Recurrent Miscarriages: Causes and Treatments

June 12, 2019
When expectant mothers suffer miscarriages before reaching the twentieth week of pregnancy, there's talk of recurrent miscarriages. In this situation, there are different treatment options. Find out more in this article.

Recurrent miscarriages refer to more than two miscarriages before 20 weeks of pregnancy. Miscarriages happen 15% of the time.

Also, the rate goes up if women have already had a miscarriage. Additionally, the number doubles if there’ve been more than two cases.

There are many different causes of recurrent miscarriages. However, in some cases, it’s hard to know exactly what caused it. There are lots of factors that can influence it.

There aren’t exact numbers on women with recurrent miscarriages. In general, about 2-5% of women of reproductive age are affected. Women who go through in vitro fertilization programs also have a higher chance.

Causes of recurrent miscarriages

Endocrine issues, genetic or anatomical problems, or disorders like thrombophilia or immune diseases are the most common causes of recurrent miscarriages. Autoimmune and infectious diseases are common causes too.

On the other hand, toxic factors like alcohol, coffee, and tobacco can cause them as well. Environmental factors like heavy metals are also causes. Additionally, they can cause problems in healthy pregnancies.

  • Endocrine factors. Having different levels of thyroid hormones or glucose will prevent pregnancies from being healthy if you don’t treat them properly. In addition, conditions like polycystic ovarian syndrome and obesity are in this category too.
  • Genetic factors. Chromosome changes in male or female karyotypes happen in 5% of recurrent miscarriages. Therefore, all couples that want to go through in vitro fertilization treatment should do a karyotype test.
  • Thrombophilias. These are the conditions that alter blood clotting and can increase risk of thrombosis. If this happens when the placenta is forming, you could have a miscarriage.
  • Anatomical factors. Doctors treat uterine problems successfully in 70-85% of the time. In general, these changes can happen naturally.
  • Immunological factors. When women suffer from immune problems, their body attacks the embryo instead of welcoming it.
  • Male factor. After age 40, sperm become less strong in the DNA. This is another case of recurrent miscarriages.
Recurrent Miscarriages: Causes and Treatments

Clinical studies in couples prone to recurrent miscarriages

If couples have two or more miscarriages, they can request a series of tests to check for the causes and perform the appropriate treatment, if any. These exams are:

  • Karyotype study in both partners
  • Hormone tests
  • Uterine imaging tests: ultrasounds, MRIs
  • Immune system tests
  • Blood clotting analysis
  • FISH in sperm to find out the strength of the sperm in the DNA
  • Figure out the amount of natural killer cells in the blood. These prevent the embryo from implanting naturally, even with in vitro fertilization techniques.

“There are many different causes of recurrent miscarriages. However, in some cases, it’s hard to know exactly what caused it. Many different factors can influence it.”

Treatments for recurrent miscarriages

The treatment will depend on the test results. There are lots of possible solutions. In fact, lots of them have great results. Some of them are:

  • Massage therapy
  • Hormone therapy
  • Surgical hysteroscopy
  • Blood clotting medication
  • Genetic test of embryos before implantation

Medical teams with psychologists, hormone specialists, gynecologists, and more are the ones that should recommend these treatments. Additionally, some treatments are more complicated than others.

Genetic treatment

Treatments for recurrent miscarriages from genetic causes involve choosing embryos with a normal genetic load. That is, they’re good to make a healthy baby.

In fact, research has made great advances in genetic science. They’re able to find out if there are too little or too many genes or chromosomes in embryos. The good news is that these studies are more detailed than FISH. FISH only looks at chromosomes.

Endocrine treatment

Doctors do this with a medication that helps hormones work like normal. They include ovarian stimulation, thyroxine, dopamine agonists and metformin.

Recurrent Miscarriages: Causes and Treatments

Anatomical treatment

The most frequent treatments for uterine complications include hysteroscopy. Additionally, expanding the uterine cavity is another possible solution to prevent miscarriages.

Blood clotting treatment

If done in time, doctors might use low molecular weight heparins (LMWH). For example, they could use blood thinners and certain vitamins.

In short, recurrent miscarriages are as frequent as they are treatable. Nowadays, there are new tests and studies in genetics and other causes. It’s possible to detect lots of the most frequent causes and treat them effectively.

  • Aborto de repetición. Sociedad Española de Fertilidad. [En línea] Disponible en: https://www.sefertilidad.net/docs/biblioteca/recomendaciones/aborto.pdf
  • Romero, B; Martínez, L; González, A; Fontes, L. Epidemiología del aborto de repetición. Progresos de obstetricia y ginecología. Vol. 55. Núm. 7.Agosto – Septiembre 2012. 297-366. DOI: 10.1016/j.pog.2011.07.009