Recurrent Miscarriage

Recurrent miscarriage overview

• A recurrent miscarriage is classified as experiencing two to three consecutive miscarriages.
• A miscarriage is the loss of a clinically-recognized pregnancy before 20 weeks.
• 15 percent of clinically-recognized pregnancies end in miscarriage, though more occur before they are clinically recognized.
• Only 2 percent of pregnant women experience two consecutive miscarriages and 1 percent of pregnant women experience three.
• Approximately 60 percent of recurrent miscarriages are caused by genetic abnormalities in the fetus.

What causes recurrent miscarriage?

The most common cause of a miscarriage and of recurrent miscarriage is a chromosomal or genetic abnormality of the fetus. Recurrent miscarriages can also be caused by infections; heart, kidney or thyroid disease; environmental factors such as exposure to radiation, smoking or drug use; cancer treatments; and a variety of other factors.

Common medical issues that cause recurrent miscarriages are:

• Genetic abnormalities
• Chromosomal abnormalities
• Hormonal abnormalities
• Metabolic abnormalities
• Uterine abnormalities (abnormally shaped uterus or cervical weakness)
• Antiphospholipid syndrome (an immune dysfunction)
• Thrombophilia, which can cause blood clots
• Male sperm DNA abnormality affecting embryo development

Diagnosing recurrent miscarriage

A woman with recurrent miscarriage should receive medical testing that may include:

• Blood work to assess hormone, glucose and immune system abnormalities
• Physical examination
• Hysteroscopy that allows the physician to look inside the uterus for problems
• Transvaginal ultrasound

Since a genetic or chromosomal abnormality in an embryo is the most common cause of recurrent miscarriage, couples should be evaluated for such abnormalities by a fertility specialist. The physician will gather family medical history of both partners and may also perform a karyotype, which is an analysis of a person’s chromosomes to detect abnormalities.