Causes of Recurrent Miscarriages

There are many possible causes of miscarriage, the most common is a random genetic problem with the developing fetus, which the body rejects since it would not be a viable, healthy person. There is nothing that can be done for this type of miscarriage as it is nature’s way of creating healthy human beings. Many women experience this type of miscarriage and go on to have a healthy, uneventful pregnancy.

Recurrent miscarriages on the other hand are when someone has had two, three or more miscarriages in a row. Below are the most common causes of recurrent miscarriages and the following are the most common tests that can be performed to find out the cause of the multiple miscarriages.

Common causes of recurrent miscarriage:

Anatomical Causes
Recurrent miscarriages that fall under this area are, unfortunately, an area that natural therapies will most likely have no effect on. If something within the bodily structure of the uterus is causing miscarriage, this is called an ‘anatomical cause’. Examples of this are a misshapen uterus, incompetent cervix, large uterine fibroids, or severe Asherman’s syndrome.

Genetic Causes
Sometimes recurrent miscarriages are due to genetic defects in either the egg or the sperm. Women and men over 35 have a greater chance of this problem occurring as the eggs and sperm may not be as healthy as they were in their younger years. Most western doctors will say there is not much you can do about this, but we disagree. While we cannot affect all genetic causes, we have seen changes in sperm and egg health in our clients after they changed to a healthier, nutrient dense, natural fertility lifestyle. This included specific supplements and therapies to help protect the egg and sperm DNA as well as to provide the ingredients for a healthier reproductive system. We will cover all of this later in this article.

Blood Clotting
Blood that is overly thick or has a tendency to clot (like in the case of a blood clotting disorder) can cause miscarriages.

As small blood clots begin to develop in the uterus, the placenta can be cut off; leaving the fetus void of the oxygen and nutrient supply it needs to survive. This can induce a spontaneous abortion, otherwise known as a miscarriage. In the event your pregnancy develops past the 24th week before the clotting develops, a stillbirth or premature birth can result. With no warning signs offered by the body that blood clots are forming, the danger often remains unseen until it is too late.

There are some tests that can be done to determine if this may be a problem for you, but they need to be performed prior to pregnancy as part of your preconception health plan. In addition, there are natural therapies that have been shown to be helpful with this type of issue and we will discuss both of these topics below.

High Homocysteine levels
If you have suffered at least one miscarriage, or your doctor has indicated that you are at a higher risk for miscarriage than most women, you may want to find out what your Homocysteine levels are.

Homocysteine is a common sulfur-containing amino acid found in the body. While it is not harmful in normal levels, when those levels get too high (especially during pregnancy), it can cause a condition called hypercoagulability. In general, your blood clots much more easily than it should. Not only can it put you at a higher risk for a heart attack and stroke, but it can put your baby in danger as well.

Immunological Disorders
For reasons unknown to doctors and scientists the body will sometimes attack the fetus or sperm; sometimes caused by elevated natural killer cells or HLA incompatibility. This is called an immunological disorder or immune system-based miscarriage. In the past, the only options available for this were the same treatments and medications organ transplant patients receive (which most doctors won’t perform), but thank goodness there are natural therapies that offer some hope in this area that have been shown to be successful through human studies.

Hormonal Imbalance
There are many links between hormonal imbalances and recurrent miscarriages. The hormonal system is an intricate orchestra of hormones that runs on a very specific schedule. If one of these hormones is out of balance, it can affect the rest of the cycle, possibly impacting early pregnancy. Some of these imbalances may be:

Low progesterone

Progesterone is necessary for pregnancy for many reasons, but one of the main ones is that it preserves the uterine lining so the new embryo can attach and be nourished while the placenta is being formed. If progesterone is low, the lining will shed, causing menstruation to begin.

High estrogen

If estrogen levels in the body are high, this can cause many issues – specifically it can be a cause of low progesterone.

