Why Do Miscarriages Keep Happening?

Understanding the causes of recurrent miscarriages

Early miscarriage is unfortunately a common event. In the vast majority of cases, it is an isolated occurrence that does not repeat itself and is followed by a normal pregnancy.

It is important to emphasize that most women who experience a miscarriage will later have a completely normal pregnancy carried to term.

When miscarriages occur repeatedly, this is referred to as recurrent pregnancy loss. According to medical guidelines, an evaluation may be considered after 3 consecutive miscarriages, although some countries begin investigations after 2 episodes.

It is essential to remember that a miscarriage is generally not related to the woman’s behavior, activity, or anything she has done wrong. In most cases, it is a biological event unrelated to maternal responsibility.

A genetic abnormality of the embryo

The most common cause of early miscarriage remains a chromosomal abnormality of the embryo.

In most cases, this is a random event related to cell division.

However, in recurrent cases, a parental chromosomal abnormality (such as a balanced translocation) may sometimes be involved.

Hormonal or metabolic disorders

Hormonal imbalance may prevent proper development of pregnancy.

The most common causes include:

• thyroid disorders (abnormal TSH)

• polycystic ovary syndrome (PCOS)

• insulin resistance

• luteal phase deficiency

These imbalances may impair embryo implantation.

Blood clotting disorders (thrombophilia)

Some women have an increased tendency to form blood clots.

Antiphospholipid syndrome (APS) is one of the most important causes of recurrent miscarriage.

It can lead to impaired blood supply to the placenta from the earliest weeks of pregnancy.

Uterine abnormalities

The shape or structure of the uterus may influence pregnancy maintenance.

Examples include:

• uterine septum

• submucosal fibroids

• intrauterine adhesions

Some abnormalities are not visible on standard ultrasound and require specialized imaging.

Immunological or inflammatory causes

In some cases, the immune system may react abnormally to pregnancy.

This may interfere with implantation or embryonic development.

Age and oocyte quality

With age, egg quality gradually decreases.

However, even in younger women, variations in oocyte quality may occur and affect embryo viability.

Multiple contributing factors

In many cases, no single cause is identified.

Recurrent miscarriage may result from a combination of hormonal, immunological, genetic, or anatomical factors.

Emotional impact and psychological support

Recurrent miscarriages can be emotionally very distressing.

They may lead to sadness, confusion, anxiety, or feelings of isolation.

It is important to acknowledge that these feelings are valid, and psychological support can be beneficial.

Some women may also feel their experience is minimized by those around them, especially since early pregnancies are often not visible.

Seeking support and talking about one’s experience is strongly encouraged when needed.

Conclusion

Recurrent miscarriages are not inevitable.

They require a structured medical evaluation to identify potentially treatable causes.

In many cases, appropriate management significantly improves the chances of a successful pregnancy.

Take care of yourself.

Kind regards,

Dr. Sandra Yene Amougui