If you have suffered from recurrent miscarriage, you know how heartbreaking the loss of a pregnancy can be. You may be wondering what the possible cause of your losses may be and how you can prevent them from happening again in the future. Unfortunately, many pregnant women experience recurrent miscarriages, which is considered two or more consecutive miscarriages. There can be many possible causes of recurrent miscarriage at this stage in pregnancy. In this blog post, we will discuss some of the most common causes of recurrent miscarriage at 6 weeks or later. We hope that this information will help you find the answers you are looking for, and that it will help you take steps to improve your health and increase your chances of having a successful pregnancy.
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What Is Recurrent Miscarriage?
Recurrent miscarriage, also known as recurrent pregnancy loss (RPL), is defined as two or more consecutive miscarriages occurring before 20 weeks gestation. Most miscarriages occur during the first trimester of pregnancy, but many also can occur in the second trimester. It is estimated to affect between 1-5% of couples trying to conceive and can cause a lot of anxiety, grief and confusion. Miscarriages may be called different things, including a missed miscarriage, a spontaneous miscarriage, or a spontaneous abortion.
Doctors will not usually do any additional type of testing until you have had three or more consecutive pregnancy losses of the same type. Some doctors do not take the early miscarriages seriously because they are so common. The miscarriage rate is estimated to be around 1 in 4 pregnancies end in loss in the United States. Some healthcare providers treat them as just “bad luck” or something unlikely to happen again. If your doctor is dismissive of your history of recurrent miscarriage, please advocate for yourself and ask for what you need. You can swtich doctors if you need to in order to make sure you are getting the treatment and the answers you deserve. The loss of pregnancy should be taken seriously, regardless of how far along you were.
Common Causes Of Recurrent Miscarriage
1. Chromosomal Abnormalities
Chromosomal abnormalities, such as aneuploidy or trisomy, are a common cause of recurrent pregnancy loss. An aneuploidy is an abnormal number of chromosomes or a problem with the structure of chromosomes. It can happen with both the mother’s egg or the male partner’s sperm. Aneuploidy can lead to miscarriages at any stage in pregnancy, but it is more common in the early weeks of pregnancy. Other common genetic abnormalities include Turner’s Syndrome and Fragile X Syndrome.
If you lose a pregnancy due to a genetic abnormality, you can have testing and genetic counseling done to determine if you are a carrier for that particular condition or if it was more likely a random occurrence. If you are far enough along in gestational age, a doctor can test the baby to see if there was a chromosomal issue. Doctors may use the terms “pregnancy tissue”, “genetic material”, or “products of conception” to describe your baby. These terms can be very hard to hear as it sometimes feels like the doctor is not treating it as your baby. Remember, you can respectfully request they use different terminology when talking to you about your baby and your pregnancy loss.
If you do receive a genetic diagnosis and it is determined you are a carrier, your doctor should be able to give you more information about next steps. They will also be able to tell you the chances of conceiving another baby with that same genetic condition.
2. Immunological causes
Immunological causes are another possible cause of recurrent miscarriage. Your body and immune system may produce antibodies that attack its own tissues and organs, including the placenta. This can lead to miscarriage because the developing fetus is unable to develop properly due to a lack of nutrient supply from the placenta. The causes of this condition are not fully understood, but it is believed to be due to an abnormal response of the immune system. Treatment options can include steroids and other immunosuppressant medications.
3. Uterine causes
A uterine problem is another possible cause of early pregnancy loss. Uterine causes include uterine abnormalities, such as uterine fibroids, a septate uterus, or polyps. These can interfere with the normal development and growth of the embryo, leading to first trimester miscarriages.
A uterine septum is a condition where the uterus is divided into two separate cavities by a wall of tissue. This causes difficulty with implantation, as the embryo may not be able to reach the endometrium and attach properly. Similarly, uterine fibroids and polyps can cause recurrent miscarriage because they interfere with normal implantation of the embryo. The septum can be corrected by a surgical procedure.
