Recurrent miscarriage
(Recurrent Gestational Loss)

It is defined as the loss of two or more consecutive pregnancies before 20 weeks. Today, there are highly effective solutions for each of the causes of recurrent gestational loss.

If you have experienced two or more consecutive miscarriages, your future pregnancies should be carefully planned and closely monitored by a maternal-fetal medicine specialist.

What is recurrent gestational loss?

Miscarriage is defined as the loss of pregnancy before 20 weeks and occurs in 15 per cent of clinically recognised pregnancies. However, when miscarriage occurs two or more times in a row it is known as gestational loss or recurrent miscarriage.

Recurrent gestational loss is divided into:

Primary: When a pregnancy has never been carried to term.
Secondary: When the couple has already had children in the past.

Causes

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Fetal problems are the cause of about 50% of cases of recurrent gestational loss, and are usually due to chromosomal and genetic alterations in the foetus, which are more common in women over 35 years of age.

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Maternal factors include uterine problems that may be due to malformations, fibroids, scarring, adhesions, infections or inflammation affecting the receptivity of the uterus. Hormonal, immunological and thrombophilic disorders must also be ruled out.

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Hormonal disorders are usually due to insufficient production of progesterone, the hormone that prepares the endometrium to receive and nourish the embryo during the first twelve weeks of pregnancy.

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Immunological disorders refer to the production of antibodies that interfere with foetal development, such as antiphospholipid antibody syndrome, while thrombophilic or blood clotting disorders can hinder normal blood supply to nourish the foetus.

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Obesity, smoking, alcoholism and exposure to chemicals may also be associated with recurrent gestational loss.

Symptoms

• Vaginal bleeding before 20 weeks of pregnancy
• Pelvic or abdominal pain
• Vaginal infections
• Urinary tract infections

The presence of these symptoms during the first months of pregnancy carries the risk of miscarriage, so it is important to see a reproductive specialist in case of suspicion, especially if heavy bleeding is present.

Can I have a baby if after recurrent gestational loss?

Today, there are highly effective solutions for each of the causes of recurrent gestational loss.

When it is due to maternal factors, treatment varies according to the cause and can range from hormone therapy to surgery in very specific cases.

However, when recurrent miscarriage is due to fetal problems, the treatment of choice is Preimplantation Genetic Diagnosis. This method is used in conjunction with In Vitro fertilization (IVF) and allows only embryos free of genetic and chromosomal abnormalities to be transferred into the mother's uterus, maximising the chances of implantation, pregnancy and having a baby at home regardless of the woman's age.

If you have experienced two or more consecutive miscarriages, your future pregnancies should be carefully planned and closely monitored by a specialist in Maternal Fetal Medicine.

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