What Causes Recurrent Miscarriage

 

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Webinar Geoffrey Sher, MD Recurrent Miscarriage

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Anatomical factors that may cause recurrent miscarriages include: 1  Uterine septum (or other congenital problems) Cervical insufficiency Fibroids (controversial) Uterine scarring. In the other half, causes can be found and these include: Abnormalities of the pregnant woman’s womb (uterus). For example, long-standing infection or inflammation of the womb A weak (incompetent) neck of the womb (cervix), also known as cervical. Another possible cause of recurrent miscarriage is a congenital anomaly of the uterus. Examples include a septate uterus, adhesions and scarring of the uterus, an incompetent cervix, fibroids, and polyps.

Women with certain medical conditions may. Recurrent miscarriage may be attributed to an underlying health condition. For example, an autoimmune disorder called antiphospholipid syndrome (APS) is associated with miscarriage and fetal death. In this condition, the immune system creates antibodies to certain substances involved in normal blood clotting. Recurrent miscarriage is two or more consecutive pregnancy losses.

In contrast, infertility is the inability to conceive. In many cases the cause of RPL is unknown. After three or more losses, a thorough evaluation is recommended by American Society of Reproductive Medicine. About 1% of couples trying to have children are affected by recurrent miscarriage.

Recurrent early miscarriages (within the first trimester) are most commonly due to genetic or chromosomal problems of the embryo, with 50-80% of spontaneous losses having abnormal chromosomal number. Structural problems of the uterus can also play a role in early miscarriage. The miscarriage may be due to poor blood supply to the pregnancy or inflammation. Some women may be born with an irregularly shaped uterus, and some women may develop abnormalities with their uterus over time.

A woman’s immune system may also play a role in recurrent pregnancy loss. Usually, the cause was a random genetic problem in the developing baby, and there was nothing that could have prevented it. 1  And as you probably know, the majority of women who have one miscarriage go on to have an uneventful next pregnancy.

Miscarriage Causes and Risk Factors Most miscarriages happen when the unborn baby has fatal genetic problems. Usually, these problems are not related to the mother. However, the likelihood of having recurrent miscarriages (at least 2 or 3) is low, only occurring in about 1 percent of women.

Studies have shown an increased risk for miscarriage in.

List of related literature:

The most common cause of late miscarriage is a maternal factor involving premature dilation of the cervix, but fibroid tumors and uterine abnormalities are other maternal causes of late miscarriage.

“Having Your Baby Through Egg Donation: Second Edition” by Evelina Weidman Sterling, Ellen Sarasohn Glazer
from Having Your Baby Through Egg Donation: Second Edition
by Evelina Weidman Sterling, Ellen Sarasohn Glazer
Jessica Kingsley Publishers, 2013

The most common known causes of stillbirth are maternal diabetes, bacterial infection, high blood pressure, placental problems, growth restriction, and umbilical cord accidents.

“Our Bodies, Ourselves: Pregnancy and Birth” by Boston Women's Health Book Collective, Judy Norsigian
from Our Bodies, Ourselves: Pregnancy and Birth
by Boston Women’s Health Book Collective, Judy Norsigian
Atria Books, 2008

Other possible causes of early miscarriage include endocrine imbalance (as in women who have luteal phase defects, hypothyroidism, or insulin-dependent diabetes mellitus with high blood glucose levels in the first trimester), immunologic factors (e.g.,

“Maternal Child Nursing Care E-Book” by Shannon E. Perry, Marilyn J. Hockenberry, Kathryn Rhodes Alden, Deitra Leonard Lowdermilk, Mary Catherine Cashion, David Wilson
from Maternal Child Nursing Care E-Book
by Shannon E. Perry, Marilyn J. Hockenberry, et. al.
Elsevier Health Sciences, 2017

Although the actual cause of the miscarriage is frequently unclear, the most common reasons include the following: • Genetic factors: Chromosomal abnormalities are probably the most common underlying cause for first and early second trimester miscarriages.

“Textbook for MRCOG-1: Basic Sciences in Obstetrics & Gynaecology” by Richa Saxena
from Textbook for MRCOG-1: Basic Sciences in Obstetrics & Gynaecology
by Richa Saxena
Jaypee Brothers,Medical Publishers Pvt. Limited, 2019

Other causes of miscarriage include endocrine abnormalities, maternal infection, uterine abnormalities (e.g., uterine fibroids, endometriosis), immunologic factors, and environmental factors.

