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6 Potential Causes of Miscarriage and Recurrent Pregnancy Loss (RPL)

By Satu Kuokkanen, MD, PhD

May 2nd, 2016 at 11:31 am

image courtesy of David Castillo Dominici/ freedigitlaphotos.net

Experiencing a pregnancy loss is always devastating for individuals hoping to establish or expand their family. Patients describe a range of grieving emotions related to the loss of a person they never had a chance to meet, love and share the future.  This grieving process may last anywhere from few weeks up to several years.  Not surprisingly, I have heard from many patients that one of the most difficult coping times was around the expected due date of the pregnancy that they miscarried.

 

It may be somewhat comforting for patients to know that they are not alone. In fact, miscarriage is the most common pregnancy complication and it affects 1 in every 6-8 confirmed pregnancies, that’s 12-15%. The risk of miscarriage increases with maternal age. While women younger than 30 years old have a 10-12% risk of pregnancy loss, the risk is four fold higher for women in their 40’s. Identifying a potential cause may help with the emotional impact of the pregnancy loss whether it is isolated or recurrent loss.

 

Recurrent pregnancy loss (RPL) is diagnosed after a woman has had two or more consecutive miscarriages and RPL affects 1 in 20 couples who are attempting to conceive. While isolated miscarriages are commonly due to chromosomal and genetic abnormalities, other factors are responsible for RPL. These factors vary depending on the gestational age of the pregnancy loss. Evaluation of potential RPL causes is important in determining whether therapy is available to the patient.

 

6 Potential causes of RPL:

 

  1. Congenital and acquired structural uterine factors. A uterine septum, a partial or complete division of the uterine cavity, is the most common congenital structural uterine abnormality.  Uterine septum and bicornuate uterus (“heart shaped womb”) have been linked to RPL. Acquired structural uterine pathologies that distort the normal uterine cavity include endometrial polyps that are skin tag-like growths of the uterine lining, fibroids that are affecting the uterine cavity, and intrauterine scarring that can develop after surgical procedures, such as dilatation and curettage (also known as D&C).  Radiology studies of the uterus with saline ultrasound (‘water sonogram”) or magnetic resonance imaging (MRI) are standard methods to evaluate the womb.

 

  1. Chronic endometritis is inflammation of the uterine lining. This condition is diagnosed by sampling of the uterine lining with an endometrial biopsy or D&C.

 

  1. Structural chromosome abnormalities of the parents is a rare but known cause of RPL. A simple blood test of both parents to assess numeric and structural chromosomal component (karyotype) is done.

 

  1. Abnormalities of blood clotting.  The well-known condition in this category is anti-phospholipid antibody syndrome (APAS) which women can acquire during their reproductive years. Anti-phospholipid antibody levels can be measured in blood for diagnostic purposes.

 

  1. Endocrine-related abnormalities include elevation in alterations in thyroid hormone secretion and diabetes with uncontrolled blood sugar levels.  Also, women with polycystic ovary syndrome (PCOS) appear to have heightened risk of pregnancy losses.

 

  1. Environmental and lifestyle factors have also been linked to an increased risk of miscarriages. Such factors may include maternal obesity, cigarette smoking, and exposure to environmental toxins. How these factors may impact pregnancy or pregnancy loss differs and is still being studied at the current time.

 

It is important to remember that, although painful, an isolated miscarriage may often be followed by a healthy and successful pregnancy. And that, RPL, while devastating, can be caused by a factor that may be treated with proper, specialized medical care. In either case, your dream of parenthood may still be within reach.

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Have you suffered one or miscarriages, been treated for an underlying cause, and gone on to have a successful pregnancy?

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Long Island IVF-WINNER: Best in Vitro Fertility Practice 2015 AND 2016

It is with humble yet excited hearts that we announce that Long Island IVF was voted the Best In Vitro Fertility Practice in the Best Of Long Island 2015 and 2016 contest…two years in a row!