Elevated prolactin

Prolactin is a hormone in the body that is abundant during lactation. Beyond promoting milk flow for the new mother, prolactin may also suppress ovulation.

Insulin resistance (PCOS)

Insulin resistance is a hormone imbalance by itself which causes a greater hormonal imbalance in the body by raising blood sugar, estrogen and testosterone levels, while lowering progesterone levels. This may in turn cause implantation failure and/or miscarriage. If insulin resistance is not addressed, development of diabetes and heart disease may result. Insulin resistance in women is closely associated with PCOS.

Thyroid disorders

Undiagnosed and untreated thyroid disease can be a cause for infertility, recurrent miscarriage and second/third trimester loss. You can easily get testing done to determine if hypothyroidism is causing your miscarriages.

Luteal Phase Defect

The luteal phase is the time period after ovulation in which the embryo is making its way down the fallopian tubes and implanting itself into the uterine lining. If this phase is too short for the embryo to implant and attach properly, a miscarriage could occur. Many women will not know this is happening unless they are fertility charting and can tell how long their luteal phase is. The most common cause of luteal phase defect is low progesterone levels.

Testing for Causes of Recurrent Miscarriages

There are many tests that can be done to help determine the cause for recurrent miscarriages. It can be both scary (not finding the cause) and hopeful (getting a diagnosis) to get testing. Just remember you may find the cause of the miscarriages and be able to move forward with treatment and the knowledge of how to take care of yourself during pregnancy. If no cause is found – know that 70% of couples who experience recurrent miscarriages without a known cause do go on to have a healthy successful pregnancy.

Make sure to find a reproductive endocrinologist that is supportive of testing and up to date with all the research being done for recurrent miscarriages, even before your third miscarriage. See some of the most common tests below. This list is not inclusive, but rather is a general guide to help you begin your learning.

Hysterosalpingogram (HSG)
This is an x-ray test of the uterus. A dye is injected into the uterus and x-rays are taken to see the shape of the uterus, blockages of the tubes, growths and other abnormalities that could cause infertility or miscarriages. This is a painful test, but a very revealing one. An HSG is generally the first test that is done when you go to see an RE (Reproductive Endocrinologist).

Autoimmune testing
Antiphospholipid syndrome (APS) is an autoimmune imbalance which causes the body’s immune system to react to certain normal substances in the blood which can increase the chance of forming blood clots. It is estimated that 10% – 25% of women with recurrent miscarriages have APS, making testing very important. Speak to your doctor about referring you to a specialist for an antiphospholipid antibody (APA) test. A positive test result for any part of this test indicates there may be other immune problems and according to Dr. Alan Beer, “…there is a 50% likelihood of elevated NK cells or Th1:T2 cytokine ratios.”

Doctors will generally treat this condition with low-dose baby aspirin and injections of heparin (blood thinner) during pregnancy.

Prothrombin Time
This is a test to see how fast the blood clots.

Thyroid Panel
Hypothyroidism has been linked to miscarriages during all trimesters. Not all doctors will do a thyroid panel test, make sure to ask and work with a doctor that is supportive and up to date on thyroid issues. In the Journal of Medical Screening (Sept. 2000) doctors reported that by screening for thyroid problems before and during pregnancy, miscarriages could be reduced. Women with hypothyroidism have 4 times the risk of a second trimester miscarriage.

Understanding Thyroid (TSH) numbers .3 to 3.0 TSH levels are considered the narrower normal range that many experts are using for diagnosis and management of hypothyroidism. Some endocrinologists believe that a percentage of women may find it difficult to get pregnant — or maintain a pregnancy — at a TSH level above 2.0. This is one condition that is best treated with thyroid hormone medication. You will also need to be monitored throughout pregnancy to make sure your levels are within the normal range and medication is adjusted regularly. The medications used to treat hypothyroidism are safe to be taken during pregnancy.

