Dr Naomi Page is one of our experts in Gynaecology and here Naomi talks about Recurrent miscarriage in the first trimester.

What is it?

This is when a person experiences 3 or more miscarriages. These do not have to be consecutive. You should be offered investigations in a dedicated recurrent miscarriage clinic after 3 miscarriages. However, in certain instances, if your healthcare professional believes there may be an underlying cause or other risk factors you may be offered investigation after 2 miscarriages.

Main causes:

• The majority of miscarriages are causes by genetic abnormalities within the pregnancy. Most of these are sporadic and not inherited from either partner.
• Non inherited clotting disorders such as antiphospholipid syndrome (APS) is also a recognized cause of recurrent miscarriage and can be tested from a blood sample.
• Disorders that can affect your hormonal balance such as polycystic ovarian syndrome (PCOS), diabetes and thyroid disorders are also known to be linked with risk of recurrent miscarriage.
• The shape of your womb may cause issues with implantation, some of these abnormalities can be treated with surgery.
• There certain type of cells in the womb called natural killer cells that may be related to risk of recurrent miscarriage. However, due to lack of substantial evidence testing is not yet recommended by the Royal College of Obstetricians and Gynecologists.
• Sadly, sometimes a reason cannot be found as to why recurrent miscarriage has occurred, this is called unexplained recurrent miscarriage as there maybe a different reason for each loss.

Possible treatments

Treatment will usually be tailored towards the cause when this is known.

Making sure you are in the best possible health prior to pregnancy is vital. This includes a healthy diet and maintaining a normal body mass index (BMI), taking pre pregnancy vitamins, reducing caffeine and alcohol intake, smoking cessation.

Resources and support

There are many excellent resources and support available. Please contact your healthcare provider on more information on these.

• RCOG
• Tommy’s
• Miscarriage association
• SANDS

We offer a recurrent miscarriage package at our clinic where a healthcare provider will take a detailed history and provide several investigations including 3D scan to review the possible causes that may be linked to your history of recurrent miscarriage. Please contact us if you wish to book and appointment or you would like further information.