What Is Recurrent Miscarriage? – Causes, Symptoms & Treatment

By BSc, MSc, PhD (senior clinical embryologist), BSc, MSc (embryologist) and BA, MA (fertility counselor).
Last Update: 07/08/2014

An abortion is an actual conception with no possibility whatsoever to have a sustainable gestation. This of course is very deceiving for the parents-to-be, because they do not only have to face to be childless when they wanted the exact opposite, but they have to deal with the tragedy of suffering an abortion and losing the baby.

The different sections of this article have been assembled into the following table of contents.

Definition

According to the World Health Organisation (WHO), an abortion is defined as the spontaneous termination of pregnancy before the fotus would be viable (its weight is inferior to 500 g on 20th week of pregnancy). Moreover, if we add the adjective recurrent we have the loss of three or more consecutive gestations before the 20th week.

When a couple suffers three consecutive losses, they have already been facing upsetting experiences for a long time and want to know the reason why they are unable to have a successful pregnancy. Likewise, it is also important to know the alternatives they have to solve the situation and finally have a full-term pregnancy.

Epidemiology varies depending on the age of the mother. A mother under age 30, has only 25% chances to have another abortion. On the other hand, being older than 40 increases the rate up to 50-60%.

Main causes

Half the recurrent miscarriages do not have a clear diagnose.

When it is not possible to determine which the cause is —which occurs in 70% of the cases—, gestation ends with a healthy newborn in the next pregnancy.

Even though there's not a clear cause in most of the cases, several risk factors can be named, such as maternal age, and previous miscarriages.

The main causes of recurrent miscarriage are:

  • Genetic factors: half the cases of abortion have a genetic origin.
  • Immunological factors: specially the antiphospholipid syndrome (APS).
  • Thrombophilia: acquired, primary, or secondary being responsible of 10-15% of the cases.

All these causes have been studied and researched, although there are causes that remain yet to be proven, like uterine anatomical abnormalities that may have a key role in this kind of abortion. Unfortunately, the research available is still not consistent enough to support such hypothesis. Finally, there are less prevalent causes like those associated with the endocrine system, infections, and the autoimmune system.

FAQs from users

I have a history of recurrent miscarriage, when should the embryo transfer be done in my case?

By José Luis de Pablo BSc, MSc, PhD (senior clinical embryologist).

The fact that a woman has had repeated miscarriages in the past has nothing to do with the day of the embryo transfer. In most of the cases, it is associated with the chromosomes of the embryos. Keeping this in mind, ideally the best treatment option in these cases would be IVF with PGD (Preimplantation Genetic Diagnosis). With PGD, we examine 6-8 cells of each embryo. It allows us to find out which embryos are genetically norma and which don't.

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References

Authors and contributors

 José Luis de Pablo
José Luis de Pablo
BSc, MSc, PhD
Senior Clinical Embryologist
Double Degree in Biology and Biochemistry from the University of Navarra. Master’s Degree about the Theoretical Basis and Laboratory Procedures in Assisted Reproduction from the University of Valencia (UV). Senior Clinical Embryologist from the ESHRE and ASEBIR Certification in Clinical Embryology. More than 15 years of experience as the director of IVF labs. More information about José Luis de Pablo
 Laura Gil Aliaga
Laura Gil Aliaga
BSc, MSc
Embryologist
Bachelor's Degree in Biology & Biochemistry from the Miguel Hernández University of Elche (UMH) and the University of Alicante (UA). Master's Degree in Biology of Human Assisted Reproduction. Embryologist at clinic UR Vistahermosa (Alicante, Spain). More information about Laura Gil Aliaga
Adapted into english by:
 Sandra Fernández
Sandra Fernández
BA, MA
Fertility Counselor
Bachelor of Arts in Translation and Interpreting (English, Spanish, Catalan, German) from the University of Valencia (UV) and Heriot-Watt University, Riccarton Campus (Edinburgh, UK). Postgraduate Course in Legal Translation from the University of Valencia. Specialist in Medical Translation, with several years of experience in the field of Assisted Reproduction. More information about Sandra Fernández

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