According to the American Society of Reproductive Medicine, when a woman has 2 or more consecutive miscarriages, the pregnancy loss is considered recurrent. Pregnancy loss is defined as a clinically recognized pregnancy that ends involuntarily before 20 weeks. Clinically-recognized means that the pregnancy has been observed on an ultrasound or that the tissue was identified after the miscarriage. Miscarriage is often caused by genetic abnormalities although the loss could also not have an identifiable reason. Other factors that can contribute to pregnancy loss include advanced maternal age, abnormalities in the uterus, the mother’s immune system, or conditions such as thyroid disease or diabetes.
The doctors at San Francisco Women’s Healthcare will provide treatment to address the cause of the recurrent miscarriages. For example, if the pregnancy loss is due to a genetic abnormality, patients are referred for genetic counseling. Some couples may opt for prenatal genetic studies or IVF, which allows for the embryos to be tested for genetic abnormality before implantation. If the miscarriages are caused by uterine abnormality, surgery to correct the uterus may be performed. If the miscarriages are caused by medical conditions like thyroid dysfunction or diabetes, specific medications are prescribed and the pregnancy is carefully monitored.
There are a variety of tests that the doctors can perform to identify the cause of recurrent miscarriage. Typically both parents will have a karyotype analysis to check for genetic abnormalities which could be passed to the embryo. The woman will also usually have an exam of her uterus and uterine cavity. This is often completed with an ultrasound, MRI, or hysteroscopy. The woman’s ovarian reserve may also be checked as lower ovarian function often means that the egg reserve is dwindling, which results in a higher likelihood of chromosomal abnormality.