It is seldom talked about, but pregnancy loss is more common than people think, at some point affecting an estimated 43% of women who’ve gone on to give birth. So why does miscarriage happen?
If you’ve experienced pregnancy loss, you’ll likely have run over that question a thousand times. But the confusion and search for answers is just one part of the pain of losing a pregnancy.
Suffering a miscarriage does not mean you won’t have a baby of your own. Most women who go through pregnancy loss will successfully carry a baby in future. And here at The Fertility and Gynaecology Academy we specialise in treating complex fertility problems, including many cases of recurrent miscarriage where couples had all but given up hope. Read on for answers to the question: why does miscarriage happen?
How common are miscarriages?
Approximately 1 in 4 pregnancies end in miscarriage. However in many of those cases, the pregnancy is so early that a woman will not know she has conceived when the miscarriage occurs. In people who are aware that they are pregnant, the miscarriage figure is lower – around 1 in 8.
Is early pregnancy loss the most common type of miscarriage?
Yes. More than 4 out of 5 miscarriages occur within the first three months of pregnancy. After the first trimester, thankfully the rate of miscarriage plummets.
Why does miscarriage happen?
Miscarriage can be devastating for a couple, and the question most often asked is why? Why does miscarriage happen and what can we do to stop it happening again?
Dr Anu Chawla says: “There are many possible reasons for miscarriage and usually the cause is not found. Most women who miscarry will have a successful pregnancy in the future, and the vast majority of miscarriages have nothing to do with anything the woman has done. That said, of course taking sensible health measures is important (see How Can I Prevent Miscarriage below.)”
The most common reason for miscarriage is abnormal chromosomes in the embryo/foetus. Chromosomes are DNA molecules that carry genetic information that steers the baby’s development. If an embryo has too few or too many chromosomes, it won’t grow properly.
Sometimes a health condition in the mother can cause a problem (for example kidney disease, uncontrolled diabetes, or a thyroid problem). And in other cases, an undetected gynaecological infection such as chlamydia or gonorrhoea can lead to miscarriage. A minority of women suffer what’s known as a weakened cervix or ‘cervical incompetence’ whereby the muscles of the cervix cannot sustain the pregnancy.
In cases of recurrent miscarriage (three or more pregnancy losses) or recurrent IVF failure, the problem may lie with the immune system. For example, if the natural killer cells which help to protect the woman’s body from disease exist at elevated levels, they can attack the embryo or interfere with the endocrine system that produces your essential pregnancy hormones. Here at The Fertility and Gynaecology Academy we specialise in the area of fertility medicine called reproductive immunology, which, in a select group of patient population, may work to diagnose and treat possible issues in the immune system that may be making it difficult for a woman to carry a baby.
Frequently, couples come to us after a series of miscarriages or after their IVF treatment has failed at other clinics. We run a series of tests on both the female and male partner to determine what the problem is, followed by treatment tailored to your body’s specific needs.
What are 3 common causes of miscarriage?
The three most common risk factors for miscarriage are advanced age of the mother, advanced age of the father, and a history of miscarriage. Around 3 in 4 miscarriages happen within the first trimester, and are usually caused by a chromosomal abnormality in the baby. Advanced age of a woman in pregnancy means a greater chance of chromosomal problems. In addition, recent research has demonstrated an association between miscarriage and advanced age of the father. And the more miscarriages a woman has suffered in the past, the greater her risk of another.
How can I prevent a miscarriage?
It is important to remember that most of the time, miscarriage occurs due to chromosomal abnormality. However, there are some lifestyle measures you can take to help reduce the risk of miscarriage, such as: avoiding alcohol and drugs, cutting down caffeine, stopping smoking (if you smoke), and eating a nutritious diet while maintaining a healthy weight and BMI before conception, in addition to getting enough rest. Leading a healthy lifestyle, basically.
In addition, if you have a long-term health condition that could put you at greater risk – for example diabetes, hypertension, blood clotting disorders, heart disease, an immune disorder, kidney disease, polycystic ovarian syndrome (PCOS) or thyroid problems – it’s a good idea to speak with your doctor before trying to get pregnant.
Gynaecological infections such as chlamydia, syphilis and gonorrhoea can, in certain scenarios, also lead to miscarriage, so if you’re trying to get pregnant it’s important to get checked out.
We also recommend following common guidance on foods to avoid in pregnancy (such as blue cheese, raw or partly cooked eggs, undercooked meat and certain kinds of seafood), as well as checking with your doctor or pharmacist before taking any medicine, including any over the counter drugs.
If you’ve suffered repeated miscarriage and want answers, The Fertility and Gynaecology Academy can run a series of tests for both the female and male partners to pinpoint the issues that may be causing miscarriage.
Here at The Fertility and Gynaecology Academy, we don’t believe repeated miscarriage is simply ‘bad luck’ or ‘one of those things’ and with the help of state of the art technology and years of expertise, we will always strive to get to the bottom of it and treat it effectively. Our recurrent miscarriage testing falls into five groups:
- Immune testing – a series of leading-edge investigations, most of which measure various immune chemicals within your blood, to ascertain if elevated levels of those chemicals may be making it difficult to carry a baby.
- Assessment of the woman’s uterine cavity to determine any abnormalities that may make it difficult for an embryo to implant, or for a baby to be carried to term, and any appropriate treatment.
- Semen analysis including the Sperm Aneuploidy Test. Our advanced sperm analysis can detect problems with sperm DNA which could cause chromosome abnormalities.
- Karyotyping of both partners to determine genetic problems which we can then screen for in the embryos.
- Infection screening to test for any infections, rare or common, that could be causing a hostile environment and affect your ability to carry a baby to term.
With these tests, the goal is to determine an appropriate treatment pathway for you, to get your body baby-friendly. There are of course never any guarantees, but as experts in recurrent miscarriage we know these interventions can improve your chances and we have helped countless couples finally achieve their dream of a baby of their own.
If you are concerned about miscarriage or any fertility issue, call us to arrange a consultation on 020 7224 1880.
