Repeated Pregnancy Loss: Causes, Risk Factors, Tests & Treatment Options

Repeated pregnancy loss can be stressful and affect women emotionally. If you are searching for answers, then understanding the causes is necessary, which can be due to hormonal conditions, age-related factors, chromosomal anomalies or genetic conditions. The patients are tested based on reproductive history, medical history and previous tests. Treatments including surgery, medications, blood thinners and hormone management will be provided after assessing the medical history. This guide covers all the details, including the pregnancy loss causes, risk factors, tests and treatment options.

Repeated Pregnancy Loss And Its Causes

Repeated pregnancy loss is when there is a loss of two or more pregnancies. The pregnancy loss can be confirmed by an ultrasound or a pregnancy test.

Miscarriage is common in 15 to 20% of pregnancies, and every pregnancy loss is not due to a reproductive or genetic issue; the reason is unpredictable.

Repeated miscarriage causes include:

Hormonal problems

• The thyroid gland is responsible for hormone production, and when the thyroid-stimulating hormone (TSH) levels are high or if the antibodies are present, then it elevates the risk of miscarriage.
• Fluctuating levels of the hormone named prolactin can increase the miscarriage risks.
• Women with Polyendocrine Metabolic Ovarian Syndrome (PMOS) can expect the risks of miscarriage.
• Diabetes can also be a factor for the miscarriage.

Age conditions

The age can impact the pregnancy, as the age increases, the quality and quantity of the eggs keep decreasing. Moreover, health issues keep increasing as your age increases.

Genetic issues

The baby’s genes are also a reason for miscarriage because, when the genes are disordered or if there are chromosomal abnormalities, then the baby cannot develop normally. Even if one of the parents is having a genetic problem and it is unknown to them, then the baby can inherit the genetic condition.

Cervical Weakness

The cervix connects the womb to the vagina, and this connective tissue shortens and opens during the labour for the baby to pass through. In some cases, this happens early, and when this happens, it is called cervical weakness.

Blood Clotting

Conditions like antiphospholipid syndrome (APS) cause the blood to clot, leading to pregnancy loss. This condition can be treated with the help of medicines like blood thinners to prevent the blood clot.

Common Risk Factors for Recurrent Miscarriage

• Previous Pregnancy Loss: The chances of miscarriage increase if you have already had two or more previous pregnancy losses. The chances of having a third pregnancy would be 20%, and if the woman had four previous pregnancies, then the chance of having the fifth pregnancy is 40%.
• Alcohol consumption increases the risk of miscarriage.
• Cigarettes can impact infertility and cause repeated pregnancy loss.
• Excess consumption of caffeine can be a risk factor for pregnancy loss, but it does not affect when taken in moderation.
• Abnormalities in the uterus, including fibroids, scars, and abnormal shape, can lead to repeated pregnancy loss.
• Exposure to toxins like radiation, mercury, lead, pesticides and cleaning solvents can be of risk for pregnancy.
• Infections, obesity and hormonal problems are other factors that can increase the risks of repeated pregnancy loss.

Symptoms of Recurrent Pregnancy Loss

The major symptom is the loss of pregnancy before 20 weeks gestation.

The symptoms include:

• Anxiety
• Depression
• Pelvic pain
• Cramping
• Vaginal bleeding

Though pregnancy loss does not affect fertility, it can lead to emotional distress and anxiety. This is when the right medical care and emotional support are required.

How Is Recurrent Pregnancy Loss Diagnosed?

The diagnosis is based on the medical history and past pregnancies of the patient.

• Genetic tests can be performed after a physical examination if the doctor suggests it.
• In the case of uterine issues, imaging tests, including sonograms, ultrasounds or MRIs, will be performed.
• A hysterosalpingogram determines the abnormalities with the uterus shape.
• Blood tests will be performed if they suspect issues related to the immune system.

What Tests Are Done for Recurrent Pregnancy Loss?

If you have faced multiple pregnancy losses, then get the tests done after referring to a doctor.

 

1.The genetic tests

• Next-generation sequencing: It sequences the entire genome and recognises the mutations and genetic variations related to the genetic illness which is causing the pregnancy losses.
• Microarray analysis: The minute genetic alterations can be revealed with this method. Genetic abnormalities involving copy number variations can be diagnosed.
• Karyotyping: This test examines the structure of chromosomes, including the cell’s quantity.
• Pre-implantation genetic testing (PGT): This method analyses the embryos for genetic conditions and chromosomal anomalies.

2.Hormonal and Metabolic Tests

• Prolactin tests: This test detects the prolactin levels that are responsible for interference with ovulation.
• Thyroid function tests: Thyroid antibodies and hormone levels will be evaluated in this test.
• Follicle Stimulating Hormone (FSH): It assesses ovarian function.
• HbA1c and Fasting Insulin: This test identifies diabetes and insulin resistance.

3. Blood Clotting Tests

• Thrombophilia screening: Identifies the inherited clotting disorders like prothrombin gene mutations.
• Antiphospholipid syndrome (APS) Panel: This test identifies the presence of beta-2 glycoprotein antibodies, anticardiolipin antibodies and lupus anticoagulant.

