There can be many causes of habitual miscarriage, so accurate diagnosis and treatment are essential.
Chromosomal abnormalities in the fetus due to parental chromosomal abnormalities can occur, which can lead to repeated miscarriages in early pregnancy. Translocation of chromosomes (translocation: cut in two or more chromosomes, and then combine with other chromosomes again to form a new chromosome) is common, and it is found in about 6% of parents (mom or dad) who have recurrent miscarriages. Even if the parent's chromosomes are normal, if the mother's age is over 35, fetal chromosomal abnormalities may appear, mainly non-disjunction (non-disjunction: when chromosome division does not occur during meiosis) which leads to an number of autosomal abnormality such as Down syndrome occurs.
- ㆍDiagnosis: Chromosomal testing of the married couple and chromosome testing of the aborted fetus
- ㆍTreatment: Genetic counseling and preimplantation genetic diagnosis
It is due to uterine malformations and intrauterine adhesions, accounting for 15-25% of miscarriages.
In addition, fibroids and cervical incompetence can also cause miscarriage.
- ㆍDiagnosis: Ultrasound, hysteroscopy and diagnostic laparoscopic surgery
- ㆍTreatment: Correction of deformities and abnormalities through surgery
Repeated miscarriages may be caused by viruses that cause fetal malformations such as TORCH (toxoplasma, measles, cytomegalovirus, herpes) or bacteria such as chlamydia and ureaplasma, and appropriate antibiotic and antiviral treatment may be required after diagnosis.
A defective luteal phase can occur when adequate progesterone is not released from ovulation to the first trimester of pregnancy, and other factors such as diabetes and thyroid disease can cause habitual miscarriage.
- ㆍDiagnosis: baseline hormone measurements and basic blood work on days 2-3 of your period, measurement of luteal phase progesterone.
- ㆍTreatment: Progesterone augmentation (ovulation induction and administration of progesterone), other treatments based on the condition
Immunological factors are thought to be responsible for about 50% of all miscarriages and about 80% of unexplained miscarriages. Immune disorders are broadly classified into autoantibody and alloimmune disorders and can be diagnosed by detecting autoantibodies associated with miscarriage or by detecting cells and cytokines involved in alloimmunity. As intravascular coagulation is known to be problematic in most immunological causes, treatment is mainly with the anticoagulants aspirin and heparin, and more recently with immunoglobulin therapy.
In most cases of unexplained habitual miscarriage, an immunological component is known to be involved, and treatment is based on the immunological component.