Causes of Multiple Miscarriage:
Multiple miscarriages, which was classically defined as >3 consecutive pregnancy losses has recently been redefined as >2 pregnancy loss, owing to an increase in the prevalence of childless couples.
Years of research in the field have identified anti-phospholipid antibody (aPL) syndrome (APS), uterine/endocrine/chromosomal abnormalities as the leading causes of multiple miscarriage. However, these three pathologies account for only 1/3 of all multiple miscarriage cases, leaving the remaining 2/3 of the cases unexplained. Recent reports suggest genetic variations as the underlying reason for these unexplained incidences.
Anti-phospholipid Antibody Syndrome (APS):
- APS is an autoimmune disorder. Antibodies mistakenly attack cells of your body.
- In APS, antibodies mistakenly attack phospholipids, found on all living cells including cells on the walls of blood vessel.
- When the anti-phospholipid (aPL) antibodies attack blood vessels, it causes blood clots and damages organ systems.
Some people have aPL but don’t show sign of APS. To be diagnosed with APS, you must have aPL and a history of health problems related to APS:
- Heart attack,
- Kidney damage,
- Deep vein thrombosis, and
- Pulmonary embolism.
Currently there is no cure for APS, but medications can help prevent associated complications. Two blood thinners: Warfarin and Heparin are commonly used to treat APS. The PillCheckTM test at Geneyouin can ascertain if you will respond well to Warfarin.
Congenital Uterine Abnormalities:
A uterine malformation causes an abnormality in the size, shape or structure of the uterus and results from abnormal development of the Müllerian duct(s) during embryogenesis. Most prevalent symptoms are infertility and multiple miscarriages.
Roughly 1% of the general population is affected by congenital uterine abnormalities. Many non-obstructing uterine abnormalities are asymptomatic and are only discovered during evaluation of recurrent miscarriage. There are several classifications of uterine abnormalities that can be diagnosed by your physician.
Unfortunately, surgical intervention is the only treatment for this condition and to increase chance of successful pregnancy.
The endocrine system is a network of glands that produce and release hormones that control many important body functions.
In general, endocrine disorder can manifest in two ways:
- When a gland release too much or too little hormones, or
- Development of lesions in the gland that affect hormone levels.
During the early stages of pregnancies, embryo attachment and implantation are extensively controlled by local hormonal environment, therefore, endocrine-related miscarriage are likely to occur early in gestation.
Three hormonal disorder are commonly linked to multiple miscarriage:
- Luteal phase defects, and
- Polycystic ovary syndrome.
A careful examination by your physician can determine the precise nature of the endocrine disorder that is causing your unsuccessful pregnancies. Treatment options are available for these conditions.
Chromosomal abnormality reflects an irregularity in the chromosome number or structure.
We have 23 pairs (two sets of 23) of chromosome, one set of 23 chromosome inherited from the mother through the egg cell, while the other set of 23 chromosome is from the father, from the sperm cell.
Sometimes an error occurs during the production of the sperm or the egg cells, with an entire chromosomes or portions of the chromosome either deleted or duplicated.
Chromosomal abnormalities that lead to recurrent pregnancy losses are usually not caused by the gain or loss of a whole chromosome.
Rather, they result from eggs or sperm cells that have portions of chromosomes duplicated or deleted, or chromosomes with translocations, where a portion of one chromosome breaks and reattaches to a different chromosome as a consequence of structural rearrangement. Also, parents with structural chromosomal abnormalities may not produce gamete with the correct amount of genetic material.
Chromosomal defects can only be detected by genetic screening and couples may benefit from pre-implantation genetic screening in conjunction with in vitro fertilization.
If you are interested to learn more about the underlying genetic cause of the rest 2/3 of the unexplained cases, please continue to my other blog titled “The Solution to Multiple Miscarriage is in your Genes!”