A pregnancy that ends abruptly in miscarriage can be devastating—not to mention brings up concerns about the prospect of future fertility.
“Will this keep happening to me?” You may wonder.
“Was there anything I could have done to prevent this?”
Dr. Ricardo Yazigi, from our Towson, MD office, often counsels women who have experienced miscarriages and discusses how a history of miscarriage impacts fertility and future conception.
Dr. Yazigi says, “The unfortunate truth is that miscarriage is common. Approximately 20 percent of confirmed pregnancies end in miscarriage. And for unconfirmed (or yet to be discovered) pregnancies, the rate of loss is even higher. All included, about 60 percent of all pregnancies will end in miscarriage.”
But there’s a bright side.
Having one miscarriage or even more than one miscarriage does not mean you will be unable to carry a baby to term successfully.
What caused my miscarriage?
“Approximately 50 percent of all miscarriages are the result of a genetic abnormality in the embryo,” informs Dr. Yazigi. In these cases, the miscarriage is nature’s way of preventing an abnormal birth.
The rest may be caused by an anatomical, immunological, or hormonal issue, or for causes that remain unknown.
Will a miscarriage impact my future fertility?
In most cases, it will not.
When a pregnancy is lost early, a miscarriage is unlikely to create issues with the uterus that will impact future pregnancy.
In some types of miscarriage, tissue must be removed through a procedure known as a dilation and curettage (D&C). As long as this procedure is performed properly, it should have no lasting impact on the mother’s uterus.
If I’ve had a miscarriage, what can I do to reduce the likelihood of having another?
Because miscarriages are quite common, one miscarriage is not considered cause for exceptional concern.
Women who’ve had two or more miscarriages, however, are considered to have recurrent miscarriages, and should be evaluated by a fertility specialist.
For women with recurrent miscarriages, determining the underlying cause is critical. If we can pinpoint a cause, we may be able to take preventative measures to reduce the likelihood of future miscarriages.
There are a number of different tests we can perform to determine the likely cause of recurrent miscarriage.
Women who have had a D&C can have the tissue collected and tested for genetic abnormalities. Genetic abnormalities fall into two categories:
- Non-recurrent – not likely to reoccur in future pregnancies. The majority of genetic abnormalities are non-recurrent.
- Recurrent – likely to reoccur in future pregnancies.
If we find that pregnancy loss is due to the result of a recurrent genetic abnormality, we may be able to create embryos through In Vitro Fertilization, and culture them in the laboratory in order to test their genetic health before placing them back in the uterus, thereby reducing the likelihood of another pregnancy loss due to genetic issues.
In cases where a woman has a miscarriage and the tissue—known as the “products of conception”—cannot be collected, doctors can perform genetic testing on the mother and father to try to determine if a genetic issue on either of them is the cause of the miscarriage.
Women who have experienced recurrent miscarriage are commonly tested for immunologic disorders. If a woman is found to have one of these conditions, doctors can take steps to reduce the likelihood that an immune system issue results in another miscarriage.
Through the use of ultrasound and X-Rays (hysterosalpingogram or HSG), doctors can assess the anatomy of women who have experienced recurrent miscarriage. If an anatomical issue is identified, it can often be corrected through surgery.
Using blood tests, doctors can assess a woman’s hormonal balance. Because hormone balance can be manipulated through the use of medication, this issue can commonly be solved before a woman attempts another pregnancy.
How can I stop worrying about having another miscarriage?
Miscarriage will always be a real and daunting fear to women who are newly pregnant or considering a pregnancy—more so for those who have experienced a miscarriage before.
Nothing will take away this fear entirely.
But remember, if we can determine the cause of the recurrent miscarriage, we can reduce the likelihood of a future pregnancy loss. With this insight, women with recurrent miscarriage can pursue future pregnancy with less fear of future pregnancy loss.
If you’ve experienced recurrent miscarriages, we encourage you to seek medical support from a fertility specialist. Take control of your reproductive health to improve your chances of having a successful pregnancy.
Editor’s Note: This post was originally published in April 2018 and has been updated for accuracy and comprehensiveness as of October 2020.