Recurrent
Miscarriage

Recurrent miscarriage, also known as recurrent pregnancy loss, is defined as the occurrence of three or more consecutive miscarriages before the 20th week of pregnancy. This condition presents a significant challenge for couples and individuals, necessitating a thorough understanding of its causes and risk factors. Exploring effective medical interventions and treatments is crucial. This page is dedicated to providing precise and expert insights into the etiology, risk factors, and evidence-based medical treatments available for recurrent miscarriage.

The most common cause of pregnancy loss is chromosomal abnormalities, some of which are considered random occurrences, rather than being genetically linked. There’s typically an extra or missing chromosome which may occur by chance as the fertilized egg divides and grows, rather than a genetic disorder inherited from the parents. Other potential causes of recurrent miscarriage include

• Poor egg quality 
• Genetic factors 
• Uterine abnormalities (e.g., a uterine septum, fibroids, endometriosis, and other conditions)
• Autoimmune disorders
• Blood clotting disorders
• Some types of Infections (e.g., sexually transmitted diseases or bacterial vaginosis)
• Hormonal imbalances
• Cervical insufficiency
• Asherman syndrome – a condition that causes the uterus to develop adhesions and scarring

Although the exact cause of recurrent miscarriage can be difficult to determine in some cases, there are several factors known to increase the risk, including:

• Advancing maternal age (causing an increase in chromosomal abnormalities in a person’s eggs)
• Smoking
• Heavy alcohol or drug use before conception and during the earliest stages of pregnancy
• Being under or overweight
• Chronic conditions (e.g., uncontrolled diabetes, high blood pressure, heart disease, polycystic ovary syndrome (PCOS), and thyroid disease)

It’s important to note that these risk factors do not necessarily cause a miscarriage and the lack of risk factors does not guarantee a healthy pregnancy.

There are various options available, depending on the underlying cause of recurrent miscarriage. To find out which options are best for your particular situation, it’s essential to consult with a fertility specialist. Common treatment options include:

• Medication (e.g., hormone supplements, like progesterone, or medication for underlying conditions)
• Lifestyle modification (e.g., avoiding alcohol and illicit drugs, quitting smoking, and maintaining a healthy weight)
• Surgical procedures (e.g., a uterine septum repair of cervical cerclage to reinforce cervical insufficiency)
• Managing chronic conditions (e.g., diabetes or thyroid disorder)
• In-vitro fertilization (IVF) with preimplantation genetic testing to screen embryos for chromosomal abnormalities before transfer, or other forms of assisted reproduction, such as egg donation or surrogacy
• Psychological support and mental health counseling when necessary to provide emotional support and tools for people to more effectively cope with recurrent miscarriage 

Your individual circumstances and any underlying causes identified during the initial diagnostic assessment will determine the right treatment for you.