Recurrent Pregnancy Loss: Fertility Treatment Options for Miscarriages

As you already know, pregnancy is divided into three trimesters. The first trimester (the first 12 weeks) is the most crucial time of any pregnancy as this is when the structure of the fetus and organ development begins. This is also the time when miscarriages and birth defects are the most common, which is why many women are advised to wait to announce their pregnancies until the second trimester. Unfortunately, the chances of recurrent pregnancy loss increases for women who have already experienced one miscarriage.

There are numerous known and unknown risk factors that can contribute to recurrent miscarriages in women of prime reproductive age. Fortunately, there are also a few reliable fertility treatment options for recurrent pregnancy loss that can increase your chances of carrying a pregnancy to term and delivering a healthy child. Keep reading to learn everything you need to know about recurrent miscarriage risk factors, why they occur, tests to identify causes, and when to visit a fertility clinic in your area.

What Are Some Risk Factors of Miscarriages?

Miscarriages, which are also known as spontaneous abortion, are more common than many people think. They can occur at least once during every woman’s reproductive life. Approximately 1 in 5 (or 15%) pregnancies end in miscarriage. For women over 40, that risk increases to 1 in 3 pregnancies ending in miscarriage.

Recurrent pregnancy loss is defined by two consecutive miscarriages. When recurrent pregnancy loss occurs, it’s important to investigate the issue in an effort to uncover, diagnose, and treat any underlying medical or environmental conditions that may be preventing a full-term pregnancy. By definition, investigation into recurrent miscarriages can only take place if the woman has endured a minimum of two consecutive miscarriages.

Women under the age of 35 who endure two or more consecutive miscarriages are at approximately a 30% increased risk of recurrent pregnancy loss.

Why Do Miscarriages Occur?

Common causes of miscarriage include:

• Aneuploidy, aka chromosomal abnormalities in the embryo or ovum. Women of an advanced reproductive age are at a greater risk of aneuploidy.
• Uterine abnormalities such as uterine septum, scarring (Asherman’s syndrome), or submucous fibroma
• Endocrine diseases such as hyperprolactinemia, thyroid disorder, or diabetes
• Coagulation disorders such as antiphospholipid syndrome
• Genetic abnormalities in both women and men, including balanced translocation
• Low ovarian reserve
• Environmental factors such as smoking (including second-hand smoke), overexposure to pollution, alcohol use, caffeine consumption, exercising, etc.

There’s also ongoing research that could suggest infectious or immunological causes could lead to recurrent pregnancy loss, but more data is needed at this time. In approximately 50% of cases of recurrent miscarriage, the cause is unknown.

Although there’s no evidence to suggest that strenuous exercise is harmful to pregnancy, there’s also no evidence to suggest that it could be beneficial. Erring on the side of caution for women with a history of miscarriages is important, which is why some fertility doctors might advise their high risk patients to refrain from strenuous exercise during pregnancy.

Tests to Identify Causes of Miscarriage

Experiencing one or two miscarriages during a woman’s reproductive years is normal, albeit extremely stressful and emotionally painful for the patient. However, if the woman experiences two or more miscarriages, one right after the other, then some diagnostic work may be necessary to understand why this is happening.

After you’ve spoken to your doctor regarding your concerns, they should take the following steps to gain a better understanding about what’s going on:

• Examine your medical history
• Perform a pelvic exam
• Order one or more diagnostic tests

If your medical history and the results of the pelvic exam don’t uncover enough information regarding the cause of recurrent pregnancy loss, then here is a list of diagnostic tests your doctor will most likely order.

• Blood hormone levels: Your doctor may order blood tests to examine the certain hormone levels in your blood such as progesterone, prolactin, and thyroid stimulating hormone.
• Glucose screening: This is a type of blood test that can diagnose diabetes mellitus, which can increase the chances of miscarriage if left untreated.
• Ovarian reserve testing: Your doctor may want to test the quality and quantity of your eggs to rule out possible age-related decrease in ovarian functioning.
• Vaginal ultrasound: High frequency sound waves are used to identify abnormalities around the or within the ovaries, uterus, and fallopian tubes.
• Sperm DNA fragmentation testing: This test reveals if the quality of the sperm and DNA fragmentation are the cause of pregnancy loss.
• Endometrial biopsy: This procedure involves examining an endometrial tissue sample to determine if there’s a possible infection causing pregnancy loss.
• Karotype: This test examines your chromosomes and is used to identify genetic defects.
• Antiphospholipid antibody testing: This is a blood test that detects immune system abnormalities that could be contributing to pregnancy loss.
• Hysteosalpingogram: Fluoroscopy and a special dye are used to evaluate the internal structure of your uterus and the stability of your fallopian tubes to sustain a pregnancy.
• Saline Sonohysterogram: A transvaginal ultrasound is performed by placing sterile water into the cavity of the uterus to identify abnormalities like fibroids, polyps, and scar tissue within the endometrial cavity.
• Hysteroscopy: A thin fiberoptic scope is inserted into the uterus to examine the uterine cavity.

When Should You Visit a Fertility Clinic?

It’s hard to know when the right time is to consult a fertility specialist regarding pregnancy. Some couples take the leap immediately after the first miscarriage because they want to do everything they can to prevent recurring pregnancy loss. Others wait until the recurrence of miscarriage before they decide to seek fertility testing or treatment.

The reality is that you need to give both your body and your heart enough time to heal before even considering trying again.

At ONE Fertility Kitchener Waterloo, we provide compassionate and transparent comprehensive fertility services to all of our patients. We understand the immense physical and emotional implications of suffering a miscarriage for all parties involved. Our experienced staff will make appropriate professional medical recommendations and provide in-depth testing to rule out all possible causes and ensure that you get the best possible care when visiting our fertility clinic. Contact us today to book a consultation with one of our esteemed fertility specialists.