and genetic testing to help identify what factors may be interfering with a healthy pregnancy.
Abnormalities of the uterus may be addressed with surgery, while you may be prescribed medications to manage other contributing conditions such as uncontrolled diabetes or blood clotting disorders.
If your recurrent pregnancy losses have no identifiable cause, your fertility specialist may recommend progesterone, low-dose aspirin, or heparin, which have been demonstrated to have the potential to decrease the risk of miscarriage.
Recurrent Miscarriage and IVF
It is not uncommon for couples who have experienced multiple pregnancy losses to go on and naturally conceive a healthy baby. However, in consultation with your fertility specialist, you may choose to pursue a pregnancy through IVF.
Because of the contribution of genetic abnormalities to recurrent miscarriage, you may be recommended to undergo preimplantation genetic testing as part of your IVF process. Preimplantation genetic testing involves assessing embryos for chromosomal issues before deciding whether to transfer them to the patient’s womb. This method helps select embryos with the best potential for a healthy, live birth.