Recurrent miscarriages are not a common problem, but they lead to serious medical and psychological issues. Recurrent miscarriage is a problem that can cause significant medical complications and has important psychological consequences. Generally, recurrent miscarriage refers to women who have had three or more previous pregnancy losses. These may be consecutive, meaning all pregnancies end in miscarriage. Alternatively, women who have already given birth and have children may experience two or three miscarriages before or after their successful births. Therefore, some women who suffer from miscarriages may already have children but face this issue when attempting to have a second or third child.
Recurrent miscarriage is not a common problem; we can state its prevalence is around 1%. However, it results in serious medical or psychological distress. We observe recurrent miscarriages in women who conceive spontaneously, as well as following vaccination (IUI) or IVF treatments. Especially when considering chemical pregnancies, we also see recurrent losses in treatment-assisted pregnancies.
What is the most common cause of recurrent miscarriages?
The answer to this question varies according to maternal age. Since the rate of pregnancy loss increases in women over the age of 38-40, we observe recurrent miscarriages and treatment-related losses more frequently in this group. Conceiving at an advanced age is difficult, and the risk of miscarriage also increases. The most significant reason for this is the age-related decline in egg quality. This is not a disease but a natural consequence of the female biological lifecycle. Therefore, to avoid such issues, we recommend that women over 35 who wish to have a baby seek medical supervision for assisted reproductive technologies or spontaneous pregnancy without delay and avoid spreading their follow-up or treatments over a long period.
What are the treatable causes of recurrent miscarriages?
We frequently encounter recurrent miscarriages in pathologies such as a uterine septum. If such uterine problems are suspected during ultrasonography, the diagnosis should be confirmed with a medicated uterine X-ray (HSG) or 3D ultrasound, and treatment should be performed via hysteroscopy. If treatment is delayed, recurrent miscarriages and the curettage procedures performed to clear remaining tissues after a miscarriage can cause intrauterine adhesions. This may necessitate multiple hysteroscopies to clear the adhesions. Intrauterine adhesions themselves can also lead to further miscarriages.
Undetected diabetes, high levels of the milk hormone (prolactin), and thyroid gland diseases can also cause recurrent miscarriages. If these are identified and their treatment is planned, a healthy pregnancy and birth will occur.
Another important issue: genetic problems. Recurrent miscarriages can occur in couples where genetic testing reveals an issue. While there is no direct “cure” for these genetic problems once detected, IVF treatment combined with genetic screening methods (PGT, NGS, Array, FISH) may be necessary to prevent miscarriage and ensure a healthy baby.
Clotting disorders or immune system problems, often cited as causes of recurrent miscarriage, are issues for which no definitive treatment method has been established, and their treatment remains controversial. Specifically, there is no consensus on the use of medications known as blood thinners.
In conclusion, recurrent miscarriages can be prevented. About 40-60% of women with recurrent miscarriages can conceive again. However, the underlying problem must first be identified. A significant portion of recurrent miscarriages can be prevented by ensuring women over 35 do not delay pregnancy, planning treatments for those with issues in sugar, thyroid, or prolactin tests, identifying couples with genetic problems, avoiding smoking, maintaining a healthy weight, and confirming a normal uterus via HSG or ultrasound. Providing reproductive health counseling to couples and enlightening them with accurate information plays a vital role in preventing recurrent miscarriages.
