Pregnancy is often seen as an exciting journey that unfolds. Still, it can sometimes take a heartbreaking turn, particularly when losses occur repeatedly. While early pregnancy loss is not uncommon, facing it twice in a row is a much rarer experience. Only about 5% of women will endure recurrent miscarriages, and roughly 1% will encounter three or more.
So, what often lies behind these heart-wrenching experiences? The most common cause is frequently attributed to genetic factors. Over half of early pregnancy losses are linked to abnormal chromosome counts in the embryo. Beyond genetics, several other factors can play a role. Issues within the uterus, such as fibroids or septa, hormone imbalances (like thyroid or insulin disorders), immune system challenges (think antiphospholipid syndrome), and blood-clotting conditions can all raise the chances of repeated losses.
Diagnosing Recurrent Miscarriage
A miscarriage is the loss of a pregnancy within the first 24 weeks of gestation. When a woman experiences three or more consecutive miscarriages, this is known as recurrent miscarriage.
Although miscarriage and infertility are different conditions, both can be equally emotionally challenging. Many of the same medical issues that affect a woman’s ability to conceive can also contribute to recurrent pregnancy loss.
If you or someone you care about has experienced multiple miscarriages, know that you are not alone. Recurrent miscarriage affects about 1% of couples trying to conceive. The risk is higher for women over the age of 35 or those who have had previous miscarriages.
Despite the emotional toll, there is hope. Many couples who have experienced recurrent miscarriages go on to conceive naturally and have successful pregnancies. For others, advances in assisted reproductive technologies like IVF offer new possibilities. IVF can help identify and address the underlying causes of pregnancy loss, improving the chances of a healthy, full-term pregnancy.
What is the main cause of recurrent miscarriages?
A common cause is the structure of the uterus. The shape or condition of the uterus can affect a pregnancy’s ability to develop properly. Uterine abnormalities such as fibroids, polyps, or adhesions (scar tissue) may interfere with embryo implantation or growth.
Hormonal imbalances also play a significant role. For pregnancy to progress normally, hormone levels must be well-regulated. Conditions such as uncontrolled diabetes, thyroid disorders, and elevated prolactin levels can disrupt this balance, making it harder to maintain a pregnancy.
Chromosomal abnormalities in the embryo are another cause. These conditions can occur during conception and are not always inherited, although the abnormalities may sometimes be passed from one or both parents. When suspected, genetic testing can help clarify the cause and guide treatment. Other less-defined causes include infections and sperm-related issues.
Lifestyle factors such as smoking, excessive alcohol or caffeine intake, exposure to environmental toxins, and obesity can increase the risk. They should be addressed as part of any fertility care plan.
How IVF Can Help After Recurrent Pregnancy Loss
In IVF, a significant part of the process occurs in the embryology lab, where eggs are fertilised and embryos are cultured, monitored, graded, and prepared for transfer or freezing. This careful process gives you more insight into factors that may cause pregnancy loss, which is especially important after multiple miscarriages.
In the lab, techniques such as Intracytoplasmic Sperm Injection (ICSI) and Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) can improve success rates. ICSI involves injecting a single sperm directly into an egg, which helps when sperm quality or quantity is low. IMSI takes this further by using a powerful microscope to select the healthiest sperm, reducing genetic risks and improving embryo quality.
With embryo grading, embryologists carefully examine embryos to select those that appear the healthiest and have the best chance of implanting and developing into a successful pregnancy.
IVF also helps manage underlying medical conditions such as uterine problems or hormonal imbalances. Your fertility specialist may recommend treatments or surgery before starting IVF to prepare the uterus for embryo transfer.
Another advantage of IVF is the option of frozen embryo transfers, which can be timed perfectly when the uterus is most receptive. This flexibility often leads to better implantation rates and healthier pregnancies.
A Chapter of Hope
While IVF does not guarantee pregnancy, it offers a personalised approach that addresses many causes of recurrent miscarriage. With careful monitoring, hormone support, and tailored care, it gives many couples renewed hope and a better chance of carrying a pregnancy to term.
If you have experienced multiple miscarriages (pregnancy losses), speak with a fertility specialist about your options.
