Recurrent Miscarriage

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• Women's Wellness
• Recurrent Miscarriage

Medically Reviewed January 2024, by Dr. Susan Mayou (GMC: 2405092) - founder of the Cadogan Clinic and one of the world's leading dermatologists

What are the risk factors of Recurrent Miscarriage?

There are two main risk factors which may increase the likelihood of multiple miscarriages.

• Age: The risk of miscarriage is the highest among couples where the woman is 35 years old or above and the man is over 40. However this doesn’t mean that all couples in this demographic will experience miscarriage.
• Previous miscarriages: Unfortunately the risk of miscarriage increases after each successive loss. In the case of recurrent miscarriage, women who have experienced three miscarriages in a row will have a 40% chance of having another one.

If you suffer from certain health conditions, this can make multiple miscarriages more likely.

What causes Recurrent Miscarriage?

Recurrent miscarriage causes are not always known, but there are some conditions which may be responsible.

• Blood clotting disorders: Some blood clotting disorders, such as systemic lupus erythematosus and antiphospholipid syndrome can affect the flow of blood to the placenta, causing clots that prevent it from working properly. This blocks the flow of essential oxygen and nutrients from reaching the baby.
• Abnormally-shaped uterus: If you have an abnormally-shaped womb, then this may be what is causing your multiple miscarriages. This may include a heart-shaped or a T-shaped uterus.  
• Cervical weakness: If your miscarriages are occuring later on in pregnancy, then a weak cervix may be responsible.
• Genetic cause: The presence of an abnormal chromosome may be behind recurrent miscarriages. This chromosome may be found in one or both parents.
• Thyroid problems: If you do not have a healthy thyroid function before getting pregnant then this may cause miscarriage or pregnancy complications.
• Thyroid antibodies: Thyroid antibodies attack the thyroid, causing it not to work properly. If the thyroid is not functioning as it should, then this can heighten the risk of miscarriage.
• Natural killer cells: Some fertility experts believe that so-called natural killer cells present in the uterus can cause miscarriage. There are tests available which can detect the presence of these cells.

Treatment and Management

Once the doctor has discovered what is causing recurrent miscarriage, then they can decide on treatment and management. Recurrent miscarriage treatment may include the following:

• Blood thinners: If blood clotting is causing multiple miscarriage then taking asprin and anticoagulant heparin can help to thin the blood. This will help to prevent blood clots, allowing the blood to flow freely in the placenta, ensuring the baby gets essential nutrients and oxygen.
• Thyroid medication: If thyroid problems are causing your recurrent miscarriages, then this is easy to treat. Thyroid medication will help to regulate your thyroid levels. Once you have been tested and the doctor is sure that you have a healthy thyroid function then you can try for a baby.
• Cervical cerclage: If a weak cervix is causing you to miscarry later on in pregnancy, your doctor may advise you to have a cervical cerclage, otherwise known as a cervical stitch, either before or during the pregnancy.
• Surgery: If scans show that you have an abnormally-shaped uterus which is causing recurrent miscarriages, then surgery may be recommended.
• Progesterone treatment: This is a relatively new recurrent miscarriage treatment. Progesterone is a hormone that thickens the uterine lining and helps the mother’s body to accept the growing baby. Women who have experienced bleeding in early pregnancy and have a history of miscarriage may benefit from progesterone treatment. This particular recurrent miscarriage treatment is administered as pessaries, which will need to be taken twice a day via the vagina.