Miscarriage occurs in a certain percentage of pregnancies, but recurrent miscarriage is diagnosed after three consecutive miscarriages before the 20th week of pregnancy.
Causes of Recurrent Miscarriage
- Autoimmune Disorders: Conditions affecting the placenta’s function during pregnancy can reduce the chances of successful implantation and early growth.
- Genetic Abnormalities: Errors in the division and pairing of genetic material may occur without any inherent issues in either parent’s genetics but rather from the combination of their genes.
- Inherited Clotting Disorders
- Infections: Certain infections can be transmitted to the fetus from the mother and may contribute to miscarriage risk.
- Polycystic Ovary Syndrome (PCOS)
- Thyroid Hormone Imbalances
Tests for Recurrent Miscarriage
- Immune System Tests: ANA, Cardiolipin Antibodies, Lupus Anticoagulant, and TPO.
- Chromosomal Analysis: Genetic testing for both parents, and if possible, cells from the lost fetus.
- Genetic Clotting Tests: Factor V Leiden, Factor II, MTHFR mutations.
- Infection Screening: Testing for infections like Rubella, CMV, Hepatitis B, and Hepatitis C.
- Hormone Testing for PCOS
- Thyroid Function Tests: TSH, T3, and T4.
- Blood Type Compatibility: Testing both parents to ensure compatibility of the Rh factor.
Recommended Tests for Identifying Causes of Recurrent Miscarriage
- Cardiolipin Antibodies
- Phospholipid Antibodies
- ANA/ENA
- Sperm Antibodies
- Anti-Thrombin III
- Lupus Anti-Coagulant
- Factor V Leiden (PCR)
- Factor II
- MTHFR
- TSH/TPO
- Protein S Free Antigen
- Protein C Functional
It is recommended to consult a healthcare provider for interpretation and guidance.
Treatment for Recurrent Miscarriage
Treatment for recurrent miscarriage focuses on addressing specific underlying causes:
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Managing Medical Conditions
Conditions like thyroid disorders, diabetes, and obesity, which increase the risk of recurrent miscarriage, should be treated appropriately.
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Addressing Chromosomal Abnormalities
Couples with genetic issues may benefit from genetic counseling, which can provide options for screening and managing potential chromosomal abnormalities in future pregnancies.
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Correcting Uterine Abnormalities
Structural issues in the uterus, such as congenital malformations or fibroids, may be treated surgically. Referral to a reproductive endocrinologist is advised in these cases.