So for couples experiencing recurrent miscarriage, there are several causes that need to be eliminated. The most common cause is an increase in female age.
And as a woman ages, she’s more and more likely to produce an egg that’s abnormal. And then that manifests itself as an abnormality in the embryo, which often then will miscarry in the early first trimester of pregnancy. Other causes that are unrelated to age include blood clotting problems and that’s something we can do some blood tests for.
A woman can have some issues within the uterus. So an abnormality such as a large fibroid, which is an overgrowth of the muscle within the uterus, and that can interfere with embryo’s implanting. So generally she’d have an ultrasound to assess for those sorts of abnormalities and there are things that can be potentially surgically treated. There are genetic causes of recurrent miscarriage. So sometimes either the male or the female partner has a slight rearrangement in their chromosomes, which is the overall genetic material. So they have all the healthy genes that they need but they’re just in a different place.
But when the body goes to make an egg or sperm, then the embryo ends up with the wrong number of chromosomes and that can result in miscarriage. And there’s a fairly simple blood test to rule that out. And there is specific treatment available if need be. Sometimes there’s hormonal imbalances in things like the woman’s thyroid function. So that can be addressed.
And there are other thought to be other causes that, to do with the blood clotting system and the immune system. But some of those are quite difficult to work out and we haven’t got fantastic tests to be able to prove who has issues within those systems. So the establishment of a healthy pregnancy is a really complex process and anything along that line can go wrong and end up in miscarriage. So generally speaking, people with recurrent miscarriage would have quite a few tests to be able to work out what the cause may be. And many people never get an answer.
The good news is, for most people with recurrent miscarriage, the numbers come up and they do tend to have a healthy pregnancy eventually.
Dr Katrina Rowan is a fertility specialist, reproductive endocrinologist and reproductive surgeon with consulting rooms in the heart of Sydney’s CBD. Katrina prides herself in her ability to guide and educate her patients. With her support, patients feel comfortable and deepen their understanding of their own unique fertility situation.https://monashivf.com/specialists/dr-katrina-rowan/