The 2nd or 3rd miscarriage can be indicative of recurrent miscarriage. What are the causes of recurrent miscarriage? Can recurrent miscarriage be prevented?
Miscarriage, or pregnancy loss, means the termination of pregnancy before the 12th week (the first trimester) of pregnancy. After the second or third miscarriage, it is necessary for the couple to be examined to ascertain whether their case is indeed a case of recurrent miscarriage and to determine the probable causes of recurrent miscarriage in the couple. Even after several miscarriages, the probability of a successful pregnancy – whether or not the couple undergo recurrent miscarriage treatment – is greater than another miscarriage, but with the treatment of the underlying causes of recurrent miscarriage, the likelihood of a successful pregnancy after recurrent miscarriage becomes significantly greater. Recurrent miscarriage can have many causes, and in 30 to 50% of cases, even after examination, the cause remains unknown.
A successful pregnancy is more likely after treating the underlying causes of recurrent miscarriage.
Miscarriage and Genetics
According to global statistics, the incidence of recurrent miscarriage is 3% to 4% of all pregnancies. Recurrent miscarriage has several causes, including genetic factors. The genetic factor is responsible in 5-10% of recurrent miscarriage cases and in 60-70% of all miscarriages. Other causes of recurrent miscarriage are anatomical causes related to the structure of the uterus, hormonal causes, autoimmune diseases such as lupus, acquired or inherited coagulation disorders, and anatomical diseases and uterine abnormalities (cervical weakness). Mother’s underlying disease (such as heart, blood or kidney diseases) is one of the major causes of recurrent miscarriage, as the body produces agents against itself that results in a miscarriage. Other causes associated with miscarriage include embryonic chromosomal abnormalities, abnormalities in the uterus, hormonal problems, disorders associated with increased coagulability of blood, infections and some of the less common causes, such as the use of certain medication or exposure to poisons, cigarettes, caffeine, abnormalities in the placenta, and factors related to the father.
Adenomyosis and miscarriage
One of the uterus abnormalities, which leads to thickening of the uterine wall and miscarriage, is adenomyosis. Due to excessive thickening of the uterus muscles in adenomyosis, there is an abnormal blood flow to the uterine lining of the uterus which lead to miscarriage.
Hormone disorders and miscarriage
Hormonal disorders are among the most important causes of recurrent miscarriage. Hormone testing with the aim of diagnosing hormonal diseases, including hypothyroidism followed by recurrent miscarriage, should be performed, because hypothyroidism may cause infertility by inducing ovulation disorders and can lead to miscarriage in. Another disease caused by hormonal imbalance is the polycystic ovary syndrome. In the polycystic ovary syndrome, miscarriage occurs due to changes in the chemical (metabolic) environment of the body. These metabolic problems must be addressed before the next pregnancy.
Another problem that can lead to a miscarriage is the progesterone deficiency at the beginning of pregnancy which I caused due to poor egg quality. When progesterone deficiency is suspected, it is recommended to use progesterone medications at the start of pregnancy after ensuring that the pregnancy is normal (and not a case of ectopic pregnancy) to prevent miscarriage.
Hypercoagulability in pregnancy
An important factor in recurrent miscarriage is hypercoagulability or excessive blood clotting in pregnancy. This condition during pregnancy produces small blood clots in the placenta and in the veins that supply blood to the uterus. If such a disorder is diagnosed in pregnancy, anticoagulants should be used to reduce the risk of miscarriage.
Keep in mind that some types of infections including toxoplasmosis, rubella, measles, cytomegalovirus and herpes can lead to miscarriage, but they are not among the causes of recurrent miscarriage. Infections such as brucellosis and malaria, on the other hand, can cause recurrent miscarriage.
Can recurrent miscarriage be prevented?
Recurrent miscarriage caused by cervical weakness can be prevented easily. Cervical weakness is diagnosed with a blood test, and can be treated with medicinal intervention. Of course, hormonal disorders, most of which occur due to ovarian failure, can be diagnosed and treated with the necessary hormones medication.