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OVERVIEW

What is recurrent pregnancy loss?

Recurrent pregnancy loss is when you have 2 or more pregnancy losses, or miscarriages. Miscarriage is when your pregnancy ends on its own in the first 20 weeks of gestation. Experts estimate that 10% to 20% of known pregnancies end in miscarriage. Having repeated miscarriages is less common. Only about 1% of women experience these.

SYMPTOMS

Each miscarriage you have may be different. One could cause pain and bleeding, while another could have no symptoms. Typical symptoms of a miscarriage include:

• Spotting or bleeding
• Mild-to-severe back pain (worse than menstrual cramps)
• White-pink mucus discharge from the vagina
• Contractions (painful, happening every 5 to 20 minutes)
• Tissue that looks like a clot passing from the vagina
• Sudden decrease in signs of pregnancy

CAUSES

What causes recurrent pregnancy loss?

It can be hard to tell what causes a miscarriage. Often it is a random problem involving chromosomes that happens at conception. In most cases, no cause is found.

Some problems and health conditions can cause repeat miscarriages. These include:

• This is when one partner has abnormal chromosomes in their eggs or sperm. One piece of a chromosome is transferred to another chromosome. The embryo might get too much or not enough of the proper chromosomes. A miscarriage could occur.
• Congenital uterus problems. There are many problems that can happen with the uterus. One common problem is a called a septate uterus. This is when the uterus is partially divided into 2 chambers. It can cause complications with pregnancy, including miscarriage.
• Growths or adhesions in the uterus. Asherman syndrome causes adhesions and scarring in the uterus. These can lead to miscarriage. Growths in the uterus also may play a role in miscarriage. These could include fibroids or polyps.

Some medical conditions could increase your risk of having multiple miscarriages. These include:

• Problems with your immune system
• Thyroid disease
• Diabetes
• Polycystic ovary syndrome
• Thrombophilia (blood clotting disorder)

Nothing you have done is causing you to have repeat miscarriages. Things like working, exercising, having sex, or morning sickness do not cause miscarriage. Any kind of fall or blow is rarely to blame. The research on the effects of alcohol, tobacco, and caffeine is unclear. So, your miscarriages are not the result of anything you did or didn’t do. You should never blame yourself for a miscarriage.

DIAGNOSIS

How is recurrent pregnancy loss diagnosed?

Your healthcare provider will probably want to do some testing. This can help them try to find a cause. They will ask about your medical history. They will get details on your past pregnancies. Your healthcare provider may do a physical exam. They may order blood tests. Your healthcare provider might order imaging tests to look at your uterus. They might also order special testing to look for genetic reasons that you’re having miscarriages.

PREVENTION

Can recurrent pregnancy loss be prevented or avoided?

There is no conclusive research that says there is anything you can do to prevent a miscarriage. You didn’t cause it, so you couldn’t have prevented it.

TREATMENT

Treatment options depend on what is causing the problem. Some possible treatments include medicines, corrective surgery, or genetic counseling. If no cause is found, not much can be done. More than half of women who don’t know the cause can go on to have a healthy pregnancy.

Living with recurrent pregnancy loss

A pregnancy loss can be emotional even if the pregnancy was unplanned. Everyone grieves a pregnancy loss differently. Some women may have trouble coping with their feelings. If you are very upset or feel like you need help, there are resources available. Talk to your healthcare provider. They may be able to refer you to a local support group.