Recurrent Miscarriage Evaluation
Recurrent pregnancy loss is a disease distinct from infertility, defined by two or more consecutive failed pregnancies. When the cause is unknown, each pregnancy loss merits careful review to determine whether specific evaluation may be appropriate. After three or more losses, a thorough evaluation by your Des Moines gynecologist is warranted.
Although approximately 25% of all recognized pregnancies result in miscarriage, less than 5% of women will experience two consecutive miscarriages, and only 1% experience three or more. Couples who experience recurrent pregnancy loss may benefit from a medical evaluation and psychological support by their Des Moines gynecologist.
Causes of Recurrent Miscarriages
Genetic/Chromosomal Causes. A chromosome analysis performed from the parents’ blood identifies an inherited genetic cause in less than 5% of couples. In contrast to the uncommon finding of an inherited genetic cause, many early miscarriages are due to the random (by chance) occurrence of a chromosomal abnormality in the embryo.
Age. The chance of a miscarriage increases as a woman ages. After age 40, more than one-third of all pregnancies end in miscarriage. Most of these embryos have an abnormal number of chromosomes.
Hormonal Abnormalities. Progesterone, a hormone produced by the ovary after ovulation, is necessary for a healthy pregnancy. Persistently low progesterone levels after ovulation, often called ‘luteal phase deficiency’, may cause repeated miscarriages.
Metabolic Abnormalities. Poorly controlled diabetes increases the risk of miscarriage. Women with diabetes improve pregnancy outcomes if blood sugars are controlled before conception.
Uterine Abnormalities. Distortion of the uterine cavity may be found in approximately 10% to 15% of women with recurrent pregnancy losses.
Antiphospholipid Syndrome. Blood tests for may identify women with antiphospholipid syndrome, a cause for 3% to 15% of recurrent miscarriages.
Thrombophilias. Inherited disorders that raise a woman’s risk of serious blood clots (thrombosis) may also increase the risk of miscarriage as well as fetal death in the second half of pregnancy.
Male factor. Some evidence suggests that abnormal integrity (intactness) of sperm DNA may affect embryo development and possibly increase miscarriage risk.
Unexplained. No explanation is found in 50% to 75% of couples with recurrent pregnancy losses.
A couple may be comforted to know that the next pregnancy is successful in 60% to 70% of those with unexplained recurrent pregnancy losses. A healthy lifestyle and folic acid supplementation is recommended before attempting another pregnancy.
We want to be your gynecologist in Des Moines; if you are suffering from recurrent miscarriages, call our office today at (515) 225-7201 to set up an appointment or to talk to any of our highly qualified staff members. We look forward to serving you.
Thank you for trusting us with your care!