Book an initial consultationMiscarriage (synonym: spontaneous abortion) is any unwanted loss of pregnancy up to the 24th week of pregnancy, i.e. before the fetus can survive outside the uterus. Miscarriage as an isolated (lonely) event is quite common. 15% of clinically recognized pregnancies end in miscarriage.
Recurrent miscarriage (RM) is defined as ≥ 3 consecutive miscarriages. They affect 0.6-1.4% of pregnancies, and the prognosis for a live birth is moderate in this group of patients.
In recent years, the two largest professional associations (ASRM and ESHRE) have changed the classic definition and included patients with ≥ 2 clinical miscarriages that are not necessarily consecutive. According to this new definition, the number of patients with this diagnosis increases to 3.25%, i.e. it almost triples, but the prognosis for a live birth becomes much better – the live birth rate after two consecutive pregnancy losses is 75-80% in the next pregnancy or within 3 years.
We believe that the traditional definition of recurrent miscarriage describes this particular group of patients better than the new definition. In addition, the old definition saves patients time-consuming and expensive diagnostic procedures and therapy attempts.
There are many possible causes of the occurrence of recurrent miscarriage (RM):
Dysfunction of the endometrium (including chronic endometritis): The endometrium, the inner layer of the uterine cavity, is not a passive tissue waiting for the embryo to be implanted, but also plays an active role in the selection of embryos that are likely to lead to a successful pregnancy.
Genetic disorders (both in the parents and in the embryos = “de novo disorders”)
Structural malformations of the fetus (developmental disorders)
Endocrine dysfunction (luteal phase deficiency, hyperprolactinemia, PCOS, thyroid disease, uncontrolled diabetes, decreased ovarian reserve)
Endometriosis: Previous studies on donor eggs have shown that endometriosis could negatively affect the quality of the eggs. Larger and more recent research suggests that endometriosis is also likely to contribute to faulty implantation.
Autoimmune diseases, especially antiphospholipid syndrome
Coagulation disorders, both bleeding diathesis and thrombophilias
Immunological factors (numerous, but still not well defined, both in terms of diagnostic and therapeutic approaches)
Abnormalities of the uterus
Factors in the male partner (still without appropriate therapeutic strategies): In recent decades, it has been shown that some male factors can also play an important role in successful live births.
We will be happy to explain diagnostic and therapeutic approaches to you in detail during your initial consultation.
