Recurrent Miscarriage: What you should know

We spoke with Dr. Hanan Al Issa, Obstetrics & Gynecology Specialist at HealthPlus Family Clinic, all about recurrent miscarriage, an issue faced by many women today. 

When you want children, nothing is tougher than the experience of recurrent miscarriage. It is considered a medical condition if a woman experiences a miscarriage at least three consecutive times before week 20 of pregnancy. While the causes of this type of miscarriage are not totally clear, many women have delivered their babies successfully, despite suffering from this difficulty.

What are the causes  

There are several conditions that lead to recurrent miscarriage, which Dr. Hanan goes through below:

Genetic issues

A genetic issue in either or both partners plays a key role in miscarriages. This may become clear if there is a flaw in the genetic makeup – such as in the chromosomes or the chromosomal structure, sadly leading to foetal loss in the early stages of your pregnancy.

Autoimmune disorders

This is when the immune system doesn’t recognise the difference between your own cells and foreign cells. The natural defence system produces a specific protein, designed to attack any healthy ‘foreign’ cells. This is where autoimmune diseases during pregnancy may lead to serious complications as these ‘foreign’ cells can include the foetus. Therefore, it’s best to consult your doctor as a couple, to evaluate your specific situation before planning for pregnancy.

Potential pre-existing conditions

There are certain conditions that can sometimes impact how a pregnancy develops. These include congenital uterine defects, or uterine diseases, such as fibroids or polyps inside the uterus. Issues related to the endocrine system can also play a role too. These include diabetes, thyroid disorders and ovarian insufficiency. If you suffer with any pre-existing conditions like these, make sure to seek medical advice around how they may affect pregnancy.

Coagulation issues 

Coagulation issues are very specific. Often this refers to antiphospholipid syndrome, a type of autoimmune disease that leads to abnormal blood clotting. This occurs when your antibodies mistakenly attack tissues in your body, causing clots to form inside your blood vessels. This syndrome may happen in isolation or in conjunction with other autoimmune conditions. Pregnant women suffering from this syndrome face serious complications, such as recurrent miscarriage and stillbirth, and must seek medical advice around pregnancy.

Age

An increasingly common issue that many couples contend with is age, as the older you are, the higher the possibility of having a miscarriage. Unfortunately, childbearing after the age of thirty-five in women, and forty in men, increases the chance of this. This is hard to reconcile with the busy demands of a modern life and has become one of the biggest challenges in fertility and pregnancy today.

Lifestyle 

Another common risk factor that many men and women have to tackle is the adverse effects of living an unhealthy lifestyle. This is something that science tells us has a big impact on the chances of miscarrying. An unhealthy lifestyle includes a diet that doesn’t provide adequate nutrition, a highly processed diet, smoking, excess caffeine, exposure to environmental pollution, obesity and psychological factors such as stress.

Treatments 

Several treatments are available, depending on the specific causes that affect you. These can include:

• Treating uterine issues through endoscopy or surgery
• Repairing the shape of the uterus through endoscopy, in the case of malformation
• Prescribing medicines to counter autoimmune diseases
• Managing diabetes
• Fixing thyroid disorders – hyperthyroidism or hypothyroidism
• Fertility treatments if recurrent miscarriage is linked to a chromosomal issue

Dr. Hanan recommends that as most recurrent miscarriage conditions are treatable, couples who face these challenges should always seek medical advice and help.

Prevention  

While treatment is important, the importance of living a healthy lifestyle cannot be overstated when it comes to sustaining any pregnancy. This means both mentally and physically. Let’s take a deeper look.

Weight 

Our body weight can have a direct impact on the chances of a healthy pregnancy. It’s important to lose any excess weight or to gain weight to a healthy level if you are underweight. Weight is a tough issue for anyone who struggles with theirs. Make sure to reach out for help if you need support in your journey towards a healthy body weight – whether that means a personal trainer, a dietician, or even an endocrinologist to address any hormonal imbalances. Whatever help you need, don’t be afraid to ask for it!

Diet and supplements 

It’s vital to follow a healthy and balanced diet to give your body the best chance of taking a pregnancy to term. Try to eat whole, unprocessed foods, with a good balance of protein, carbohydrates, and healthy fats, all from a variety of sources. Eat an abundance of good quality fresh fruit and vegetables daily, and consider taking proper supplements on advice from a doctor, as all of this can help you get enough micronutrients and vitamins for your body to be at its best.

Potentially damaging habits

Smoking is strongly advised against, as is excessive caffeine, whether from coffee, tea, matcha lattes or green tea. Caffeine in moderation is allowed, so try to cut down if your intake is more than a small to moderate level.

Exercise

Boost the chances of having a full-term pregnancy by performing regular (but not excessive!) exercise. Appropriate exercise for pregnancy is encouraged as it helps keep your body healthier and stronger, while reducing the effects of inflammation.

Stress reduction

Like many challenges, one of the best ways to set yourself up for a healthy pregnancy is to minimise stress and psychological pressure. This isn’t always easy, especially if you have experienced recurrent miscarriage. Try to adopt calming lifestyle changes, such as a daily meditation, a grounding morning walk, time in nature, journaling, and anything else that helps your mental wellbeing. If you need to, reach out to a therapist or doctor for advice.

As you can see, there are many factors that contribute to recurrent miscarriage, but, with lifestyle adjustments and the right medical advice and treatment, you can put yourself in the best possible position to deliver a healthy baby, despite this condition.

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