What causes recurrent miscarriage?
Recurrent miscarriage can be devastating. Sadly, around one in six pregnancies are miscarried, and each miscarriage increases the risk of it happening again. While the exact cause of recurrent miscarriage varies from person to person, scientists may have recently discovered a missing ‘key piece of the miscarriage puzzle’.
While miscarriage research up to now has tended to focus on the embryo, researchers at the University of Warwick and the University Hospitals Coventry and Warwickshire NHS Trust have been studying the womb linings of women experiencing recurrent miscarriage, and have discovered an abnormal process in this tissue which could explain why the problem keeps happening.
Diagnostic testing of this issue and appropriate treatment has now led to healthy births for a number of women previously struggling to carry a pregnancy through to term.
What qualifies as recurrent miscarriage?
“Globally, recurrent pregnancy loss is defined as two consecutive pregnancy losses. However, in the UK we limit the definition of recurrent pregnancy loss to three consecutive losses,” explains Consultant Gynaecologist and Aria fertility expert Ms Srividya Seshadri. Ms Seshadri is widely published on recurrent miscarriage and its causes.
“However, I believe that we need to start investigating after two pregnancy losses because it has a devastating effect on the emotions as well as a physical impact on the individual or couple going through this experience.”
While the recent discovery about abnormal womb lining is undoubtedly important, there are many other reasons for recurrent miscarriage, some of which may be easily resolved without medical intervention. Ms Seshadri defines these as ‘modifiable’ and ‘non-modifiable’ risk factors.
Modifiable risk factors
If you have suffered one or more miscarriages, and are uncertain whether it is appropriate to seek medical advice, the first thing to consider may be your lifestyle, as certain habits can impede your body’s ability to retain a pregnancy. Modifiable risk factors for recurrent pregnancy loss include:
- Smoking
- Alcohol consumption
- Recreational drug use
- A Body Mass Index (BMI) of 30+
If any of these apply to you, then it may be advisable to make some healthy changes to your lifestyle and see if that helps before seeking medical intervention. Ms Seshadri has published a clinical review on prepregancy advice, also called preconception care, in the British Medical Journal.
Non-modifiable risk factors
Sadly, not all fertility issues can be solved by giving up smoking or shedding some pounds. Some non-modifiable risk factors include:
- Thrombophilia – this is an inherited capacity for the blood to over or under clot
- Chromosomal imbalance – this can come from either parent
- Womb abnormalities – as well as the lining issue mentioned above, this could be fibroids, polyps or an unusually shaped uterus that makes it difficult for a foetus to grow
- Uncontrolled diabetes
- Thyroid problems
- Autoimmune disorders
How to treat recurrent miscarriage
Here at Aria, we firmly believe that both parents need to be tested in order to diagnose the reasons behind recurrent miscarriage, so we carry out sperm analysis and sperm DNA fragmentation, as well as ultrasound scans and ovarian reserve tests.
“The final modality of treatment – and I’m delighted to say that The Royal Australian and New Zealand College of Obstetricians and Gynaecologists have suggested that this may be an option – is to proceed with IVF treatment,” comments Ms Seshadri.
“This may seem alarming – recommending IVF treatment for a couple that are trying to conceive naturally, but if one of the main reasons for recurrent pregnancy loss is chronic embryo aneuploidy or chromosomal abnormalities, depending on the mother’s or father’s age, then it would make sense to proceed with IVF treatment and genetic screening of embryos in the laboratory, rather than the uterus rejecting these chromosomal abnormal embryos resulting in pregnancy loss.”
We provide a fully personalised, confidential service to get to the bottom of your fertility problems and tailor a treatment plan that is right for you and your family-to-be. Whether that is lifestyle adaptations and nutritional or hormonal supplements, or IVF treatment, our fertility experts will be there to hold your hand every step of the way.
For more information or to book a consultation, please contact us.