Recurrent miscarriages are one of the main reasons why patients visit a fertility specialist.
Approximately 20–25% of pregnancies end in miscarriage. Recurrent pregnancy loss is defined as the loss of three or more consecutive pregnancies before 20 weeks of pregnancy.
A miscarriage is a spontaneous pregnancy loss that occurs before 20 weeks of pregnancy. When miscarriages occur repeatedly, this is known as recurrent pregnancy loss. However, some experts maintain that miscarriages may not be consecutive.
Having had a live birth before or between miscarriages does not appear to reduce the risk of a subsequent miscarriage. There is no universal consensus on the number of miscarriages that warrant further investigation.
At IVF-Life, we believe it is important to try to prevent patients from experiencing another pregnancy loss. We therefore consider it necessary to carry out the appropriate investigations to identify possible causes and reduce the risk of recurrence.
Most miscarriages occur before 12 weeks of pregnancy, that is, during the first trimester. They can be classified according to when they occur:
When a patient has had a miscarriage twice, the probability of having a miscarriage again is between 24-30%. After the third miscarriage the percentage rises to 30-33%. The causes of recurrent miscarriage can be divided into known and unexplained causes. Known causes are:
Possible causes include genetic abnormalities in the embryo, abnormalities in the parents' karyotypes and chromosomal abnormalities associated with advanced maternal age and/or certain semen abnormalities.
A growing number of studies have linked paternal age over 45 with an increased incidence of miscarriage.
Immunological or coagulation disorders in the mother, such as antiphospholipid syndrome, are one of the main causes of recurrent miscarriages.
Infections during the first trimester, such as cytomegalovirus infection, toxoplasmosis or rubella, may increase the risk of miscarriage. Other reasons for repeated miscarriages can be uterine abnormalities, cervical insufficiency or the presence of fibroids within the uterine cavity.
In a significant proportion of cases of recurrent miscarriage, no specific cause can be identified.
Other factors may adversely affect pregnancy outcomes and increase the risk of recurrent miscarriage or complications during pregnancy.
Examples of these are maternal obesity, associated pathologies such as high blood pressure or diabetes, and also multiple pregnancies. That is why at IVF-Life we have the technology and experience to transfer a single embryo without affecting our success rates.
Patients frequently ask us about factors such as lifestyle and stress. Although the evidence is not conclusive, certain lifestyle factors may influence the risk of pregnancy loss.
In order to prevent further miscarriages, we must carry out different studies and evaluate all the factors. Parental karyotyping may be carried out as part of the investigation. Sometimes the preimplantation genetic testing can be performed to rule out structural alterations. Some of these chromosomal abnormalities compromise the viability of the embryo, leading to implantation failure or miscarriage, and others would lead to a disease in the future baby.
We can also carry out the preimplantation genetic testing for aneuploidy (PGT-A). We carry out a genetic study for the detection of aneuploidies associated with advanced maternal age or pathological semen. In this way, we can select the embryos with the greatest implantation potential and give rise to a viable pregnancy.
Serological screening is also carried out at the beginning of treatment to rule out pathologies already mentioned in this article such as rubella, cytomegalovirus and toxoplasmosis.
An ultrasound scan or hysterosalpingography (HSG) may also be performed. This test evaluates the shape of the uterus and checks whether the fallopian tubes are patent. This will help us to rule out uterine malformations or fibroids.
It is important to carry out a study of thrombophilias, or blood clotting disorders, as they tend to form clots or thrombus.
IVF-Life's assisted reproduction specialists recommend maintaining a healthy lifestyle and looking after both physical and emotional well-being during the first weeks of pregnancy. It is important to maintain these healthy habits after embryo transfer and once embryo implantation and pregnancy have been confirmed. During this period, it is also advisable to monitor potential risk factors.
During this period, it is also advisable to control risk factors. Avoiding tobacco and alcohol is important, as is maintaining adequate levels of nutrients such as folic acid and vitamin D.
At IVF-Life, our ability to provide personalised reproductive care is based on tailoring each treatment to the individual patient. For this reason, we are committed to offering each patient a treatment plan that meets their specific needs.