What treatments are available for women who have repeated miscarriages?

Miscarriage is the unexpected ending of a pregnancy in the first 20 weeks of gestation. It is a common and often devastating experience for many women and couples. According to the American Congress of Obstetricians and Gynecologists (ACOG), about 9-12% of clinically confirmed pregnancies end in miscarriage, and the rate may be as high as 26% for pregnancies that are not diagnosed or confirmed. Most miscarriages occur randomly and are due to genetic abnormalities in the embryo that prevent its normal development. However, some women have repeated miscarriages, which is defined as having two or more miscarriages in a row. Repeated miscarriages affect less than 5% of women under age 35, and less than 1% of women experience three or more. Repeated miscarriages can have a profound impact on the physical, emotional, and mental health of the affected women and their partners. They may also cause anxiety and fear about future pregnancies and reduce the chances of having a healthy baby. Therefore, finding the cause and the treatment for repeated miscarriages is crucial for many women who want to have a successful pregnancy and a healthy child.

Causes of repeated miscarriages

The causes of repeated miscarriages are not well understood, and in more than half of the cases, no clear cause can be found. However, some possible factors that may increase the risk of repeated miscarriages are:

  • Genetic problems: In some couples, one partner may have a chromosomal abnormality, such as a translocation, that does not affect their own health but can cause problems in the embryos. This can result in genetic imbalances that lead to miscarriage. Genetic testing of the parents and the miscarried tissue can help identify this problem.
  • Anatomical problems: Some women may have structural abnormalities of the uterus or the cervix that can interfere with the implantation or the growth of the embryo. These may include a septate uterus, which is a partial division of the uterus by a thin tissue; fibroids or polyps, which are benign growths of the uterus; or an incompetent cervix, which is a weak or short cervix that cannot hold the pregnancy. These problems can be diagnosed by imaging tests, such as ultrasound, MRI, or hysteroscopy.
  • Hormonal problems: Some women may have hormonal imbalances that can affect the ovulation, the implantation, or the maintenance of the pregnancy. These may include diabetes, thyroid disease, polycystic ovary syndrome (PCOS), or luteal phase defects. These problems can be diagnosed by blood tests and treated with medication or lifestyle changes.
  • Immunological problems: Some women may have immune system disorders that can cause the body to attack the embryo or the placenta, or cause blood clotting problems that can affect the blood flow to the uterus. These may include antiphospholipid syndrome (APS), which is an autoimmune condition that causes blood clots; or alloimmune problems, which are caused by an incompatibility between the mother’s and the father’s blood types or tissue types. These problems can be diagnosed by blood tests and treated with medication, such as blood thinners or immunoglobulins.
  • Infections: Some infections, such as chlamydia, gonorrhea, syphilis, or toxoplasmosis, can cause inflammation or damage to the reproductive organs or the embryo, and increase the risk of miscarriage. These infections can be diagnosed by urine, blood, or tissue tests and treated with antibiotics or antiviral drugs.
  • Environmental factors: Some environmental factors, such as smoking, alcohol, drugs, caffeine, or exposure to radiation or toxins, can harm the embryo or the placenta, and increase the risk of miscarriage. These factors can be avoided or reduced by the woman or her partner before and during pregnancy.

Treatments for repeated miscarriages

The treatment for repeated miscarriages depends on the cause and the individual situation of the woman and her partner. Some possible treatments are:

  • Genetic counseling: If the cause of repeated miscarriages is a genetic problem, the couple may benefit from genetic counseling, which can help them understand the risk of recurrence, the options for testing, and the choices for future pregnancies. Some options may include using donor eggs or sperm, preimplantation genetic testing (PGT) with in vitro fertilization (IVF), or prenatal testing with chorionic villus sampling (CVS) or amniocentesis.
  • Surgery: If the cause of repeated miscarriages is an anatomical problem, such as a septate uterus or a fibroid, surgery may be an option to correct the abnormality and improve the chances of a successful pregnancy. Surgery may involve removing or cutting the septum, removing or shrinking the fibroid, or placing a stitch around the cervix to prevent it from opening prematurely.
  • Medication: If the cause of repeated miscarriages is a hormonal or immunological problem, medication may be an option to treat the underlying condition and improve the chances of a successful pregnancy. Medication may include insulin or metformin for diabetes, thyroid hormone for thyroid disease, clomiphene or letrozole for ovulation induction, progesterone for luteal phase defect, heparin or aspirin for blood clotting problems, or steroids or immunoglobulins for immune system disorders.
  • Lifestyle changes: If the cause of repeated miscarriages is an environmental factor, lifestyle changes may be an option to reduce exposure to harmful substances and improve the chances of a successful pregnancy. Lifestyle changes may include quitting smoking, avoiding alcohol and drugs, limiting caffeine intake, eating a healthy diet, exercising regularly, managing stress, and avoiding radiation or toxins.

Support and coping

Having repeated miscarriages can be a traumatic and isolating experience for many women and couples. They may feel grief, anger, guilt, depression, anxiety, or fear about their future. They may also face social stigma, lack of understanding, or insensitive comments from others. It is important to seek support and coping strategies to deal with the emotional and mental impact of repeated miscarriages. Some possible sources of support and coping are:

  • Professional help: A doctor, a counselor, a therapist, or a psychiatrist can provide medical, psychological, or psychiatric help to women and couples who have repeated miscarriages. They can offer diagnosis, treatment, advice, or medication to help them cope with their physical and emotional health.
  • Support groups: A support group can provide a safe and supportive space for women and couples who have repeated miscarriages to share their experiences, feelings, and stories with others who have gone through the same. They can offer empathy, understanding, comfort, or information to help them cope with their loss and hope for their future.
  • Online resources: Online resources, such as websites, blogs, forums, or podcasts, can provide information, education, or inspiration for women and couples who have repeated miscarriages. They can offer facts, tips, research, or stories to help them understand their condition and options and to motivate them to keep trying or move on.
  • Family and friends: Family and friends can provide emotional and practical support for women and couples who have repeated miscarriages. They can offer love, care, and sympathy, or help to help them cope with their grief and recovery. They can also respect their privacy, boundaries, or wishes, and avoid making judgments, assumptions, or comparisons.

Conclusion

Repeated miscarriages are a common and challenging problem for many women and couples who want to have a baby. They can have various causes, some of which can be identified and treated, and some of which remain unknown or untreatable. They can also have a significant impact on the physical, emotional, and mental health of the affected women and their partners. Therefore, finding the cause and the treatment for repeated miscarriages is essential for many women who want to have a successful pregnancy and a healthy child. However, even if the cause and the treatment are not found, there is still hope and support for women and couples who have repeated miscarriages. They can seek professional help, join support groups, access online resources, or rely on family and friends to cope with their situation and look forward to the future.

List of facts and figures related to miscarriages

References

1: [Repeated Miscarriages | ACOG](2

Learn more1madisonwomenshealth.com

2acog.org

3flo.health

4verywellfamily.com

5medicalnewstoday.com

6my.clevelandclinic.org

7en.wikipedia.org