Miscarriages are common, and one or even two miscarriages are not in themselves indicative of future infertility. Many couples go on to have healthy children unassisted after losing two pregnancies. However, after two miscarriages, you may want to look more closely at possible reasons.
There are many causes, but they are usually divided into two groups — early and late.
Recurrent early miscarriages (within the first trimester) are most commonly due to genetic or chromosomal problems of the fetus or structural problems of the uterus.
Late miscarriage can be the result of uterine abnormalities, autoimmune problems, an incompetent cervix or premature labor. Clotting abnormalities can also contribute to second-or third-trimester loss.
A history of recurrent miscarriage calls for intervention by a reproductive endocrinologist. At the Washington University Reproductive Endocrinology and Infertility Center, we perform a range of tests on both the mother and the fetal tissue, when available. These may include:
- Anatomical testing –- sonography (ultrasound test or HSG (X-ray)
- Testing for auto-immune disorders
- Thyroid panel
- Endometrial biopsy
- Blood work for serum progesterone levels
- Chromosome testing of fetal tissue
- Blood clotting studies
- Chromosome testing of parents