Causes of miscarriage, a multipart series

Part I overview

Miscarriage is amongst the most emotionally painful experiences a human being can endure. Recurrent miscarriage, which is two or more consecutive losses, may be truly unbearable.  At our fertility practice in Los Angeles, the Center for Fertility and Gynecology, we are experts in diagnosing and treating all causes of pregnancy loss.  This series of blog posts will explore each cause of miscarriage independently and touch on the specific treatment options appropriate for each.

When approaching a diagnosis of recurrent pregnancy loss, it is important to consider a multitude of possible causes.  One way to organize these causes is through categorization.  There are 7 main categories and each patient with RPL will fit into at least one.  The categories are as follows:

I.                    Structural abnormalities of the uterus

a.       Septum, fibroids, polyps and more

II.                  Random chromosomal errors

a.       Trisomy, Turner’s, etc.

III.                Inherited chromosomal errors

a.       Translocations

IV.                Immunological based

a.       Antiphospholipid antibodies, thyroid antibodies

V.                  Coagulation based  

a.       Factor five Leiden, MTHFR, thrombophilias

VI.                Environmental

a.       Tobacco, alcohol, radiation

VII.              Unexplained

a.       ????????????

While all patients will fit into at least one category, some may qualify for 2 or more.  This is important because the treatment is different for each category.  Thus, if a patient fits into more than one category, she may require more than one treatment.

Regardless of the cause, all patients with recurrent pregnancy loss will benefit from a detailed history and meticulous physical exam.   Further, providing a safe environment where patients can speak about their experiences and feelings helps them to regain some of the control which was lost through their ordeal.

Recurrent pregnancy loss is one of the most difficult aspects of fertility treatment, however, with the right approach, proper testing, ample determination and a little luck : ), most patients can ultimately be successful.

If you have any questions about recurrent pregnancy loss, or fertility treatment in general, feel free to contact us, we would be happy to speak with you.