Recurrent Pregnancy Loss
Miscarriage is a genuine concern for all expectant parents, but it is of particular concern for those who have experienced recurrent pregnancy losses. Many men and women have great difficulties carrying a pregnancy to term, and, if you have suffered repeated losses, you may be wondering if you will ever welcome a baby into your arms. Here is some information on the causes of recurrent pregnancy loss and treatment methods that may help you overcome recurrent miscarriage.
What is Recurrent Pregnancy Loss?
Recurrent pregnancy loss is defined as the loss of three or more pregnancies in a row. These miscarriages generally occur during the first or second trimester, before the 20th week of pregnancy. Also known as recurrent miscarriage, recurrent pregnancy loss is an extremely emotional and challenging experience to go through. It can be especially difficult for some couples to deal with miscarriage, as the cause of recurrent pregnancy loss is often never discovered. With the help of diagnostic testing and treatment, however, it is possible for couples suffering from recurrent miscarriage to go on to have a healthy child.
How Common Is Recurrent Pregnancy Loss?
Though many people don’t realize it, miscarriage is actually a fairly common occurrence during pregnancy. In fact, 25% of all pregnancies end in miscarriage in the first trimester. Many researchers theorize that the number of single miscarriages is actually much higher – around 50% - because numerous women don’t even know that they are pregnant when it happens. Most women who experience single miscarriages go on to have healthy pregnancies.
Recurrent pregnancy losses are more rare, but they do happen. In fact, approximately 5% of couples experience two miscarriages in a row, while about 3% of couples experience three miscarriages in a row. Less than 2% of couples experience more than 3 consecutive miscarriages.
Risk Factors for Recurrent Pregnancy Loss
Though any woman can experience recurrent miscarriage, certain factors do increase your chances of experiencing multiple losses. These factors include:
- Age: As a woman grows older, her chances of experience a miscarriage increase. Your risk rises steadily after the age of 30 and even more quickly after the age of 40.
- Lifestyle: Women who smoke, drink a lot of alcohol, or take drugs are more likely to experience recurrent miscarriage.
- Previous Miscarriage: Women who have already experienced two previous miscarriages are more likely to experience recurrent pregnancy loss.
Causes of Recurrent Pregnancy Loss
Unfortunately, 50% of couples experiencing recurrent pregnancy loss never find out the cause of their miscarriages. Yet, some apparent causes of recurrent pregnancy loss have been identified.
The most common cause of single miscarriages is genetic abnormalities in the embryo. Such abnormalities also appear to play a role in between 3% and 5% of recurrent miscarriages. Many embryos that are conceived contain the wrong number of chromosomes or chromosomes that are arranged in the wrong order. This makes it impossible for the embryo to live, so the body aborts the pregnancy. Some of these chromosomal problems are passed down from the mother or father to the child.
Sometimes the shape or size of the uterus can impede upon the implantation of an embryo or prevent proper growth and development. Women with a particularly scarred uterus or divisions within the uterus can experience recurrent miscarriage. Structural abnormalities are thought to contribute to at least 2% of all cases of recurrent pregnancy loss.
Hormonal imbalances are believed to play a role in at least 20% of recurrent pregnancy losses. Many women suffer from disorders such as PCOS (polycystic ovarian syndrome), which disturbs the natural balance of hormones needed to ensure a healthy pregnancy. Women with high levels of luteinizing hormone and low levels of progesterone often experience recurrent pregnancy loss.
Blood Clotting Disorders
Blood clotting disorders appear to play a role in 15% of all cases of recurrent miscarriage. Blood clotting disorders prevent the placenta from getting a proper blood supply during pregnancy, causing the fetus to die. This is often due to the presence of high levels of antiphospholipid antibodies (APA) and anticardiolipin antibodies
Treating Recurrent Miscarriage
It is possible to treat to recurrent miscarriage. There are a number of diagnostic tests that can be done to find out the cause of your recurrent pregnancy loss. There are also certain medical treatments that can be undertaken in order to increase your chances of having a full-term pregnancy. Treatment may include:
- Chromosome Analysis: Chromosome analysis can be performed on you, your partner, and your fetus to determine if there are any genetic abnormalities present. A genetic counselor can then guide you and offer advice on ways to reduce the chances of having a child with a genetic deformity.
- Surgery: There are surgical procedures available to help reduce scarring in the uterus or to open up the uterus if it is divided.
- Anticoagulants: If a blood disorder is contributing to recurrent miscarriage, baby aspirin and heparin treatment can help to thin the blood, to prevent it from clotting.
- Hormone Therapy: Hormone therapy, including the use of human chorionic gonadotropin (hCG) often helps women with hormone disorders to carry a pregnancy to term.