Recurrent Miscarriage

One of the most difficult aspects of Recurrent Miscarriages is the uncertainty of it. Through specialised testing, experts can often pinpoint a contributing factor. For a lot of couples, even if a cause is not found, the chances of a successful pregnancy remain high.

Here are some categories of primary causes that specialists have investigated over the years.

1. Genetic and Chromosomal Factors (This affects 2-5% of couples)

Embryo Chromosome Issues: This is perhaps the most common cause of a single miscarriage, often due to random errors in cell division (aneuploidy). However, recurrent losses may sometimes suggest a higher baseline risk in the parents’ DNA.

Parental Translocations: Rarely, one parent may carry a balanced chromosomal abnormality (like a translocation). They are healthy, but their eggs or sperm have an increased chance of creating an embryo, with an unbalanced, non-viable set of chromosomes.

2. Hormonal and Endocrine Imbalances

Thyroid Disorders: Conditions like hypothyroidism or hyperthyroidism, if untreated, can interfere with pregnancy maintenance.

Diabetes: Poorly controlled blood sugar levels (Type 1 or Type 2 Diabetes) can increase the risk of miscarriage.

Polycystic Ovary Syndrome (PCOS): PCOS is associated with hormonal imbalances that can sometimes impact the success of a pregnancy.

Luteal Phase Defect: While controversial, this theory suggests insufficient progesterone production, which is essential for supporting the uterine lining

3. Anatomical and Uterine Factors

Uterine Septum: A wall of tissue dividing the uterus. This congenital abnormality is the most common uterine factor associated with RM and is often treatable with a minor procedure.

Fibroids And Polyps: These non-cancerous growths can sometimes interfere with implantation or blood supply to the developing embryo, depending on their size and location.

Asherman’s Syndrome: Scar tissue within the uterus, often resulting from previous surgeries, which can reduce the size of the uterine cavity.

4. Autoimmune And Thrombophilia Issues (Blood Clotting)

Antiphospholipid Syndrome (APS): This is the most established treatable cause of RM. It is an autoimmune disorder where the body produces antibodies that can increase the risk of blood clots forming in the placenta, obstructing blood flow to the baby.

Inherited Thrombophilia’s: Genetic conditions that slightly increase the tendacy to clot (like Factor V Leiden) are often investigated, although their direct link to Recurrent Miscarriage

is still being studies.

The Path Forward: Investigation & Treatment of Recurrent Miscarriage

The good news is that for many couples experiencing Recurrent Miscarriage, there is a clear, step by step investigative process. This usually involves consulting a Reproductive Endocrinologist or a specialist RM clinic.

Diagnostic Testing May Include:

1. Blood Tests: Screening for hormonal issues (thyroid, prolactin, etc.), diabetes, and autoimmune disorders, particularly Antiphospholid Syndrome (APS.)
2. Karyotyping: Blood test performed on both parents to check for balanced chromosomal translocations.
3. Uterine Imaging: Procedures like a saline infusion sonogram (SIS) or hysteroscopy to visualize the uterine cavity and check for anatomical abnormalities like a septum or fibroids.