Making Sense of Recurrent Miscarriage

Recurrent miscarriage, or recurring pregnancy loss, is an emotionally charged and heartbreaking experience for many couples. Sadly, as many as 25 percent of pregnancies will end in a miscarriage, usually before the first trimester is completed.

Learn about the causes of miscarriage
The loss of two or more pregnancies is considered, by medical definition, recurrent miscarriage. For half of all miscarriages, the cause is never determined. On the bright side, most women who experience a miscarriage (or several) will ultimately go on to have healthy babies.

Causes of recurrent miscarriage include:

  • Chromosomal abnormalities in either parent
  • Advanced maternal age - the mother is over 35 years old
  • Hormonal problems
  • Any medical condition ranging from Celiac disease to Lupus, obesity or thyroid problems
  • Problems with the uterus due to polyps, fibroids, or uterine septum, or any other condition
  • Asherman’s  syndrome (scar tissue in the uterus)
  • Thrombophilia

With recurrent miscarriage, family history may come into play. Share any pertinent information about your genetic family tree with your doctor. For example, if anyone in your family has Down’s syndrome, Turner’s syndrome or any other chromosomal abnormalities, your doctor should know.

Get tested for recurrent miscarriage
If you have experienced recurrent pregnancy loss, the main objective is to prevent subsequent ones. Seeing a doctor after experiencing a miscarriage is important for two main reasons: the doctor may be able to figure out what happened, and be able to help you avoid a future miscarriage. For your health, it’s important to make sure that your body fully-shed the loss. 

Your doctor may recommend one of these tests after recurrent miscarriages:

  • Hysterosalpingogram (HSG) to identify problems with the uterus or fallopian tubes
  • Blood tests for the man and woman to ascertain the health of their chromosomes, potential clotting disorders and immunological agents, including Anticoagulant and Cardiolipin Antibody testing
  • Hormonal blood tests (including thyroid and pituitary)
  • Preimplantation Genetic Screening (PGS) - especially if undergoing in vitro fertilization (IVF)

By examining the genetic health of embryos prior to implantation, PGS screens help reduce the likelihood of having a pregnancy with a chromosome problem, like Down’s syndrome. PGS may increase your likelihood of having a successful pregnancy

Have an action plan
The more you know, the better your odds are of having a successful pregnancy. Couples who have experienced multiple pregnancy loss often have an easier time trying again if they have an action plan. An action plan focuses on physical health and treatment options. An action plan can also restore a sense of calm. Talking to your doctor can stack the odds of a successful pregnancy in your favor. Being vigilant about testing for every potential known cause of recurrent miscarriage can do the same. So, be vocal about your concerns, your family genetics and your fears. All are part of creating a successful action plan.

Focus on your partnership
Staying intimate may seem difficult after recurring pregnancy loss, but it’s one of the most important things you can do to help your relationship stay strong during this emotionally charged time. Staying sexually active after a positive pregnancy test – even if you experienced a miscarriage the last time you were pregnant – can help take the stress down a notch, something that is good for you, your partner and your pregnancy.

If participating in sexual intimacy is just too stressful an idea to entertain, consider talking to a counselor or sit down with your partner and share what you’re feeling, thinking and experiencing. Communication is key to keeping stress levels down and pregnancy success rates up.

Remain healthy after miscarriage
When pregnancy does not come easily, make sure to follow these healthy lifestyle tips to boost your fertility: 

  • Achieve a healthy fertility weight
  • Refrain from smoking
  • Don’t consume caffeine or alcohol
  • Engage in moderate, regular exercise
  • Avoid contact sports
  • Try to reduce stress
  • Take prenatal vitamins containing folic acid daily
  • Avoid exposure to toxic products and chemicals at home and at work

Supporting each other after recurrent pregnancy loss
Because men and women grieve differently, it’s easy for each partner to feel alone and unsupported after recurring pregnancy loss or recurrent miscarriage.

Women tend to be expressive and emotional and often seek out guidance, support and validation from people outside the partnership. Men often seem less emotional and often seem to grieve alone, without sharing their experience with anyone outside the couple. Of course, there are exceptions to these generalizations.

If the partners of any sex appear to be grieving divergently, it’s your job to say something.  It’s easy for one partner to feel isolated and alone after recurring pregnancy loss.  Again, communication is key, and it’s easier said than done. Approaching a grieving or stressed-out partner when you, yourself are grieving and stressed-out is no small task.

Learning to understand and accept each partner’s personal grieving style can go a long way towards helping you both experience the loss and be supported in it. The healing period may take longer for one of you.  Just remember, you need each other most right now, so take steps to reach out and help one another.

Once you have both restored your centers of gravity, you can and will find the courage to try again.

This may be a very difficult time for one or both of you.  But together, with understanding and patience, you may find yourselves to be a stronger couple, something that will benefit your future children immensely.

Hope is a powerful tool and, given that most women who experience recurrent miscarriage will one day conceive and give birth to a healthy baby, it is a realistic outlook. Recurrent miscarriage and recurring pregnancy loss are most likely a painful step along the journey to building the family you’ve always wanted.

Ask a doctor about fertility after miscarriage

This content is Copyright The American Fertility Association (AFA) 2010. This content is intended for personal use and may not be distributed or reproduced without AFA consent. Please contact info@theafa.org or visit theafa.org for more information.

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