Some people may experience feelings of worry and anxiety about a new pregnancy after the heartbreak of a miscarriage. However, one miscarriage is not an indicator of future pregnancy prospects. Due to various causes, up to 20% of pregnancies unexpectedly end in the early stages, but repeated miscarriages occur in no more than 1% of women [1].
What impact do genetic causes have on miscarriage?
About half of all early miscarriages are associated with chromosomal defects and occur before 12 weeks [2]. Often it is a one-time genetic glitch. But if there are chromosomal mutations in one of the parents, miscarriages may become recurrent. Therefore, if there are repeated miscarriages, genetic counseling is recommended. Medical professionals may offer the solution of IVF with preimplantation diagnosis [2], which involves implanting only healthy embryos into the uterus.
Can a miscarriage be caused by a compromised Immune system?
Up to 20% of recurrent miscarriage is due to antiphospholipid syndrome (APS), an autoimmune disease that increases blood clotting [2]. The blood vessels are blocked by blood clots, which leads to the death of the embryo. This usually happens around the 10th gestational week, during the formation of the placenta.
Such miscarriage is called missed miscarriage because it can occur without any of the usual symptoms. Blood tests for lupus anticoagulant and antiphospholipid antibody levels are done to detect APS. Based on the test results, drug therapy can be prescribed to the mother to help prevent thrombosis. It is better to start this before pregnancy, and sometimes the mother will have to continue this therapy until giving birth.
How can hormones increase the risk of a miscarriage?
Luteal phase defect (LPD) is another common cause of early miscarriage. After the release of the egg from the follicle, a corpus luteum should form within the ovary, which is responsible for the production of progesterone and the thickening of the endometrium (lining of the uterus). If fertilization occurs, then the successful implantation of the embryo will depend on the activity of the corpus luteum. If the corpus luteum does not serve its function and the endometrial layer remains thin, then the embryo cannot firmly anchor. This leads to early miscarriage. In some cases, hormone therapy can help.
Can anatomical causes increase the risk of a miscarriage?
A bicornuate uterus, an internal septum in the uterus, large fibroids, scars, and polyps can all cause recurrent miscarriages [2]. Usually, these conditions are diagnosed by ultrasound or, in difficult cases, using hysterosalpingography (HSG). They can be remedied by surgery.
Unfortunately, it is not possible to determine the cause of recurrent miscarriage in 50–70% of women [1]. Perhaps close attention should be paid not just to medical factors, but also to psychological and social factors.
Many women can ovulate and become pregnant as soon as two weeks after having a miscarriage [3]. It is important that you feel emotionally and physically ready for pregnancy after miscarriage. Dealing with the event of a miscarriage can be difficult so be sure to ask your healthcare provider for guidance and support after experiencing a lost pregnancy.
This article was created in association with UNFPA, the United Nations sexual and reproductive health agency.