Progesterone
Adequate progesterone levels are critical for maintaining a healthy pregnancy. Low progesterone levels have been linked to miscarriages. Generally, you are tested around day 21 of a 28-day cycle to determine what your progesterone level is at. You can get blood testing done by visiting an RE or by saliva testing through an online lab.

Karyotyping
A type of test to examine chromosomes for genetic issues. This test is best performed on both parents.

Fetal Tissue Testing If you are currently going through a miscarriage and choose to have a D&C, you can have karyotyping done on the tissue that is collected to rule out genetic issues. Doctors can perform this test from the following samples: blood, amniotic fluid, or placental tissue.

5 Steps to Decreasing the Chance of Recurrent Miscarriages

Natural therapies are a great option for helping to support your body and prepare for pregnancy. As with any approach to trying to decrease the chance of miscarriage there are no guarantees, but these steps will help to nourish and support the body, inviting a healthy pregnancy to occur.

Preparing ahead of time for your pregnancy is also important for decreasing the chances of a miscarriage; these steps must be in practice for at least 3 months before you become pregnant again. If you are currently experiencing a miscarriage, contact your doctor or midwife right away.

1. Prepare for Conception

The first step is to prepare your body with fertility cleansing. Fertility cleansing helps to support the liver in cleansing the body of old toxins and excess hormones while encouraging the uterus to cleanse itself of ‘old’ contents, increasing uterine circulation and tone.

2. Eat a Nutrient Dense Fertility Diet

The next step is to nourish and build up your body to be a healthy, baby-friendly body. This can easily be done through eating a nutrient dense Fertility Diet. What you eat has an impact on:

• The health of your eggs
• Your hormonal balance
• Creating a healthy placenta
• Decreasing chances of a miscarriage
• Building nutrient storage for baby
• Creating a healthy reproductive system

You will want to make sure you are eating a fertility diet consistently for at least 90 days before you begin trying to conceive for your best chances of creating a healthy pregnancy.

3. Apply Fertility or Abdominal Massage

Another important element of promoting a healthy conception is to increase circulation to the uterus. High stress levels leave us living in a state of fight or flight which signals our bodies to send all the blood to the muscles and brain in preparation for running away or fighting, the results of which are decreased circulation to the uterus.

There are three options for massage when it comes to supporting reproductive circulation. You can find a massage therapist who specializes in abdominal massage (or better yet a fertility massage therapist).

4. Build a Healthy Foundation

One of the major foundational steps to increasing your chances of having a healthy pregnancy is to take some basic vitamins, minerals, and EFA’s (essential fatty acids). There are specific vitamins and minerals that are necessary for a healthy reproductive system, hormonal balance, and ovulation.

Building a healthy foundation is a two-punch step. You will want to be taking a multivitamin and an omega-3 supplement, but the key here is not to just take any multivitamin. The best multivitamin to take for fertility and pregnancy is a prenatal multivitamin. But be careful when you are choosing which one to take. NOT ALL SUPPLEMENTS ARE CREATED EQUAL. Make sure you are taking a whole food prenatal multivitamin. You also need to make sure your prenatal vitamin contains B6, B12 and folic acid (folate). This combination has been shown to help prevent miscarriages due to high homocysteine levels.

Essential fatty acids are also extremely important for miscarriage prevention. EFA’s, specifically omega-3’s, are responsible for regulating the inflammation response, improving cellular integrity and maintaining hormonal balance, all key factors in helping the body prevent miscarriage.

General tips for preventing miscarriage…

• Bed rest and removal of stress factors is the most important first step to take. Get off of your feet.
• Vitamin E in amounts up to 600 IU per day (use only 50 IU if you have high blood pressure, heart disease, or diabetes).

If your recurrent miscarriages are due to any of these three reasons, there are natural remedies that have been shown to help decrease the chances recurrent miscarriages.

• Immunological
• Hormonal (low progesterone)
• Chromosomal (you could have some impact, it matters if it is the egg)