Recurrent Miscarriage: Common Causes, Diagnosis, And Treatment

What Can Cause A Miscarriage?

At IRMS we know that one of the most emotionally and physically painful events one can go through is a miscarriage. To undergo multiple miscarriages takes an even greater toll particularly when the cause is not known. We strongly recommend that after a miscarriage we look to identify the reason(s) for the miscarriage as quickly as possible so as not to waste time or to risk additional miscarriages.

Recurrent miscarriage is defined as 3 (some articles say 2) or more consecutive, spontaneous pregnancy losses before 20 weeks gestation. Approximately 20% of pregnancies end in miscarriage with most occurring within the first 12 weeks.

Common Reasons Of Recurrent Miscarriage

Miscarriages may be caused by different conditions but miscarriages are most commonly caused by abnormal chromosomal development within the embryo itself.

Your medical history, a pelvic exam, and one or more of the tests listed below are necessary in diagnosing possible causes of your recurring miscarriages:

  • Karyotype – mapping of your chromosomes, used to diagnose genetic defects
  • Hysterosalpingogram – procedure that uses x-rays and a special dye to evaluate the shape of the inside of your uterus
  • Laparoscopy – outpatient surgical procedure in which your doctor uses a narrow fiber optic telescope inserted through an incision near your navel to evaluate your uterus, fallopian tubes, and ovaries
  • Hysteroscopy – procedure in which your doctor uses a narrow fiber optic telescope inserted into the uterus to look inside your uterine cavity
  • Vaginal ultrasound – scan that uses high-frequency sound waves to detect abnormalities in and around the uterus, ovaries, and fallopian tubes
  • Blood hormone levels – blood tests that reveal the levels of certain hormones in your blood, such as prolactin, thyroid, and progesterone
  • Endometrial biopsy – procedure in which a sample of your endometrial tissue is examined under a microscope to determine if it is appropriately developed for implanting an embryo
  • Glucose screening – blood test used to diagnose diabetes mellitus, which, if left uncontrolled, increases the likelihood of miscarriage
  • Antibodies tests – blood tests used to detect an immune-system abnormality
Recurrent Miscarriage Treatment

After a thorough evaluation, we recommend proceeding with IVF with genetic testing, or preimplantation genetic testing (PGT), of the embryos created prior to implantation. PGT is when we perform an embryo biopsy, where we remove a cell or cells from the embryo to test it for overall chromosomal normalcy.

We then transfer back only normal embryos, generally one embryo at a time, thereby increasing the chances of successful pregnancy reaching full term.