4. Hormonal causes
Hormonal imbalances and causes are another possible cause of recurrent miscarriages before 6 weeks. Low levels of progesterone, a hormone essential for pregnancy, can cause recurrent miscarriages at this stage. Low levels of progesterone can be caused by various factors, such as ovarian dysfunction, polycystic ovarian syndrome (PCOS), or endometriosis.
PCOS is one of the most common causes of female infertility and can also pose an increased risk of miscarriage. Common symptoms of PCOS can include irregular periods, insulin resistance, high levels of male hormones, weight gain, and polycystic ovaries. The symptoms vary for each person. If you think you may have PCOS, check with your healthcare provider. They can do testing to confirm the diagnosis and help you come up with treatment options.
5. Lifestyle causes
Lifestyle factors are another possible cause of recurrent pregnancy loss. Factors such as maternal age, smoking, drinking alcohol and using recreational drugs can all increase the risk of recurrent miscarriage.
You can increase your chances of a healthy pregnancy by maintaining a healthy lifestyle. This includes eating a balanced diet, exercising regularly, avoiding cigarette smoking and recreational drug use, and drinking alcohol in moderation. Your healthcare provider can provide more information on how to create a healthy lifestyle that helps you to increase your chances of a successful pregnancy.
6. Environmental causes
Environmental factors are another possible cause of recurrent miscarriage. Exposure to certain environmental toxins, such as lead and mercury, have been linked to a higher risk of miscarriage at this stage of pregnancy. If you work at a job that involves these types of chemicals, it is important to speak with your healthcare provider about ways to reduce exposure and protect yourself. You may need to ask to switch your role at work or switch to a different job completely.
Make sure your home does not contain lead paint. If your house was built before 1978, it is likely that it does contain lead paint. It is important to have the paint tested for lead and if necessary, have it removed by a professional team. Staying on top of these things and making sure you are living and working in a safe environment are important to help reduce your risk factors during the early months of pregnancy (and the later months as well).
7. Medical Conditions
Certain medical conditions can also cause recurrent miscarriages. Be sure you explain all relevant medical history to your doctors so they have all of the information needed. These include diabetes mellitus, thyroid disease, autoimmune diseases and chronic infections such as chlamydia or gonorrhea.
Uncontrolled diabetes can cause recurrent miscarriage because it causes changes in the placenta and increases inflammation. Hypothyroidism can also cause problems with implantation and early pregnancy development, leading to a higher risk of recurrent miscarriage. Autoimmune diseases, such as lupus or rheumatoid arthritis, can also lead to recurrent miscarriages due to an overactive immune system attacking the fetus.
Chronic infections such as chlamydia or gonorrhea can cause inflammation and changes in the uterus, leading to recurrent miscarriages. Bacterial vaginosis is another type of infection that can lead to recurrent miscarriage. These types of infections should be treated promptly with antibiotics to reduce the risk of miscarriage.
Antiphospholipid Syndrome (APS), a disorder characterized by the presence of antiphospholipid antibodies, is another possible cause of recurrent miscarriages. This is also sometimes referred to as antiphospholipid antibody syndrome. APS is considered a “sticky blood” syndrome, wherein the presence of antiphospholipid antibodies causes the blood to clot more easily and can lead to recurrent miscarriage.
8. Unknown Causes
In some cases, the causes of recurrent miscarriage remain unknown. This is very common and can be due to a variety of factors such as genetic abnormalities or other unknown causes. Even after testing is performed, you may not get a definitive answer on what is causing your previous miscarriages.
It is important to remember that even if the causes remain unknown, there are still things you can do to reduce your risk of recurrent miscarriage. For example, eating a healthy diet and getting regular prenatal care can help lower your risk of miscarriage. In addition, your doctor can prescribe low-dose aspirin and progesterone to as a precautionary measure depending upon your situation.