“Lewis's Medical-Surgical Nursing E-Book: Assessment and Management of Clinical Problems, Single Volume” by Mariann M. Harding, Jeffrey Kwong, Dottie Roberts, Debra Hagler, Courtney Reinisch
from Lewis’s Medical-Surgical Nursing E-Book: Assessment and Management of Clinical Problems, Single Volume
by Mariann M. Harding, Jeffrey Kwong, et. al.
Elsevier Health Sciences, 2019

Other factors are stress, uterine anomalies or cervical trauma; uterine stretch caused by multiple gestation or polyhydramnios; smoking, drug, or alcohol use; and maternal age extremes or low socioeconomic and educational status or an uncontrolled medical condition.

“Core Curriculum for Maternal-Newborn Nursing E-Book” by AWHONN, Susan Mattson, Judy E. Smith
from Core Curriculum for Maternal-Newborn Nursing E-Book
by AWHONN, Susan Mattson, Judy E. Smith
Elsevier Health Sciences, 2010

Recurrent miscarriage, three or more consecutive miscarriages, occur in 2% to 3% of women and are usually caused by chromosomal abnormalities, metabolic disorders, immune factors, problems with the woman’s reproductive anatomy, or metabolic disorders (Horn & Alexander, 2005).

“Dimensions of Human Behavior: The Changing Life Course” by Elizabeth D. Hutchison
from Dimensions of Human Behavior: The Changing Life Course
by Elizabeth D. Hutchison
SAGE Publications, 2008

• Previous repeated miscarriages may be due to genetic causes, antiphospholipid antibody syndrome, syphilis, mullerian anomalies such as an intrauterine septum or concomitant pathology such as fibroids in the uterus or immunological causes.

“Manual of Obstetrics E-book” by Daftary, SUDIP Chakravarti, Muralidhar Pai, Prahalad Kushtagi
from Manual of Obstetrics E-book
by Daftary, SUDIP Chakravarti, et. al.
Elsevier Health Sciences, 2015

Other contributing causes to recurrent miscarriage are: endocrine abnormalities; blood disorders; environmental agents; immunologic reactions; and maternal

“Infertility Counseling: A Comprehensive Handbook for Clinicians” by Sharon N. Covington, Linda Hammer Burns
from Infertility Counseling: A Comprehensive Handbook for Clinicians
by Sharon N. Covington, Linda Hammer Burns
Cambridge University Press, 2006

Other causes are trauma, sudden uterine decompression, short cord, supine hypotension syndrome, placental anomalies, sick placenta, folic acid deficiency, uterine factor, torsion of the uterus, cocaine abuse, thrombophilias, prior abruption, etc.

“Elsevier Comprehensive Guide to Combined Medical Services (UPSC)-E-Book” by Rajeev Kumar, Prakash Nayak
from Elsevier Comprehensive Guide to Combined Medical Services (UPSC)-E-Book
by Rajeev Kumar, Prakash Nayak
Elsevier Health Sciences, 2015

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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46 comments

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  • Watch the next video in this series, all about what we did differently to have a successful pregnancy after miscarriage: https://www.youtube.com/watch?v=t5AV1-Ow-WM

  • Thank you for this video! I wish I could find a doctor who takes my concerns about recurrent miscarriage seriously ��. I just had my fifth miscarriage and this was the latest it’s happened (I was 13.5 weeks). I’ve had two perfectly healthy pregnancies so I don’t know what’s going on. All the doctors I’ve seen have told me it’s just bad luck and keep trying.

  • After having three children with no issues I suddenly started having miscarriages.
    I’ve Just had my 5th back to back loss. We’ve tried progesterone, low dose aspirin. Lots of tests. Still waiting on our rainbow ��

  • I had recurrent miscarriage in early trimester and again twice within two month my Gyn give me injection that I should inject my belly for six months and pills to insert in my vag as soon as I start using that I had miscarriage with my second pregnancy what was the problem Dr Uthuman what must I do rectify it.

  • What a through explanation! I absolutely enjoyed your lecture. As a medical professional I found the information to be accurate, easy to understand, and mentally stimulating. Thank you for being so informative!

  • Ive just watch your videos and love the way you’ve explain it…i just want to ask hope you apprehend to reply..since 2013 i got pregnant but got miscarriage at that time my age is 39 till now hopeless to get pregnant again.Do i still have a chance to get pregnant again?and if so what medicine can i take to get pregnant? Have a heart to reply pls!

