Fertility after Miscarriage: Understanding the causes and how to move forward

Miscarriage, the term used for loss of any pregnancy before 20 weeks gestation, is more common that people realise. It’s thought that around 1 in 8 known pregnancies will end in miscarriage and most miscarriages occur before a woman even realises she is pregnant. 

Many women struggle with fertility after miscarriage as the event will have undoubtedly caused some emotional trauma. To look at how we can move forward, we must understand what may have caused the miscarriage in the first place. 

There are numerous causes of miscarriage, depending on the individual's and family's medical history, the timing of conception and when the miscarriages occurred. Some of which can run in the family, but these are not necessarily hereditary factors as often thought and a family history may just be purely coincidental. 

Here we look at some of the known contributing factors as to why a pregnancy may not progress to term as hoped, what factors may influence recurrent miscarriage and also how we can diagnose the potential cause and provide appropriate help and fertility after miscarriage support for couples struggling with miscarriage;

Factors in Miscarriage

Chromosomal Abnormalities

A significant portion of miscarriages occur due to chromosomal abnormalities in the fetus. These abnormalities may result from errors during the formation of eggs or sperm, or during fertilisation.

Maternal Age

Advanced maternal age (usually defined as 35 and older) is associated with a higher risk of miscarriage. As women age, the quality of their eggs decreases, increasing the likelihood of chromosomal abnormalities.

Sperm Quality

Any abnormalities in sperm parameters have the potential to increase the risk of an implantation failure, or cause a developing embryo to be compromised, leading to a higher risk of miscarriage. Sperm health parameters should also be considered for couples who are experiencing recurrent miscarriage. For more information on how sperm can impact conception and pregnancy, read our Male Fertility Blog: How is Sperm Health linked ot Infertility & Miscarriage Risk?

Medical conditions

Certain medical conditions in the mother, such as diabetes, thyroid disorders, polycystic ovary syndrome (PCOS), autoimmune disorders, and blood clotting disorders can increase the risk of miscarriage.

Uterine abnormalities

Structural issues in the uterus, such as fibroids, polyps, or an abnormally shaped uterus, may interfere with implantation or the ability to carry a pregnancy to term.

Hormonal imbalances

Imbalances in hormones, including progesterone and estrogen, can affect the development and maintenance of a pregnancy.

Infections

Infections during pregnancy, such as bacterial vaginosis, cytomegalovirus (CMV), listeriosis, and certain sexually transmitted infections can increase the risk of miscarriage.

Environmental factors

Exposure to certain environmental toxins, such as radiation, chemicals, or heavy metals may increase the risk of miscarriage.

Lifestyle factors

Smoking, excessive alcohol consumption, drug use, and obesity have been associated with an increased risk of miscarriage.

Recurrent Miscarriage

Recurrent miscarriage, defined as three or more consecutive pregnancy losses, is uncommon and only affects around 1 in 100 women. Recurrent miscarriage may be caused by some of the reasons mentioned previously, as well as the following additional factors;

Genetic factors

Some couples may carry genetic mutations that increase the risk of miscarriage.

Immune system issues

Abnormal immune responses may contribute to recurrent miscarriages by attacking the developing fetus as a foreign body.

Thrombophilia

Inherited blood clotting disorders can increase the risk of blood clots in the placenta, leading to miscarriage.

Lifestyle factors

Chronic stress, extreme physical exertion, and poor nutrition may contribute to recurrent miscarriages.

Advice & Support

It is essential for individuals experiencing problems with fertility after miscarriage undergo thorough medical evaluation to identify any underlying causes and receive appropriate treatment or management. Consulting with a healthcare provider or fertility specialist is crucial for personalised guidance and support.

If you or someone you know is experiencing concerns about fertility after miscarriage or recurrent miscarriage, there are several steps that can be taken to seek help and support:

1. Consult a healthcare provider

It's essential to schedule an appointment with a healthcare provider, preferably one specialising in reproductive health or fertility after miscarriage, such as our own Dr Koita (FRCOG). Fertility specialists can conduct a thorough evaluation to determine the potential cause of miscarriage and provide you with personalised guidance based on your unique, individual circumstances.

2. Genetic testing
For couples experiencing recurrent miscarriages, genetic testing may be recommended. Genetic tests can help to assess the risk of inherited genetic conditions that may be contributing to miscarriage and provide information on available testing and treatment options.

3. Fertility testing
Fertility testing after miscarriage may include assessing hormone levels, evaluating ovarian function, and conducting tests to assess sperm quality (if applicable). These tests can help identify any underlying fertility issues that may be impacting pregnancy outcomes.

4. Ultrasound and imaging
Imaging tests, such as ultrasounds, may be performed to assess the uterus and pelvic structures for any abnormalities that could contribute to miscarriage or other fertility issues.

 

5. Treatment options
Depending on the underlying cause of miscarriage or fertility concerns, various treatment options may be available. These could include hormonal therapy, surgical procedures to correct structural abnormalities in the uterus, or assisted reproductive technologies such as in vitro fertilization (IVF) or intrauterine insemination (IUI).

6. Lifestyle modifications
Making healthy lifestyle choices can positively impact fertility and pregnancy outcomes. This includes maintaining a balanced diet, achieving a healthy weight, avoiding smoking and excessive alcohol consumption, managing stress, and getting regular exercise.

7. Emotional support
Experiencing miscarriage or fertility challenges can be emotionally difficult. It's essential to seek emotional support from loved ones, support groups, fertility counselors who specialise in reproductive health and pregnancy loss.

 

8. Second opinion
If you're uncertain about your diagnosis or treatment plan from an existing care provider after experiencing miscarriage or recurrent miscarriages, don't hesitate to seek a second opinion from Dr Irfana Koita, our fertility specialist, who has many years of experience supporting couples who have been where you are now. Dr Koita can review your medical history and circumstances and provide recommendations for tests to diagnose the likely cause and help you plan for a fully supported pregnancy. 

 

In Summary

Remember that each person's journey with fertility and pregnancy loss is unique, and there is no one-size-fits-all approach. By seeking help from qualified healthcare professionals and accessing appropriate support networks, individuals experiencing fertility after miscarriage concerns can receive the care and guidance they need to help them navigate their fertility journey effectively.

Book an Advisory Call

Book a Consultation

Request to speak to a Fertility Counsellor