Recurrent Pregnancy Loss
Women who have had three or more miscarriages may be experiencing a condition known as recurrent pregnancy loss, a troubling diagnosis that presents both physical and emotional concerns for couples. The exact cause of a miscarriage is not always known, however, most miscarriages that occur in the first trimester of pregnancy are often caused by chromosomal abnormalities in the fetus. While most cases of miscarriage are isolated occurrences, multiple miscarriages may be due to other underlying physical factors.
Causes of Recurrent Pregnancy Loss
While early-term miscarriages may be caused by chromosomal abnormalities, these type of genetic problems happen by chance, and there is no specific medical condition that causes them. Multiple miscarriages and recurrent pregnancy loss may be caused by other factors that may include:
- Hormonal imbalances
- Abnormal uterine shape
- Blood clotting disorders
- Incompetent cervix
- Exposure to environmental toxins
- Diabetes mellitus
- Polycystic ovary syndrome
- Immune system disorders
- Thyroid disease
Lifestyle factors such as smoking, and alcohol and drug use may contribute to recurrent pregnancy loss. In addition, women may be at increased risk for miscarriage as they get older, as women over the age of 40 have an increased risk of of chromosomal abnormalities that may lead to miscarriage.
Evaluation of Recurrent Pregnancy Loss
After multiple miscarriages, a woman may be evaluated by her doctor to determine the cause for recurrent pregnancy loss. A physical examination will be performed as well as a full medical history review. Tests for recurrent pregnancy loss may include an evaluation of the uterine cavity through either a hysterosalpingogram or sonohystogram and blood tests to identify chromosome abnormalities, hormone levels or other blood related risk factors. Genetic testing may also be performed to help detect any genetic causes for recurrent pregnancy loss.
Recurrent Pregnancy Loss Treatment
Recurrent pregnancy loss can be emotionally upsetting and frustrating, especially when the exact cause is not known. Treatment is available and is especially effective when the cause of recurrent pregnancy loss can be identified. Treatments may vary based on the cause of past pregnancy loss, but the common goal is to assist in a successful pregnancy. Treatments may include:
- Pre-implantation genetic diagnosis
- In vitro fertilization
- Ovulation induction
- Hormone treatments
- Surgical corrections for fibroids, polyps or other physical abnormalities in the uterus
- Medications for blood clots
Other recommendations may include decreasing stress, quitting smoking, avoiding alcohol,and taking folic acid supplements. In many cases, even if the cause of past pregnancy loss remains unexplained, treatment results in a successful pregnancy. The patient should discuss all fertility treatment options with their doctor in order to determine the best approach for a successful pregnancy in the future.