Patient education: Repeat pregnancy loss (The Basics)

What is repeat pregnancy loss? — A pregnancy loss, or "miscarriage," is when a pregnancy ends on its own before 20 weeks. "Repeat pregnancy loss" is when a person has had 2 or more losses.

What causes repeat pregnancy loss? — In some cases, repeat pregnancy loss is caused by:

●Chromosome problems in the fetus – A "fetus" is what a baby is called while it grows inside of you. Chromosomes are structures in cells that contain thousands of genes. Chromosome problems usually happen by chance. Rarely, they happen because a parent has a chromosome problem. The risk of the fetus having chromosome problems also increases as you get older.

●Conditions in which something changes the shape of the inside of your uterus (figure 1)

●An autoimmune condition – When you have an autoimmune condition, your immune system (infection-fighting system) attacks healthy tissue in your body instead of infections.

●Other medical conditions – If you have certain medical problems, this can cause repeat pregnancy loss. Examples include diabetes, thyroid disease, blood clotting problems, or hormone problems.

In many cases, though, doctors don't know why repeat pregnancy loss happens.

Why am I having repeat pregnancy loss? — To figure out why you are having repeat pregnancy loss, your doctor or nurse will:

●Talk with you, and ask about your past pregnancies, monthly periods, and medical conditions

●Do an exam, including a pelvic exam

●Do blood tests – These include tests to check your immune system, blood clotting system, and hormone levels. They also include tests to check for certain medical conditions, such as thyroid disease or diabetes.

●Do an imaging test to check your uterus – Your doctor can do different types of imaging tests. A common test is a special type of ultrasound. (An ultrasound uses sound waves to create images of the inside of the body.)

●Do a test to look inside your uterus – This involves having a thin tube with a camera and light on the end put into your vagina and up into your uterus.

●Do chromosome tests on you and the baby's father – Before and after testing, you will talk with a genetic counselor. This is a person who specializes in genetic problems.

You might have other tests, too, depending on your individual situation.

How is repeat pregnancy loss treated? — If your doctor or nurse finds a possible cause that can be treated, they will treat it. Treatment might help improve your chances of having a successful pregnancy.

For example, problems in the uterus can sometimes be treated with surgery. Certain medical, immune, or hormone problems can sometimes be treated with medicines.

Is there anything I can do on my own to avoid another pregnancy loss? — There is no sure way to avoid having another loss. But you might be able to lower your chances of having one by avoiding cigarettes, alcohol, caffeine, and other drugs or medicines not prescribed by a doctor or nurse. You can also try to stay at a healthy weight and start taking folic acid supplements before you get pregnant.

Will I be able to have a baby someday? — Most people who have repeat pregnancy loss are able to have a baby in the future.

Let your doctor or nurse know when you are planning to get pregnant and then as soon as you think that you are pregnant. They will monitor your pregnancy to make sure that it is developing normally.

How can I get support if I'm having a hard time coping? — Having repeat pregnancy loss can be very tough. If you are having a hard time coping, talk to your doctor or nurse. They can help you find a counselor to talk to.

Some people also find it helpful to go to a support group for people who have experienced repeat losses.

More on this topic

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Patient education: Coping after pregnancy loss (The Basics)
Patient education: Bleeding in early pregnancy (The Basics)
Patient education: Uterine fibroids (The Basics)
Patient education: How to plan and prepare for a healthy pregnancy (The Basics)

Patient education: Pregnancy loss (Beyond the Basics)
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