Repeated abortions
When there is a history of 2 or more miscarriages consecutively, it is called repeated abortion. It is seen in about 3% of women attempting to conceive.
Some common questions related to recurrent miscarriage include:
- What are the causes of recurrent abortion?
The most common cause is genetic abnormality in the embryo. The risk of genetically abnormal embryo increases with age.
The other common conditions include:
- Uterine abnormality- congenital malformation in the uterus such as uterine septa, fibroid or polyp in the uterus or adhesions in the uterine cavity.
- Immunological conditions- The most frequent abnormality is antiphospholipid antibody syndrome. Abortions occur due to abnormal clotting of blood.
- Chronic diseases in the mother- Diabetes mellitus, uncontrolled hypertension, Renal disease, thyroid disorder
- Occasionally PCOS may cause repeated miscarriage.
- What are the tests done for repeated miscarriage?
- Evaluation begins with a thorough medical history and pelvic examination.
- Uterus is evaluated with an ultrasound scan, MRI or hysteroscopy.
- Genetic abnormalities in the male and female partner needs to be tested for. If any transmissible chromosomal abnormality is detected, IVF with preimplantation genetic testing of the embryo is preferred.
- Other blood tests to rule out immunological conditions and other medical conditions are done.
- What if all tests are normal?
If all tests are normal, the chance of having a live birth in the subsequent pregnancy is 65 in 100 women. So do not loose hope. - Is treatment available for any abnormality detected during testing?
Yes, your doctor will treat the condition depending on the abnormality detected. Correction of blood sugar, BP, thyroid condition or antiphospholipid antibody syndrome is possible with medication.
Corrective surgery for abnormality in uterus can be done in case of septate uterus, fibroid uterus, polyp or adhesions inside the uterus. - Which doctor is best for Recurrent miscarriage treatment?
Dr Sneha J is a Gynecologist and best fertility specialist. She has completed MD OBG from the top university AIIMS , Delhi and University fellowship in Fertility/ Reproductive medicine. She had further training in dealing with these conditions, as a visiting fellow at high output centres in Madrid, Spain and Chicago,USA. A gynaecologist experienced in treatment of these conditions is best for PCOD/PCOS treatment.
Frequently Asked Questions
Repeated abortion is generally described as a history of two or more consecutive miscarriages. If this has happened to you, it is appropriate to discuss your history with a specialist rather than waiting for another pregnancy loss. An evaluation for recurrent miscarriage can help identify possible contributing factors.
Yes. Genetic abnormalities in the embryo are a common cause of recurrent abortion, and the likelihood of a genetically abnormal embryo can increase with age. Your individual risk should be assessed according to your age and reproductive history. Recurrent pregnancy loss can have more than one contributing factor.
Yes. Several uterine abnormalities may contribute to repeated pregnancy loss, including a septate uterus, fibroids, polyps, and adhesions inside the uterine cavity. Appropriate imaging or hysteroscopy can help identify these problems. Uterine abnormalities and miscarriage should be evaluated when clinically indicated.
Certain chronic maternal conditions may contribute to pregnancy loss, including diabetes, uncontrolled hypertension, kidney disease, and thyroid disorders. Managing an underlying medical condition can therefore be an important part of recurrent miscarriage treatment when such a condition is identified.
Yes. Antiphospholipid antibody syndrome is a condition in which abnormal blood clotting can contribute to pregnancy loss. When clinically appropriate, blood tests may be used to investigate immunological and other medical conditions. Antiphospholipid syndrome and miscarriage should be assessed by a qualified specialist rather than assumed from symptoms alone.
Genetic abnormalities in both the male and female partner may need to be evaluated in selected cases. If a transmissible chromosomal abnormality is detected, IVF with preimplantation genetic testing may sometimes be considered. Genetic testing after recurrent miscarriage should be recommended based on the couple's clinical assessment.
A normal ultrasound does not necessarily rule out every possible cause. Evaluation can include medical history, pelvic examination, uterine assessment, genetic testing, and blood tests for immunological or other medical conditions. Recurrent miscarriage evaluation may therefore require several types of investigation.
Hysteroscopy can be used to evaluate the uterine cavity. Ultrasound, MRI, and hysteroscopy may help assess abnormalities such as septa, fibroids, polyps, or adhesions. Whether hysteroscopy for recurrent miscarriage is appropriate depends on the findings and your doctor's assessment.
Yes. When investigations do not identify an abnormality, a successful future pregnancy may still be possible. An unexplained history of miscarriage does not mean that a healthy pregnancy is impossible. Unexplained recurrent miscarriage should be discussed with a fertility or gynaecology specialist for individualized guidance.
In some cases, yes. Treatment depends on the abnormality identified during evaluation. Examples may include managing blood sugar, blood pressure, thyroid disease, or antiphospholipid antibody syndrome, while certain uterine abnormalities may be treated surgically. Treatment after recurrent miscarriage should be planned according to the specific cause identified.
