Recurrent miscarriage

What is recurrent pregnancy loss?

A miscarriage, also known as an “early miscarriage”, occurs when a pregnancy ends before the 20th week of pregnancy. The term “recurrent pregnancy loss” is used when a woman suffers two or more miscarriages in a row. Recurrent pregnancy loss is a serious medical problem that requires precise clarification.

Frequency and age

Recurrent miscarriages are a sensitive issue that puts emotional and physical strain on many couples. It is estimated that around 0.4-2% of couples are affected by recurrent miscarriages. The frequency increases with a woman’s age, especially from the age of 35. Women under the age of 30 are generally less likely to have recurrent miscarriages, while women over the age of 40 are more likely to experience further pregnancy loss.

What are the causes of a recurrent miscarriage?

There are various possible causes of recurrent miscarriages. These can be the woman’s as well as the partner’s. The most common causes include

• Chromosomal abnormalities: About 3-5% of couples with recurrent miscarriages have a chromosomal alteration, such as a so-called balanced translocation. These changes are often the cause of miscarriages in early pregnancy and affect around 50% of these losses.
• Uterine anomalies: Uterine anomalies, such as polyps or adhesions, or congenital changes such as a uterine septum, can also cause miscarriages. These are found in 10-50% of couples with recurrent miscarriages.
• Antiphospholipid antibody syndrome: This syndrome can be a cause of miscarriages and is often diagnosed by the presence of certain antibodies in the blood.
• Endocrine factors: Hormonal disorders such as poorly controlled diabetes, thyroid problems or PCO syndrome can cause recurrent miscarriages in some couples.

Assessment and diagnosis

In order to find out why repeated miscarriages occur, a thorough diagnosis is required. Your doctor will talk to you in detail about your previous pregnancies, your medical history and any pre-existing conditions.

The examination usually includes:

• Karyotyping: This test checks the parents’ chromosomes for abnormalities that could be passed on to the child. If no cause was found in previous tests, this test may be useful. In most cases, however, it is only carried out after other examinations.
• Uterine examination: To detect possible abnormalities of the uterus, for example by means of water ultrasound. These tests help to find malformations or adhesions that could be the cause of miscarriages. A sample of the uterine lining can also be taken as part of this examination to rule out chronic inflammation.
• Antiphospholipid syndrome: If this syndrome is suspected, a determination of specific antibodies is recommended to check the risk of miscarriage.
• Thyroid function: An examination for thyroid problems is useful, as undetected thyroid disorders can be associated with miscarriages.
• Special immunology consultation: As immunological factors can play a major role, we now offer a special immunology consultation. In collaboration with experienced immunology specialists, we check whether immunological characteristics may be contributing to your risk of miscarriage and look at how we can improve this situation.

Treatment and support

The treatment of recurrent miscarriages depends on the cause identified and can vary depending on the individual situation. In some cases, drug treatment or hormonal therapy may be necessary to maintain a pregnancy. If there is a structural abnormality of the uterus, surgical treatment may be considered. Other causes can be avoided by targeted genetic testing.

Psychological support

Recurrent miscarriages are an emotional burden for many couples. Depending on the individual’s reaction, it is important to seek psychological support in order to come to terms with the loss and promote mental health. Our clinic therefore offers not only medical help, but also psychological counseling to support you during this difficult time. Talking to therapists can help you to overcome your fears and grief and look to the future with strength.