Recurrent miscarriage is that when you miscarry more than three times consecutively. It is a devastating experience. Recurrent miscarriage affects 1% of all couples who are trying for a baby. There are a number of risk factors involved in this condition. They include medical conditions of the uterus, hormonal factors, infections etc. However, the exact cause may not be identified in many cases. If the cause is identified, proper treatment should be done to remedy the situation so that you do not suffer from miscarriages in future. You need to have a complete medical checkup before you try for another baby and follow the instructions of your health care provider as closely as possible.
While miscarriage occurs in 15% to 20% or pregnancies, recurrent miscarriage is noted in 1% of all couples trying to conceive. If you miscarry three times in a row, this is called recurrent miscarriage. Recurrent miscarriage symptoms can develop in women who have previously given birth successfully. One or two miscarriage is not thought to be medically significant, but if you have three miscarriages, your doctor will conduct a number of tests to determine what the problem is and how to remedy it.
Causes of recurrent miscarriage
There are various causes leading to recurrent miscarriage. Some of these are as follows:
- The most common cause is known as anti phospholipids syndrome (APS). These are antibodies manufactured by your immune system and they attack the fats in your body. They prevent the embryo from becoming embedded in the uterus wall and is also thought to interfere with the blood supply to the womb. As a result, miscarriages occur.
- Genetic causes account for a large number of recurrent miscarriages. Chromosomal errors are generally caused after the egg is fertilized. It is not an inherited trait from the parents. The abnormal chromosome causes the abortion. This situation is commonly observed if the parents are older than thirty five or forty years of age. In very few cases, one of the parents may have a chromosomal defect which does not affect the parent but may have an adverse reaction in case of the fetus.
- In some cases, recurrent miscarriage may occur due to abnormal shape of the uterus and the cervix of the woman. You may have double uterus or only half of the uterus has developed. In cases of such abnormalities, the cervix dilates too early and leads to miscarriages.
- Women with polycystic ovarian syndrome are more likely to experience recurrent miscarriage.
- Autoimmune disorders like lupus may also cause this condition.
- Uncontrolled diabetes, serious thyroid problems, infections like rubella, bacterial Vaginosis etc increase the risks of recurrent miscarriage.
- Recent studies suggest that certain deformities in the sperm can also lead to repeated miscarriages.
However, in many cases, the actual cause of recurrent miscarriage cannot be identified. The issue is even more complicated by the fact that each of the miscarriages may be caused by a different factor.
Treatment for recurrent miscarriages
If repeated tests fail to determine the cause of recurrent miscarriage, then it will not be possible to choose a viable treatment. However, if the medical cause is identified, proper treatment is necessary to remedy the situation to ensure that you can carry your baby to term. The treatment will therefore depend on the cause of the recurrent miscarriage in your case.
Some treatments used for recurrent miscarriage are as follows:
- If APS is seen to be the culprit, treatment with low doses of aspirin and heparin has been seen to increase the rate of live birth to 70%.
- Some treatment has been tried with progesterone, but the project is still ongoing to understand the effectiveness of this treatment.
- If the problem is that the cervix dilates too early, a cervical stitch may be inserted in the end of first trimester and removed at the end of the pregnancy. However, there is no data to suggest how helpful this step may be.
- New experimental treatments using immunotherapy, steroids HCG supplements are now being tried, but no clinical evidence are yet available to support these management strategies.