As reproductive endocrinologists we spend most of our day helping couples achieve the goal of becoming pregnant. Getting pregnant is only half the battle. Unfortunately, experiencing a miscarriage is something that happens more often than you may think. It is estimated that 50% of conceptions result in a miscarriage.
After a miscarriage, it is an emotional and confusing time which is often filled with devastation and heartbreak. Couples want answers. They want to know what went wrong, and most importantly know how they can prevent another miscarriage from happening.
While it is reassuring to know that many couples will go on to deliver a healthy baby, it is important to recognize that there are identifiable risk factors that may contribute to recurrent miscarriages.
While miscarriages are common, only 5% of females will experience two consecutive losses. With 2 or more pregnancy losses, it is then defined as recurrent miscarriage. After 2 miscarriages, the chance for another is 24%; after 3 losses the chance is 30%; after 4 losses the risk of another miscarriage increases to 40-50%; and after 6 losses, the chance for another is 53%. So, your chance for having a live birth with your next pregnancy is always higher unless you have experienced 6 or more miscarriages.
In couples that have recurrent miscarriages, it is important that a thorough work up is done so treatable risk factors can be identified. Often, steps can be taken to decrease the impact of the risk factors. For instance, a couple should be tested for possible inheritable genetic issues. Couples may elect to do IVF (in vitro fertilization) and test the embryos by a process called Preimplantation Genetic Diagnosis (PGD). PGD allows the implantation of genetically normal embryos into the uterus.
Another possible cause could be Antiphospholipid Antibody Syndrome. This is a syndrome that predisposes patients to blood clots and poor pregnancy outcomes. It is diagnosed when specific antibodies are detected in the mom’s blood. For patients who are diagnosed with this syndrome, blood thinners and aspirin are prescribed to decrease the risk of an adverse pregnancy by up to 50%.
The uterus comes in different shapes and sizes and sometimes these differences are the reason for recurrent miscarriage. Certain abnormalities treated through surgical repair and may result in a decreased risk of miscarriage by 50%.
It is important to test for abnormalities in endocrine hormones. Even subtle thyroid diseases, diabetes and insulin resistance, and “older eggs” can contribute to miscarriage.
Miscarriage may leave you feeling alone, sad, or angry. Realize you are not alone! Talk to your doctor about your feelings and find out if a work up is appropriate for you. Don’t be afraid to ask for help.
Summa Health System’s reproductive endocrinology and infertility specialists can offer assistance. Find out more.