The doctors, nurses, embryologists, and the rest of the Long Island IVF staff are so proud of this honor and so thankful to every one of you who took the time to vote. From the moms juggling LIIVF babies… to the dads coaching LIIVF teens…to the parents sending LIIVF adults off to college or down the aisles… to the LIIVF patients still on their journeys to parenthood who are confident in the care they’re receiving…we thank you all.

We love what we’ve gotten to do every day more than 28 years…build families. If you are having trouble conceiving, please call us. Many of our nurses and staff were also our patients, so we really do understand what you’re going through. And we’d like to help. 631-752-0606.

 

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I’m Still Standing

By Tracey Minella

May 5th, 2013 at 5:07 pm

 

Today is International Bereaved Mother’s Day.

Celebrated on the Sunday before Mother’s Day, it’s dedicated to those who have suffered the pain of miscarriage, stillbirth, losing an infant or child, or are suffering from infertility. To those who are still standing.

This year there is a world-wide project known as #iamstillstanding , through Still Standing Magazine, which encourages women and men who have suffered these unspeakable losses to share their stories, post a picture, or simply to speak their children’s names…to acknowledge the grief and help in some small way to bring a measure of healing. You can participate through Facebook, Twitter, Instagram and/or Pinterest. Go here for more information: https://www.facebook.com/events/552753651414253/

The stories already uploaded are hard to read, yet comforting. They are heart-warming, and heart-breaking. They will take your breath away.

In addition to Still Standing Magazine, two helpful resources for bereaved parents are Carlymarie’s Project Heal https://www.facebook.com/CarlyMarieProjectHeal?fref=ts and A Heart to Hold https://www.facebook.com/AHearttoHold?fref=ts. The first is support from a bereaved mother and artist and the second is a non-profit organization that provides hand-sewn hearts of the exact weight of the lost baby to bereaved moms, so they have something soft of significant weight to hold during their grieving.

For those local women who are looking for professional, one-on-one or group counseling to process your grief over infertility or other related losses, please contact Long Island IVF to speak to our professionals or go here for more information: http://www.longislandivf.com/mind_body.cfm

May those suffering find some measure of comfort in the above resources.

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Are there any additional resources you can recommend for others who may be grieving?

Photo credit: http://www.publicdomainpictures.net/view-image.php?image=238&picture=statue-of-an-angel

 

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Today is Bereaved Mother’s Day and National Infertility Survival Day

By Tracey Minella

May 6th, 2012 at 4:44 pm

Early May is tough. And Mother’s Day is probably the hardest day of the year when you’re childless and TTC.
But for those who have lost a child, it must be unbearable.
If you or someone you know has experienced this unimaginable pain and loss, today is dedicated to supporting you and to acknowledging and remembering your child. It is National Bereaved Mother’s Day, the first Sunday in May.
I spent some time on a beautiful site owned by CarlyMarie, the woman behind the creation of Bereaved Mother’s Day. It’s a beautiful, supportive, calming place where extraordinary women can go to attempt to heal from extraordinary pain.
Check it out here: http://carlymarieprojectheal.com/2012/05/international-bereaved-mothers-day.html
So whether you are coping with infertility or with the devastation of infant or child loss, please know that there is support out there, in blogs, forums, and counseling support groups, to help you when you are ready to seek it. Please ask.
Blessings to you and your angels.

And for those still trying to build their families who need financial assistance to do so, please consider entering Long Island IVF’s “Extreme Family-Buiding Make-Over ” Contest, where the Grand Prize will be a FREE basic Micro-IVF cycle, valued at $3,900.00. Go to the April 23, 2012 blog post herein to enter, or check out the rules on our Facebook page at http://www.facebook.com/longislandivf?ref=tn_tnmn
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What have you done to help yourself through the pain? What memorial or tribute comforted you? Do you know of any other good support services? Let us know.
Photo credit: carly marie @ http://internationalbabylostmothersday.blogspot.com/

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