  • Thanks doctor I have learned a lot from you so far even if it’s only 24 hours that I discovered your channel and you explain every well and answering our questions too. God bless you mighty thanks for your efforts well done ����

  • Hi hun, thank you soo much for making this video and congratulations on your rainbow baby, it really gives me hope. I have just experienced my 5th early loss �� me and my partner have been tested for everything and all came back ok. I am considering asking for a referral to a specialist again as it has been a couple of years since I was last ttc. I have been told I can get prescribed progesterone next time I get pregnant (didn’t have chance to this time as i miscarried really early ☹️ ) but I would love to know what your protocol was so i can perhaps try myself or speak to my GP, sometimes I feel we are more of an expert in this field than they are! Thank you xxxx

  • Ive just watch your videos and love the way you’ve explain it…i just want to ask hope you apprehend to reply..since 2013 i got pregnant but got miscarriage at that time my age is 39 till now hopeless to get pregnant again.Do i still have a chance to get pregnant again?and if so what medicine can i take to get pregnant? Have a heart to reply pls!

  • Hello Dr,
    I would like to know what causes me to delay in my period for a full week yet I don’t use any thing and can it be possible for me to normalize to 3_4days like others.

  • Im 39 gonna be 40 in few months had last baby 13 yrs ago recently trying again 14 months n had 2 miscarriages should i just give up cause my age??

  • Thank you for sharing this, I’m in a similar situation at the moment with already having a 4 year old with a very easy/healthy pregnancy, in the last year I have had 2 early miscarriages 1 at 5 weeks and 1 at 8 weeks and have literally just had a traumatic miscarriage at 14 weeks so still recovering. I want to start trying again asap but obviously scared… did you contact your GP as soon as you found out you were pregnant again as I’ve had no support in what to do next if I get pregnant, so glad you ended up with another healthy baby:)

  • 3 chemical pregnacy in one year i have pcos and this pregnacies was all assited with clomid or femara my doctor say they cant do anything to prevent that can you explain why chemical pregnany occur and chances of normal pregnancy in future. I age 23

  • What you showed first is what the said about both my babies. I feel alot better knowing i can pen point the problem God bless you for being brave enough to tell the whole truth to us who did not go to college and got a degree in medicine and puting it in symple terms

  • My journey was miscarriage with an ex, successful natural conception with husband, then problems for 2 years finally diagnosed with PCOS. Started clomid had 3 miscarriages, dr combined metformin and clomid and then successful conception with live birth healthy baby. Miscarriage, then back on clomid but instead of metformin took inofolic supplement, success leading to live birth. Then miscarriage again and now another successful pregnancy but natural conception ����‍♀️ very random 2 out of 4 babies successfully conceived with husband needed the help with clomid but the other 2 were natural. Also PCOS on last few scans wasn’t present anymore so could be dormant again. ����‍♀️

  • Hi
    I am new to your channel, diagnosed with pcos, had two miscarriages at week 8. Given clomid this month, but no symptom of pregnancy. What should i do to escape?

  • I have a question as you said a women with a thick lining that becomes thick during a cycle cannot have a damaged uterus lining but I have spoken to a women who has had severe damage but here womb was getting thick but it was the hormones getting thick over the scar tissue is this correct as you have not mentioned it thankyou

  • Hi what was the name of the last thing you mention to take 81mgs a day? I did not catch the name. Thank you so much for the information and your help with this.

  • Mirembe with my second loss he draw blood for test, is when he decide to give vaccines and pills when I fall pregnant for the third time pregnancy after loss it again he scan me and told me everything is fine even measure my womb and check the cervix said its fine that was last year September. Now maybe I can try RHD with him or how?

  • Please I have some questions
    1. How can one treat staphylococcus
    2. How can one clean uterus
    3. Is it permitted to have sex during the first week to the fifth week of pregnancy
    4. How one knows if she can ovulate or can’t ovulate
    5. Is it possible for a sperm to be unable to fertilize an egg even after the test confirms it good?

  • Dr. Davis, I came across this video when searching for help understanding the process of testing after recurrent pregnancy loss. I have had 3 miscarriages in the past 10 months and I also have a healthy 3 year old daughter. I’m 32 and have no known health issues. I just started seeing a fertility specialist but as part of their initial work up, they want to do a hysteroscopy. My question is…should we wait to see what our lab testing shows before we jump to the hysteroscopy? I had all kinds of blood work done, chromosomal testing as well as an ultrasound so far. I’m awaiting the results from these tests. Thank you.

