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 is recurrent miscarriage?

Recurrent miscarriage is the miscarriage of two or more consecutive pregnancies, often indicating that there may be a fertility issue related to a genetic or uterine defect. Recurrent miscarriage is also known as repeated miscarriage and recurrent pregnancy loss.

The medical definition of miscarriage is spontaneous abortion prior to the 20th week of pregnancy. Miscarriages are fairly common and occur in 15-30 percent of all pregnancies.

About 15 percent of pregnancies that have been clinically recognized (visualized by ultrasound or identified by pregnancy tissue) end in miscarriage. Because many women have a miscarriage before they even know they are pregnant, the actual number of pregnancies ending in miscarriage is much higher.

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.

What are the symptoms of recurrent miscarriage?

Recurrent miscarriage symptoms are typically not any more severe than those in a normal miscarriage. When having a miscarriage or a recurrent miscarriage, many women experience:

  • Bleeding
  • Cramps
  • Fever
  • Abdominal pain
  • Passing of fetal tissue

If a woman shows signs of any of these symptoms while pregnant, she should see her doctor or go to the emergency room immediately.

Treatment for recurrent miscarriage

Between 50-75 percent of all cases of recurrent miscarriage are unexplainable. The good news is that 60-70 percent of couples with unexplained recurrent pregnancy loss will have a successful next pregnancy.

Treatments for diagnosed causes include: