ALL CAUSES OF MISCARRIAGE
Miscarriage is the loss of a pregnancy before 20 gestational weeks and occurs in about 20% of all pregnancies. When a couple suffers two or more pregnancy losses, this is termed recurrent miscarriage. The experience of any pregnancy loss is both physically and emotionally draining. A complete evaluation is needed to identify the causes and best treatments to reduce the chance of having another pregnancy loss.
The Recurrent Pregnancy Loss Center at Fertility Associates of Memphis has experts in genetics, immunology, endocrinology, and minimally invasive surgery. Our group has published the largest study in the world on the causes of recurrent miscarriages. After a thorough evaluation and directed treatment, the majority of couples will eventually have a successful outcome.
Genetic or chromosomal abnormalities are found in over 50% of early pregnancy losses when special testing is performed on the miscarriage and are considered random events. However in 3 % to 5% cases, there may be a chromosomal abnormality in one of the parents that can be a concern for future pregnancies.
Hormonal imbalances are important for the maintenance of any pregnancy, and as women advance in reproductive years, progesterone deficiencies are common. Pre-diabetic conditions and imbalances in thyroid hormone are commonly found in women who have miscarriages and can easily be corrected. Low ovarian reserve may be an issue that affects the quality of eggs that are available for pregnancy. This is usually identified in women who are older.
Uterine abnormalities, both those that develop from birth and those that develop later in life, are common causes of miscarriage. These include abnormally shapes of the uterus such as a septum and abnormal growths within the uterus such as fibroids or polyps. These can usually easily be corrected with minimally invasive surgery.
Autoimmune problems occur when a mother’s immune system reacts against the placenta causing problems in the growth and development of the baby. These include antiphospholipid antibodies and can be treated with injections of heparin throughout pregnancy. The Recurrent Pregnancy Loss Center is one of the world’s leaders in research and treatment of Antiphospholipid Syndrome, a major cause of recurrent pregnancy loss.
Lifestyle factors are also potential issues that will increase the chances of having a pregnancy loss. Tobacco use of more than 5 cigarettes per day, alcohol use of more than three drinks per week, and caffeinated drinks of more than 4 per day will each increase the risk of miscarriage. Women who are obese (BMI > 30) also have increased risks of pregnancy loss; for every BMI unit over 30 the risk of miscarriage increases 1% to 2%.