Recurrent Pregnancy Loss

What is recurrent pregnancy loss? Learn what it is and the treatment options that may be available for you.

During the early weeks of pregnancy, many women experience a miscarriage, or pregnancy loss. In fact, between 10 to 15 percent of all pregnancies end in miscarriage. Recurrent pregnancy loss is a condition defined as two or more failed pregnancies. The good news is that about two out of three women who experience recurrent pregnancy loss will have a healthy pregnancy without treatment.

What causes recurrent pregnancy loss?

In about 60 percent of the cases, recurrent pregnancy loss occurs as a result of chromosomal abnormality. Every person has 23 pairs of chromosomes in their bodies, for a total of 46. Each pair has a chromosome from the mother and one from the father. Most abnormalities occur when there are not enough chromosomes — or there are too many. This can occur randomly, but the chances increase with advanced age of the mother.

Other cases of recurrent pregnancy loss include genetic issues, problems with the structure of the reproductive organs or other medical conditions.

When should I contact a specialist?

If you have had two or more miscarriages, it is recommended that you talk with a reproductive endocrinologist who is board certified fertility specialist. He or she may ask you about your health and pregnancy history, perform a physical exam and blood testing to help identify the cause. Based on your situation, your doctor may recommend certain treatments.

What treatments are available for recurrent pregnancy loss?

There are various treatment options available. Discuss with your fertility specialist to determine if one of these treatments may be right for you

Genetic screening with blood testing. The fertility specialist can identify if a person has too few or too many chromosomes or a chromosomal issue called translocation. This occurs when chromosomes are rearranged or a piece of one chromosome is transferred to another. Translocation and other chromosomal issues can affect a fetus, which can lead to miscarriage.
Surgery. This may be recommended if there are structural issues with the uterus such as having a septate (divided) or bicornuate (heart-shaped) uterus. Surgery may also be suggested for a woman who has scar tissue or fibroids. Fibroids are benign tumors that can interfere with implantation or block the fallopian tubes and hinder the fertilized egg from reaching the uterus.
Blood-thinning medications. Issues with clotting or a woman’s autoimmune system can contribute to miscarriage. For women who have these issues, a fertility specialist may recommend low-dose aspirin or other blood-thinning medications. It is important to talk with your doctor before taking these medications, as they can cause bleeding problems.
Lifestyle changes. Making healthy choices and taking care of yourself is important, especially when you are pregnant. Many lifestyle factors can affect a woman’s chances of having a miscarriage, including smoking and the use of drugs, alcohol and caffeine. It is also important to maintain a healthy weight, as being overweight may contribute to an increased risk of miscarriage. Talk to your doctor or fertility nurse if you need help making healthy changes.
Treatment for other issues. Some health issues may contribute to miscarriages. Conditions such as diabetes, thyroid disease and elevated prolactin (a type of hormone) levels should be treated to provide the best chance at having a healthy pregnancy.

By Kristin Nelson, Contributing Writer

Sources

March of Dimes. Miscarriage. Accessed May 3, 2017.
Resolve. Multiple miscarriage. Accessed May 3, 2017.
American College of Obstetricians and Gynecologists. Repeated miscarriages. Accessed May 3, 2017.
American Society for Reproductive Medicine. ReproductiveFacts.org. Treatment of recurrent pregnancy loss. Accessed May 3, 2017.

Last Updated: July 19, 2017