  • I am a patient with Type 1 diabetes which is controlled, hba1c is always 6.2mmol/L and I have hypothyroidism, I was pregnant with twins and lost both at 6 weeks, I was tested AFTER the fact and I have been diagnosed with having high levels of Antibodies, would this have contributed alone to the loss or would it be the antibodies in conjunction with other diabetes related issues? I will be getting treatment for the antibodies this week and will start trying again, I just want to know if the fact that I have hypothyroidism may have been the main contributing factor.

  • I have (4) living children. Zero issues in pregnancy. My blood type is also Aso I know I’m blessed alone to have them without zero issues thanks to Rogham. Anyways my 5th was born with a rare genetic disease not hereditary and only (40) cases reported world wide. They told me she would have two years to live and she passed at 4 months old. Since then me, my husband and my children have wanted just one more baby, but I’ve been miscarrying. I had a missed miscarriage at 14 weeks. We found out it was twins 1 measuring (8) weeks and the other measuring (10) weeks. Anyways we chucked it off as a fluke and that was a bad idea… since then I’ve had a chemical pregnancy every single month. My doctor suggested I may have been sensitized because of my blood type but we don’t think that because we don’t think it would cause loss at implantation and I’m having these losses so early on! So she did prescribe me progesterone and now I’m switching to a high risk doctor for further testing. Lots of blood tests. Hopefully we figure it out. It’s so hard to hang on to being able to get pregnant but not being able to keep the babies, specially after having such a easy time with my first (4) it’s really just mind blowing to me ��

  • I have 2 miscarriage one was at 9 week it was a blighted ovum and the other was at 7 weeks the baby stop developing. I was 23 years old and I want to become a mother. What can I do to do have a normal pregnancy.

  • I sent for altar sound, the result was Fibroid with the size 22mm. I will be pregnant by November and i hope it will not affect my baby and this will be my first pregnancy.

    Doc, what medication can i use to get rid of it?
    Please reply me.

  • Hello Dr Uthuman,is there a chance of giving healthy baby when a woman has taken poison in past(3yrs from now), because i heard woman who has taken poison cant deliver healthy babies.

  • I lost my baby in seventh month-28th week, due to placenta abruption..My wife was diagnosed with high BP of around 140/90 during sixth month and was taking medicines for that, but one day in morning, suddenly she started bleeding and we rush to hospital where we come to know that baby’s heart beat has stopped.I want to know all possible reasons of placenta abruption, causes and the medical tests or treatments through which this can be avoided…Many thanks in advance..

  • So strange I am doing your lockdown baby classes with my 5 month old little boy & stumbled across your video. I had 4 before we got lucky. I’m 42 so we were pretty sure it was poor egg quality but we made some lifestyle changes and after the fourth gave up, had an accident and the rest is history. Thanks for the classes they are keeping me sane. Just catching up on wk 6.

  • evening DR please I need your help am married with one child. I lost 4 pregnances after my first child. since then I have never conserve again and my son is now 5yrs old lam warriod I don’t wnt to loose my married help me

  • Hi there, just came across your channel. Interested in your feedback regarding miscarriage after a heartbeat has been heard, could that still be chromosomal or would that be something else like hormone or blood clotting disorder? TIA

  • Hello Mr. Sher and thank you for very educative and thought inspiring material.
    My question, if I may, would be 1. what do you think about Hyperemesis Gravidarum. What causes you mentioned could it be related to, if any? Could it be autoimmune reaction of one’s immune system that reacts in a most unbearable way, such as excesive wommiting and inability to drink nothing but Coca-Cola (in my case), because even water was to much to bear not to mention any kind of food. I had to terminate two of my early pregnancies for this reason in their 6 and 8th weaks because I lost so much weight that my own life was in danger. With huge regrets, needless to say. 2. I waited two years and have been trying for 4 months to get pregnant with my new partner, had known exactly when my ovulation was and had the time before and after covered. However, I did not succeed and I am not pregnant. I must emphasized that I got pregnant right away with my two previous terminated pregnancies and did not even know than what ovulation tests are. Now, being 36, it does not seem to work which may, of course, have something to do with my partner, or there may be some problems with implantation after the two abortions. Would you have any thoughts on this? Thank you.

