Causes of Recurrent Miscarriage - Recurrent Abortion | Dr N Layyous

Causes of Recurrent Miscarriage - Recurrent Abortion

Causes of Recurrent Miscarriage (Abortion): -

1-Parental chromosome abnormalities causing Recurrent Miscarriage (Abortion):

identified in between 3-5% of couples with Recurrent Miscarriage. The most common cause is balanced or reciprocal translocation twice as many females compared with males are identified as carrying structural chromosome abnormality, this is most likely due to structural abnormalities with males associated with infertility.

 2-Fetal aneuploidy: -

Trisomy or Monosomy is the most common identified chromosome abnormality in human miscarriage; about 30% of miscarriages are trisomy and increase with maternal age.

 3- Endocrinopathy causing Recurrent Miscarriage (Abortion): -

Luteal phase defect which has women with recurrent miscarriage, the diagnoses of luteal phase defect based on luteal phase progesterone level and endometrial biopsy patient with PCOS associated with higher rate of pregnancy loss. Hormonal responses of the endometrial to be receptive to the embryo.

 4- Antiphospholipid syndrome: -

it’s the most important treatable cause of recurrent miscarriage. In the first trimester of the pregnancy, the majority of miscarriages accrue, after fetal heart which ascribed to thrombosis of the uteroplacental vasculature using of Aspirin alone as prophylactic agent increase live birth to 40% , when adding heparin with aspirin the rate will increase to 60%.

 5-Thrombophilic defects

 6- Immune dysfunction which causes of Recurrent Miscarriage ( Abortion ):-

• (NK) Natural killer cells: The Lymphocytes, part of immune system present in peripheral blood, have more killing ability than uterine natural killing (NK) cells.
• Embryo has to be receptive to implantation. This needs continuous interaction between embryo and uterus mainly by cytokines which secreted by the immune cells of the uterus. If immune cells don’t respond to the signal from embryo adhesion and implantation will not occur.

7- Structural uterine abnormalities causes of Recurrent Miscarriage ( Abortion ): -

The prevalence of uterine abnormalities among women with Recurrent Miscarriage range from (1.8-37.6) %

 8- Uterine environment that inhibits embryos from implantation, classified as anatomic, hormonal and immunological:

• Endometrial polyps: Benign outgrowths of the endometrium in the uterine cavity.
• Sub mucous fibroids: Benign tumors which protrude from the uterine wall into the uterine cavity.
• Uterine Synechia: Due to scarring or adhesion in the uterine cavity.

9- Infectious agents causing Recurrent Miscarriage (Abortion)

 10- Environmental: - tobacco, alcohol, radiation chemotherapy

 11- Psychological causes of Recurrent Miscarriage (Abortion).

 12- Idiopathic (Unknown): - 40% of recurrent pregnancy loss

Frequently asked questions:

Why does early miscarriage occur?

In most cases, no specific cause can be identified, but the most common cause is believed to be a chromosomal abnormality in the fetus.

Is two miscarriages considered recurrent miscarriage?

No.

What does recurrent miscarriage indicate?

It indicates a problem with the mother, whether it's blood clots, a uterine problem, or a genetic issue causing a chromosomal abnormality in the fetus.

How can I maintain a pregnancy after recurrent miscarriages?

Continuous follow-up with your doctor before trying to conceive is essential to determine the cause and avoid future occurrences.

Does recurrent miscarriage affect the uterus?

Yes, especially if it was followed by a dilation and curettage (D&C).

What are the risks of recurrent miscarriage for the mother?

• Weak or damaged uterus, which may delay pregnancy.

• Reproductive tract infections and pelvic inflammatory disease.

• Psychological problems that may persist for up to 6 months, such as anxiety and depression.

In which month is the risk of miscarriage lowest?

By the 12th week of pregnancy, the risk of miscarriage decreases to 5%.

Can artificial insemination help treat miscarriage?

Yes, if there is a genetic problem, coordination with an embryology lab is possible to avoid any chromosomal issues.

Can the husband be the cause of recurrent miscarriage?

Yes, if there is a chromosomal abnormality.

Is it a hereditary disease?

No.

What factors increase the chances of miscarriage?

Age over 30

Uncontrolled health conditions such as diabetes

Maternal obesity

When is a dilation and curettage (D&C) procedure necessary?

- Heavy, persistent bleeding

- Signs of infection

- If medications are ineffective

Is intercourse safe during pregnancy?

It's best to avoid it during the first 3 months, especially in cases of recurrent miscarriage.

Dr Najeeb Layyous F.R.C.O.G

Consultant Obstetrician, Gynecologist and Infertility Specialist