Five Things You Should Know about Recurrent Miscarriages
1. Three or More in a Row is “Recurrent”
The technical definition for recurrent miscarriages or “recurrent pregnancy loss” (RPL) requires three or more consecutive losses of recognized pregnancies before the 20th week or 5th month of pregnancy. Currently it is not clear whether very early pregnancy losses diagnosed by sensitive pregnancy tests and not by ultrasound (also known as biochemical pregnancies) should be included in the definition. Most doctors believe it is reasonable to send tests and start treatment of RPL after two consecutive miscarriages.
2. Early Pregnancy Loss is an Emotionally Traumatic Experience
EPL is similar to losing a child or other loved one. In addition, it is one of the most frustrating and difficult areas for doctors in reproductive medicine because the cause is often unknown and there are not many treatments that have been proven to work. However, one of the treatments that has been proven to improve outcome is good, old-fashioned TLC. Studies have shown that women who are monitored closely and supported by their doctors and loved ones do better than women who aren’t.
3. Most Women With RPL Will Eventually Have a Healthy Live Born Baby
It’s important to remember that most women with RPL have a good chance of eventually having a successful pregnancy, whether or not a cause is discovered and treatment initiated. In one study, the overall live birth rates after normal and abnormal diagnostic evaluations for RPL were 77 and 71 percent, respectively. In another, eight of 17 women with six or more consecutive unexplained miscarriages subsequently had a successful pregnancy.
4. Miscarriage is Common but Recurrent Miscarriage is Not
About 15 percent of pregnant women experience sporadic loss of a recognized pregnancy. Just 2 percent of pregnant women experience two pregnancy losses in a row, and only about 1 percent have three consecutive pregnancy losses. The risk of recurrence depends on many factors. After one miscarriage, the chance of a second miscarriage is about 14 to 21 percent. After two or three miscarriages the rate is 24 to 29 percent and 31 to 33 percent, respectively. However, there are several factors that significantly influence these rates, including cause of the RPL, age of the mother, and previous history of a live birth. However, it’s important to remember that the prognosis for a successful future pregnancy is good in nearly all women with RPL.
5. Stress Does Not Cause Miscarriages
Although a frequent concern of patients, there is no evidence from well-designed studies showing a relationship between RPL and stress.
