Miscarriage and Fertility

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We're a national network of over 100 fertility specialists. All our specialists treat miscarriage and recurrent miscarriages.

It's a topic that's not often discussed, yet miscarriage happens in as many as 25 percent of all pregnancies.

Miscarriage is a term that refers to the loss of a pregnancy within the first 20 weeks, and it most often occurs in the first trimester. You may also hear the term spontaneous abortion used to describe miscarriage. According to Dr. Lisa Erickson of The Center for Reproductive Medicine in Minneapolis/St. Paul, there are other categories of miscarriage that include inevitable, missed, and incomplete abortion.

In general, first trimester loss occurs for one of two reasons:

  • A fetus that is not developing properly and/or
  • A placenta that is not attaching to the uterine wall properly

There are numerous reasons for a pregnancy to begin and end so soon. It is believed that the vast majority of these early losses are due to genetic or chromosomal problems with the fetus.

Other possible causes are:

  • Blighted ovum, a condition that is usually genetic in which the placental sac may be developing without a fetus
  • Uterine infection
  • Certain medications taken by the mother (although this is a rare cause)
  • Low hormone levels, particularly progesterone, which may signify an unhealthy pregnancy at the start
  • Structural abnormalities of the uterus
  • Fibroid tumors
  • Immune system dysfunction

The odds for miscarriage following assisted reproduction treatment depend largely on the age of the woman. Says Dr. Erickson, "The higher the age, the higher the risk for miscarriage. The miscarriage rate is not higher for IVF than it is for anyone else getting pregnant, and is probably actually lower with IVF because of the selection process." At The Center for Reproductive Medicine, for example, the post-IVF miscarriage rate starts at eight percent for women under age 35. See CRM's success rates on their site.

If the pregnancy is nonviable, there is no intervention. When asked if first trimester threatened miscarriages can be prevented, Erickson comments, "Depends. Sometimes bedrest and progesterone supplementation can help if indicated. A review of possible etiologies (causes) determines additional treatment options."

The typical first sign of an impending miscarriage is spotting or cramping after conception. Additionally, some women may notice diminished pregnancy symptoms. Some women do not notice any symptoms at all and are unaware that the pregnancy is nonviable at their first OB visit.

"Patients having bleeding and cramping want to know if their pregnancy is healthy or not," adds Erickson, "and the medical profession may not be able to stop the process, but we can provide information in a timely manner." Miscarriage is confirmed through ultrasounds and hCG blood tests.

The good news -- experiencing one miscarriage usually has little to no predictive value on future successful pregnancies. Reproductive endocrinologists are not only expert in facilitating conception, but also in helping women with recurrent pregnancy loss by providing the diagnostic workup and possible treatment options.

See a fertility specialist now
We're a national network of over 100 fertility specialists. All our specialists treat miscarriage and recurrent miscarriages.