Miscarriage

Miscarriage can be heartbreaking. A miscarriage is a pregnancy that ends within the first 20 weeks. Most miscarriages happen within the first trimester and once a pregnancy reaches the 12 week mark, the risk of miscarriage falls to only 2%.

Sometimes women will experience cramping and heavy bleeding, but for some women there are no symptoms and the foetus dies but stays in the uterus. This is known as a ‘missed’ or ‘silent’ miscarriage and women are usually given the option of having a surgical procedure, using medication or waiting for nature to take its course and for the foetus to be passed from the uterus.

Understanding miscarriage

Prevalence

It’s estimated that around 10-20% of pregnancies end in miscarriage. But some studies suggest that the actual rate of early pregnancy losses could be as high as between 60-75% of conceptions – with the vast majority happening before a woman realises she is pregnant.

However, the rate of miscarriage does increase as women get older. Read more about age and fertility.

Causes

It’s important to remember that there is almost always nothing that could have been done to prevent a pregnancy being lost and nothing that can be done to hang on to a pregnancy that is destined to end in miscarriage.

The vast majority of miscarriages are unexplained, partly because they are not usually investigated until a woman has two or three in a row. A random genetic abnormality is the most common cause of miscarriage.

About 9 out of 10 genetically abnormal pregnancies will not survive past the first trimester. In normal human cells there are 46 chromosomes, which contain DNA and genes. When cells have the wrong number of chromosomes, the error is known as aneuploidy – the best-known example of which is Down syndrome which is the result of having three copies of chromosome 21 instead of the usual two.

Recurrent miscarriage

While miscarriage is usually a one-time occurrence, up to one in 20 couples experience two miscarriages in a row and one in a hundred suffer three or more – this is known as recurrent miscarriage.

Some of the known causes of recurrent miscarriage are:

• Chromosome abnormalities
• Abnormalities of the uterus
• Blood clotting disorders
• Immune disorders
• Hormonal disorders
• Infections
• Lifestyle factors such as smoking, alcohol and recreational drugs.

The role of IVF

As random chromosome problems are thought to be the cause of the majority of miscarriages, Genea Hollywood offers GeneSure^™, a leading embryo screening technique (Preimplantation Genetic Screening or PGS) that allow scientists to screen an embryo in the lab as part of the IVF process and to ensure it has the correct number and sequence of chromosomes in the DNA before proceeding to embryo transfer.

For women over 38, GeneSure^™ has been shown to double the live birth rate and halve the miscarriage rate per embryo transfer, making it a worthwhile option for couples experiencing recurrent miscarriage^*.

When to seek help

If women have two or more miscarriages in a row, we recommend speaking with a Fertility Specialist so tests can be done to see if there is an underlying cause.

More than half of the time these investigations don’t find any explanation for the miscarriages – and this is good news, as it means a healthy pregnancy is likely to be achieved in the future without medical intervention. Knowing this, can help to reduce anxiety around being able to achieve a healthy pregnancy.