Recurrent Miscarriages: Renewed Hope For A Healthy Pregnancy
There is nothing more incredible than watching the blue line appear on a pregnancy test revealing you are having a baby. For some women, little planning is involved and it can be a shock. For others, it is an absolute miracle, after months, sometimes years, of trying.
Either way, the joy and excitement can turn to heartbreak if the life that has been growing inside of you suddenly ends with a miscarriage. No doubt, you will want to understand why you have lost your baby and if it can be prevented from happening again.
For some women miscarriages happen repeatedly and the heartbreak of recurrent miscarriage is devastating; not only dealing with the emotional roller-coaster, but also having to endure investigations to understand why the pregnancies didn’t make full term.
In this article, we explore why miscarriages occur and what advice and treatment your doctor or consultant can give you to improve your chances of a healthy pregnancy.
How common are miscarriages?
Miscarriages are far more common than people imagine. It is estimated that one in five pregnancies will end in miscarriage1, and some medical professionals would argue one in four. In fact, many miscarriages occur before a woman becomes aware she is pregnant.
‘Recurrent miscarriage’ is a diagnosis given when a woman has had three or more miscarriages in a row2. Women who have experienced this should be offered tests to find the cause, even if they have experienced a successful pregnancy previously.
They might also be offered tests following two early miscarriages if they are in their late 30s or 40s, or have taken a long time to conceive.
As women get older, the chance of miscarrying increases3. From 12% in the mid 20s, this rises to 25% in the late 30s, and over half of all pregnancies end in miscarriage after the age of 40.
But what are the causes and why do some women suffer recurrent miscarriages?
What causes a miscarriage?
There are many reasons why miscarriages occur and unfortunately the causes are not always clear. Sometimes there are no underlying problems. If you have been told that the reason for your miscarriage is unknown, it might be a relief to discover that there are no physical issues with you or your partner, but it is still disheartening to not have the answers you need.
Chromosomal abnormalities is one of the main reasons for miscarriage, and is more common in older mothers. Chromosomes are the genetic structures found within the nucleus of every human cell. They contain our DNA and the features inherited from our ancestors. For around 3-5 out of 100 couples who experience recurrent miscarriages, they are carrying a chromosomal abnormality, and even though it might not affect them, this can be passed on to the foetus4.
Other probable causes include:
- A weak cervix
- Autoimmune factors
- Infections (very rarely)
- Blood conditions such as thrombophilia
- Polycystic ovaries (not a direct cause but an association)
- Diabetes and thyroid problems
- Sperm DNA fragmentation
Taking fate into your own hands
In cases where couples have experienced recurrent miscarriages, additional testing is recommended for women and their partners. These include chromosome analysis, thrombophilia screening, hysteroscopy, immune tests (although not evidence based), thyroid function tests and blood sugar levels for women. Men are also advised to undergo chromosome analysis and DNA fragmentation tests.
When deciding on a clinic, it is vitally important to choose somewhere that offers an all-encompassing service. A clinic that is able to tailor its treatments to suit the needs of the individual, and is open, and therefore accessible, 7 days a week.
Private Pregnancy can recommend a number of top fertility clinics both in the UK and abroad, to support you with your diagnosis and help realise your dream of having a baby. We also have useful articles, including “IVF Success Rates in The UK”. Please take time to browse through the information and your available options.
A holistic approach to fertility problems is absolutely necessary in order to improve the chances of a successful pregnancy. Every aspect of a patient’s lifestyle and health should be investigated to understand the issues before providing appropriate advice and treatment.
These are some of the investigations that your consultant might carry out:
- Screening for genetic problems: karyotyping
- Treatment for aPL antibodies
- Treatment for antinuclear antibodies
- Screening for abnormalities in the structure of your womb
- Screening for infections
- Testing for thrombophilia, both congenital and acquired
- Immune testing
The testing can seem overwhelming. It can also place pressure on your relationship and could leave you questioning whether or not you want to keep trying for a baby. This is why, before you take action it is advisable to consider counselling to help you with your future decisions. Meeting with a trained counsellor is an opportunity to express your frustrations and discuss methods to cope with treatment and outcomes.
Most importantly, recurrent miscarriage needn’t mean that you will never have a baby. Arming yourself with plenty of information, investigating the issues that are causing the problems, and getting the right assistance from professionals will dramatically increase your chances of having a healthy full term pregnancy.
We thank Mr Paul Serhal, Medical Director at the Centre for Reproductive and Genetic Health (CRGH) in London for providing specialist knowledge for this article.
The Centre for Reproductive and Genetic Health (CRGH) consistently delivers top success rates in IVF and other assisted reproductive treatments, making The CRGH one of the best fertility centres in the UK. The centre currently has the highest live birth rate for IVF in London (per embryo transferred), and the largest series of live births from egg freezing treatment in the UK (as recognised by the Human Fertilisation and Embryology Authority). As well as excelling in IVF and egg freezing, The CRGH has the largest donor egg bank in the UK, no patient waiting list for treatment, including the egg recipient program.
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