  • Do you have any knowledge of uterus didephys and its effects on miscarriage? I had one of my wombs removed years ago as it had no outlet to the cervix. This year I’ve had one missed miscarriage and three very early losses, I’m worried it’s an implantation issue. I’m currently waiting for my referral to a recurrent miscarriage clinic.

  • Dear Doctor I have 9yrs with my wife but we have failed to get a baby how can u help me in this issue. But I HV never seen any medical Dr but my has been using herbal medicine only thnx am Muhindo

  • Good morning DR, you are really doing a good work here. Please can you make a video on how to conceive a baby boy, if you have can you link me to the video thanks.

  • Hi Dr am 25 year old sorry my English is not good so I had 3 miscarriage gyn told me to test blood and she told me progesterone is low I Tek duphaston so I get pregnant and still I was teking duphaston and I had miscarriage ���� 5week but am trusting Allah one day inshallah ������

  • Hi Dr. Davis! What are your thoughts on the use of progesterone to prevent miscarriage in those with a history of rpl? I know a lot of docs that prescribe it but in doing some research I found that it does not make a significant difference in outcome of live birth. Is it more of a can’t hurt to try progesterone type thing?

  • Thank you so much for sharing this video and congratulations on your rainbow baby! My story is very similar to yours; I had a perfectly normal pregnancy and had my daughter in 2017. Decided to start trying again January 2020 and fell pregnant straight away, but sadly lost that pregnancy. Lost another in May 2020 and now again going through another loss. 3 in total. I don’t understand because we were able to have our daughter with no problems whatsoever! Would love to hear what you did differently for your rainbow baby. xx

  • I’ve learned so much from you and just wanted to thank you for these lectures! I truly trust all of your opinions and hope to share my new knowledge with others:)

  • After how many chemicals would you consider increasing the clomid amount being taken? To clarify, clomid has nothing to do with chemical pregnancies and won’t help prevent one, it just helps you ovulate. Is that correct?

  • Hello, I have 2 kids (9 and 5), both were conceived super easily. Now I am 43 and we have had 3 miscarriages within 6 months of trying. All before 5 weeks. I tried projestron after the positive test during the 3rd one. I have no known health issues at all. I have had 2 c-section; my doc says there is nothing wrong he can see (with the US). Can this be just due to egg quality -my age? Thank you so much for the videos!

  • Hi Dr. Uthuman. Thanks for the good work done. My question is, what happens if both parents are of raucous factor +, or if both parents have raucous factor -?? Thanks so much

  • My congratulations! I’m struggling with secondary infertility myself. I’m so sorry you’ve also faced it. I read some of the comments under videos about secondary infertility and it breaks my heart to see replies like “You don’t actually have it” or “Just give it to God” or “When you least expect it it will happen”. I get such responses a lot. I understand some ppl just want to say something so we’d feel better. But I should say it doesn’t really work… Sometimes people would say “stop worrying about it and it will happen,” but you know, that’s just a thing that people say. I was told pretty the same stuff when I just had a failed IVF cycle. Same when I had a miscarriage. But here’s nothing they can say. Anyway, stories like yours make me believe it will happen for us one day. Going abroad to have a cycle with donor eggs. Fingers crossed!

  • What a great video. I have just had my fifth miscarriage in a row. Last one was tested trimsony 16. I am 39 and a half. Should I quit now or should I try a bit longer? I keep having MMC so my body knows what to do but my babies don’t seem to make it:-( I have a 2 and a half year old son so know we can make life but is it just too late?

  • Doctor! Pliz help me to calculate my dangers days coz I do not know extra days which I can become pregnant why coz have no fixed monthly period

  • So my situations is as follows:
    Ive had 5 miscarriages.
    I have 2 living boys.
    I have had a Hysteroscopy and Laproscopy that came back totally normal.
    I had my embryo tested on my 4th miscarriage after a D&C and it came back as Triploid/tripoly syndrome? Which i guess is where 2 sperm fertilized my egg at the exact same time.
    Could this be causing my recurrent miscarriages? Like, could something be going on with my eggs making it susceptible to not hardening after being fertilized by the first sperm? Or could I have just have had bad luck 5 times?

  • Sir, me and my wife both are beta thalassemia career!
    Can I have a totaly thalassemia free child by IVF?
    Please Ans.

    Please make a video on it!

    Please sir.