Testing for Recurrent Pregnancy Loss
As previously mentioned, most doctors will not perform any type of additional testing until you have had three or more consecutive losses of the same type. Tests may include a karyotype test to check for chromosomal abnormalities, various blood tests to check hormone levels and an ultrasound to look for any structural problems in the uterus.
RPL testing can be done to test for things like blood clotting disorders, an autoimmune disorder, and other genetic causes. They can also test for the lupus anticoagulant. This is another condition that can cause recurrent losses. The results of these tests will help your doctor determine the best treatment plan for you and your partner.
An endometrial biopsy can be performed in order to check for abnormalities of the uterus. This test involves taking a sample of the uterine lining and examining it under a microscope. If an abnormality is found, your doctor will be able to recommend treatment that can help increase your chances of success in future pregnancies.
There are many types of testing available, so talk with your doctor about what the best option for you is.
Treatment Options For Recurrent Miscarriage
Treatment of recurrent pregnancy loss will depend on the underlying cause. If a medical condition is found to be causing the miscarriages, it will likely need to be treated first. Hormonal treatments such as progesterone supplements or fertility drugs may help in some cases. Surgery may also be necessary to correct any uterine abnormalities that are causing the recurrent miscarriages. These fertility treatments are usually performed by a healthcare provider that specializes in reproductive medicine.
If no underlying causes are found, you and your partner can consider fertility treatments such as in-vitro fertilization (IVF) or intrauterine insemination (IUI) to help increase your chances of having a successful pregnancy. By undergoing a treatment such as IVF, you can choose to have the embryos sent for genetic testing in order to ensure there are no chromosomal issues before implanting the embryo.
If you are found to be a genetic carrier for something, you can go the above IVF route and test the embryo before implantation to make sure they do not have the condition. During a subsequent pregnancy, you can also have a chorionic villus sampling done. This test is where a small sample of the placenta is taken and tested for a chromosomal abnormality. It can help to identify any genetic issues early in pregnancy.
An incompetent cervix is when the cervix is too weak to support a pregnancy. If it is found that an incompetent cervix is the cause of your losses, a stitch called a cerclage can be placed to help keep the cervix closed. This is usually done in early pregnancy to help improve the pregnancy outcome. Unfortunately, doctors do not routinely check the cervical length and you will not know you have this condition until after you have experienced loss.
As you can see, there are a variety of diffferent treatment options available. These options depend on the cause of the miscarriage. It is best to meet with a doctor in the reproductive endocrinology field because they are more specialized in diagnosing and treating recurrent pregnancy loss. They will be able to do the proper testing and go over all of your available options.
Where Can I Get Support When Going Through Recurrent Pregnancy Loss?
Experiencing recurrent pregnancy loss is one of the most difficult experiences a pregnant woman can go through. It is important to remember that you are not alone. There are resources available to help you cope with your situation. Consider seeking support from family, friends, or a mental health professional trained in dealing with pregnancy loss or grief. You can also find support in online communities or a support group specifically for those who have experienced recurrent miscarriages. Finding others who have also been through early pregnancy losses, or pregnancy loss of any kind, can be a great source of emotional support. These are the people that will understand exactly how you feel and what you are going through because they have been through it as well.
Buying or creating a special memento or keepsake for your baby can be helpful as well. This can be anything from a necklace, another piece of jewelry, or even something as simple as writing your baby’s name on a rock and keeping it somewhere special. Anything that can help you remember the life of your baby can be comforting in times of despair. It does not matter how many weeks of gestation you were.
Recurrent miscarriages can be caused by various factors, including hormone imbalances, lifestyle causes, environmental causes and medical conditions. It is important to advocate for testing and explore all possible causes in order to have the best chance of your next pregnancy being successful. You need to know the specific cause if you want the best treatment options. If you ever feel something is wrong, please bring it up to your doctor and push for the testing you need. There are a variety of treatment options available to help you have a successful pregnancy. Additionally, there are also many resources and support groups available to help you cope with recurrent pregnancy loss. Make sure you do what you need to do to take care of your physical and mental health.
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