Recurrent pregnancy loss (RPL) or recurrent miscarriage is defined as a consecutive loss of two or more pregnancies. Miscarriages commonly occur in 10-15% of all pregnancies, and it is mostly seen in the first trimester, before 20 weeks. One or two miscarriages do not indicate future infertility. However, recurrent miscarriages leave patients in anxiety and question their ability to have a healthy pregnancy.
More than 50% of the couples will give birth to healthy children even after losing two pregnancies. However, please take a close look at recurrent miscarriages, and it’s possible causes.

Types Of Miscarriage:

There were many reasons for miscarriage, and they are classified into early and late miscarriages.

Recurrent early miscarriages: They occur within the first trimester, which is mostly caused due to genetic or chromosomal problems. Experts say that structural issues associated with the uterus might also play a part in early miscarriages.

Recurrent late miscarriage: They might be a result of uterine abnormalities, autoimmune disorders, a disorganized cervix, or premature labor.

Causes Of Recurrent Miscarriages or Pregnancy Loss

Many factors can contribute to recurrent miscarriage. Most pregnancy losses might be due to chromosomal abnormalities. However, doctors may not find out possible reasons always. But they can help you in many ways and remember most couples have had a good chance of having a baby even after recurrent miscarriages.

Genetic: Abnormalities of the embryo’s chromosomes is one most common cause of recurrent miscarriages, and 50-80% of miscarriages happen in the first trimester.

Uterine abnormalities: Around 15% of all recurrent miscarriages are caused due to structural problems of uterine. These uterus abnormalities are something like you’re born with, i.e., congenital abnormalities or birth defects such as the abnormally shaped uterus. Growth of Fibroids or polyps within the uterus in some women might show an effect on pregnancy.

Hormonal disorders: Endocrine abnormalities that warrant research include diseases associated with thyroid and pituitary glands, diabetic problems, or PCOS (polycystic ovarian syndrome).

Autoimmune diseases: Antiphospholipid syndrome (APS) is an autoimmune disorder that is defined by blood clots in the arteries or veins that can lead to multiple pregnancy losses or premature birth due to placental abnormalities.

Medical conditions: Medical conditions that are not treated like insulin resistance and hypothyroidism can increase the risk of pregnancy loss and poor obstetric outcomes.

Infections: It is believed that infections are unlikely to cause miscarriages and that too multiple pregnancy losses. However, some suspected infectious causes that lead to miscarriages are bacteria mycoplasma, ureaplasma, and Chlamydia.

Cervical weakness: If you are having a history of late miscarriages, then you may be at risk of cervical weakness, also called cervical incompetence. You may need to undergo scanning from 14 weeks to evaluate your cervix length. Depending on your test and pregnancy, you might be recommended to have a cervical stitch before pregnancy or during pregnancy.

Woman of age over 35 years and the man is over 40; then those couples are at the highest risk of miscarriage. Some experts also say that natural killer cells present in a woman’s uterus might play a role in infertility and these miscarriages.

Diagnosis Of Recurrent Miscarriages or Pregnancy Loss

  • Karyotype blood tests are performed for the couples to rule out chromosomal abnormalities.
  • Evaluation of your uterus, ovaries, and fallopian tubes is performed by vaginal ultrasound to rule out congenital or acquired abnormalities.
  • Hysterosalpingogram to evaluate the shape of the inside of your uterus and fallopian tubes.
  • Blood tests to evaluate the hormone levels of prolactin, thyroid, and progesterone to eliminate possible immunologic factors that cause miscarriages.
  • Endometrial biopsy is performed to determine whether an infection is preventing the progress of your pregnancy.
  • Women experiencing miscarriages should be screened for diabetes mellitus.
  • Sperm DNA fragmentation testing determines the quality of sperm and DNA fragmentation, which might play a role in pregnancy loss.
  • Ovarian reserve testing – evaluating the quantity and quality of the egg.

Treatment For Recurrent Miscarriages or Pregnancy Loss

The treatment for recurrent miscarriages depends upon the laboratory tests and cause of miscarriage. One of the couples carrying chromosomal abnormality is often referred for genetic counseling to discuss the possibilities of a viable pregnancy. In vitro fertilization (IVF) with PGD – preimplantation genetic diagnosis might also be done.

Women with a uterine septum(extra tissue), scar tissues, and uterine fibroids can be treated surgically, which helps to reduce the risk of miscarriage. You can also increase your odds of a successful pregnancy by following some simple steps such as taking folic acid, quitting smoking, limit your caffeine intake and screen for STDs, etc.

Having pregnancy loss can be overwhelming, but the repeated loss of pregnancy is a very traumatic experience. If you lost your pregnancy three or more times in a row, you should consult a specialist who can treat recurrent miscarriages. They will perform the necessary tests to find a possible reason and suggest treatment accordingly. If you are having any doubts or experiencing miscarriages, don’t hesitate to consult our experts at Angels Fertility Clinic in Hyderabad.