Recurrent Pregnancy Loss
There is no experience more difficult than having to go through a miscarriage during pregnancy. Miscarriage is not only physically taxing, but very emotionally challenging, as well. Yet, pregnancy loss can be even harder to deal with when it occurs time and time again. Known as recurrent pregnancy loss, repeated miscarriage is difficult for both partners involved. It can also make fertility treatments particularly challenging. However, with appropriate treatment, a successful pregnancy can be achieved.
About Recurrent Pregnancy Loss
Recurrent pregnancy loss occurs when a women loses three or more consecutive pregnancies. Commonly referred to as recurrent miscarriage, the majority of recurrent pregnancy losses occur early in pregnancy, typically during the first or second trimester. Recurrent pregnancy loss is very difficult for couples to experience, especially because a cause for these miscarriages is often never determined. Nevertheless, by undergoing specific fertility testing and treatment, there is hope that couples who have experienced multiple miscarriages will go on to welcome a healthy child of their own.
Is Recurrent Pregnancy Loss Common?
Though miscarriage is a devastating experience, it actually occurs more often than most people know. In fact, more than 25% of all pregnancies end in a first trimester miscarriage, and it is likely that this number is actually much higher. This is because many pregnancies are miscarried before a woman even realizes she is pregnant. True miscarriage rates may be as high as 50% of all pregnancies.
Recurrent miscarriages are much more rare, but they can occur. It is thought that at least 5% of American couples have experienced two consecutive miscarriages, while approximately 3% of couples have experienced three consecutive miscarriages. Fewer than 3% of American couples go through more than three miscarriages in a row.
Who's At Risk For Experiencing Recurrent Pregnancy Loss?
Any couple can experience a recurrent miscarriage; however, there are certain factors that may increase your risk. Risk factors for recurrent miscarriage include:
- History of Previous Miscarriage: While experiencing one previous miscarriage won't increase your risk of recurrent miscarriage, women who have experienced two pregnancy losses are more likely to undergo recurrent pregnancy loss.
- Age: Age often increase your chances for miscarriage. Women who are over the age of 30 are more likely to have a miscarriage, while women over the age of 40 have significantly higher risks.
- Lifestlye: Certain lifestyle factors can also increase your risk of experiencing recurrent miscarriage, particularly smoking, heavy drinking, and drug use.
What Causes Recurrent Pregnancy Loss?
Unfortunately, it is difficult to pinpoint the underlying cause of pregnancy loss. In fact, more than 50% of couples that experience the problem never find out what is responsible for their miscarriages. However, there are a number of conditions that do underlie some cases of recurrent miscarriage.
Blood Clotting Disorders
Blood clotting disorders are believed to contribute to 15% of all recurrent pregnancy losses. These clotting disorders contribute to improper blood flow in the placenta, which means that the growing fetus does not receive the correct amount of oxygen and nutrition to survive. As a result, the fetus is miscarried. Blood clotting disorders are often due to immune disorders, particularly the presence of elevated levels of anticardiolipin antibodies and antiphospholipid antibodies in the bloodstream.
The vast majority of miscarriages can be attributed to genetic problems with the embryo itself. In order for an embryo to develop properly, it needs to contain healthy chromosomes that are organized in the appropriate order. Sometimes, these chromosomes become misshapen or misplaced during embryo development. As a result, the embryo dies early in pregnancy. These unhealthy chromosomes are often passed down from parent to child. It is believed that between 3% and 5% of recurrent miscarriages are due to genetic factors.
In order for your baby to grow and develop properly, your uterus needs to be the proper size and shape. Some women suffer from uterine abnormalities, which can directly impact how an embryo implants and grows. Uterine factors, such as scarring, containing division or being abnormally small, can contribute to multiple miscarriages.
Hormonal imbalance contributes to at least 20% of all recurrent pregnancy losses. Disorders, including PCOS (polycystic ovarian syndrome), often disturb the balance of hormones necessary to maintain a healthy pregnancy. Women experiencing multiple miscarriages often have low levels of progesterone and high levels of luteinizing hormone, which can interfere with pregnancy.
How Do You Treat Recurrent Pre
There is hope for couples who are experiencing recurrent pregnancy loss. There are a variety of diagnostic tests and exams that can be performed in order to determine the underlying cause of miscarriage. Medical treatment can then be pursued in order to increase your chances of healthy pregnancy. The most common treatments include:
- Surgery: If you are suffering from uterine abnormalities such as scarring or uterine divisions, surgery can help to repair your uterus. This can help to ensure better implantation and growth of an embryo.
- Chromosome Analysis: Your health care provider can perform tests on you, you partner, and your fetus to determine if chromosome abnormalities may be contributing to your miscarriages. If chromosomal abnormalities are present, a genetic counselor can advise you on ways to reduce your chances of having a child with a genetic disease or deformity.
- Hormone Therapy: Hormone therapy often helps to restore hormonal imbalances in women suffering from multiple miscarriages. In particular, human chorionic gonadotropin (hCG) can help to increase your chances of carrying a pregnancy to term.
- Anticoagulants: If a blood disorder proves to be contributing to your recurrent miscarriages, anticoagulants can be administered to help improve blood circulation to the placenta. Low-dose aspirin and heparin are both used to treat these blood disorders.