4. Uterine Assessment

• Transvaginal ultrasound identifies polyps, uterine septum, fibroids and other abnormalities.
• Hysteroscopy analyses the uterus for the treatment of adhesions or polyps.
• Sonohysterogram provides the clear view of uterine lining.

Can Recurrent Pregnancy Loss Be Treated?

Yes, the repeated pregnancy loss can be treated.

The treatments include surgical correction, hormone management, medication for cases involving blood clotting and lifestyle management.

Note: The treatment method is based purely on the medical condition of the patient.

Treatment Options for Recurrent Miscarriage

Surgery 

• If there are issues like fibroids, scar tissue or extra tissue in the uterus, then a surgery can be performed to address this issue.
• This process involves correcting the shape of the uterus.
• The surgery is performed with the help of a hysteroscope.

Genetic Counselling

• The suggested treatment for the patients with genetic issues includes in vitro fertilisation (IVF) with preimplantation genetic testing for a structural rearrangement.
• In this case one of the parents carries the genetic disease.

Blood Thinning Medications

• Thrombophilia is a blood clotting disorder that causes clotting of blood, and antiphospholipid antibody syndrome is a condition under thrombophilia.
• Medicines like heparin and aspirin are given in lower doses to improve the chances of pregnancy.

Hormone Management

• Proper lifestyle management can improve the chances of pregnancy but does not act as a treatment.
• Quitting smoking and alcohol and limiting the caffeine intake can lower the risk of repeated pregnancy loss.
• Progesterone can be provided for some cases involving early pregnancy bleeding.
• Hormone management is effective for the people with abnormal blood sugar levels and thyroid dysfunction.

Can You Have A Healthy Pregnancy After Recurrent Miscarriage?

Yes, healthy pregnancy is possible even after recurrent miscarriage. But as the number of miscarriages increases, the difficulty in getting pregnant increases.

Specialist care and medical support are necessary after two or more pregnancy losses.

• Start consuming folic acid supplements before 3 months of pregnancy.
• Control thyroid and blood sugar levels. Get checked for blood sugar levels and thyroid levels and treat them before pregnancy.
• Smoking and drinking should be totally avoided to increase the chance of pregnancy.
• Follow a healthy body weight.
• Manage anxiety and reduce stress by practising relaxation techniques.

When Immediate Care Is Required?

• Having severe abdominal pain or pelvic pain
• Heavy bleeding
• Symptoms like fever and chills, which could possibly be due to the infection.

 

Specialist care and medical support are necessary after two or more pregnancy losses, and for some women, that conversation eventually includes surrogacy as a medically necessary option.”

Key Takeaways

• Repeated pregnancy loss happens when there are two or more pregnancy losses.
• The recurrent pregnancy loss causes include hormonal problems, genetic issues, cervical weakness, blood clotting and age conditions.
• The risk factors include consumption of alcohol, caffeine in excess, obesity, hormonal problems, abnormalities in the uterus and previous pregnancy losses.
• Genetic tests, blood clotting tests, uterine assessment, hormonal tests and metabolic tests can detect pregnancy loss issues.
• Recurrent pregnancy loss treatments include surgery, blood-thinning medications and hormonal management.
• Supplements like folic acid, regular checkups and following a healthy lifestyle can reduce the chances of repeated pregnancy loss.

Freuently Asked Questions

1. What causes recurrent pregnancy loss?

Recurrent pregnancy loss causes include hormonal problems, age conditions, genetic issues, cervical weakness and blood clotting conditions.

2. How is recurrent pregnancy loss evaluation done?

The recurrent pregnancy evaluation is performed based on the medical history, physical examination, genetic tests, hormonal assessments and uterine cavity tests.

3. How will the pregnancy be after recurrent miscarriage?

The chances of pregnancy keep decreasing as the recurrent miscarriage increases. So, it is necessary to seek medical care, follow a healthy diet, take caffeine in moderation, and quit smoking and alcohol.

4. How to prevent recurrent pregnancy loss?

Quitting smoking, limiting caffeine, taking folic acid, which is a vitamin B supplement, and getting tested for diabetes can prevent the recurrent pregnancy losses.

5. What genetic disorders cause pregnancy loss?

Chromosomal abnormalities and inherited parent genetic disorders like thrombophilia and thalassaemia can cause pregnancy loss.

6. What are the types of miscarriages?

The miscarriages are of mainly two types, including early and late miscarriage. Recurring early miscarriage occurs due to the chromosomal or genetic problems. Recurrent late miscarriage occurs due to the autoimmune problems, incompetent cervix, premature labour or uterine abnormalities.

7. Can IVF improve the chances of successful pregnancy for recurrent pregnancy losses?

IVF is combined with genetic testing to improve the chances of pregnancy. But it cannot be made sure that every IVF procedure will be successful.

8. What are the chances of success after recurrent pregnancy loss?

The chances of success after recurrent pregnancy loss are about 60 to 75%. The success rate keeps decreasing with the increase in the number of pregnancy losses.