Miscarriage. Why does it happen?

The tragic reality is that between 10% and 20% of women will miscarry, most often in the first 13 weeks. The shock and grief for the baby you never got to hold is incomparable and it’s very easy for you to you all too quickly point the finger of blame at yourself

We turned to Dr. Anamika Rao from Manchester Fertility Clinic to help us understand  miscarriage and to answer some of the most common asked questions:

What is an early miscarriage?

An early miscarriage is the loss of a pregnancy in the first 3 months.

Why does miscarriage happen?

The implantation and progress of pregnancy is complex and dependent on various factors. These include fetal, maternal, and environmental factors. The most common cause of a miscarriage is thought to be the abnormality in the chromosomes (the genetic building blocks) of the implanting embryo.

How do you know if you are miscarrying or not? (If you are bleeding or spotting, is this a sign? What does it mean if you are simply ‘spotting’?)

The main symptoms of a miscarriage are vaginal spotting or bleeding with or without abdominal cramping pains. In some women, however, there is no symptom and the miscarriage is diagnosed during an early ultrasound scan. Spotting in early pregnancy is a relatively common occurrence and can be very alarming but it does not necessarily indicate a miscarriage.

What is happening to the body during the miscarriage?

During the miscarriage, your uterus squeezes to push out the fetus inside its cavity and therefore you experience cramps and bleeding. It is completely safe to take paracetamol and/or a hot compress for pain relief.

What do you do if you think you are miscarrying?

If you experience any symptoms of miscarriage, please contact your clinic, midwife, or GP for advice. They will assess your symptoms and can help you with the right support and advice.

Are women who conceived through IVF more likely to miscarry than those that conceived naturally?

Research suggests that IVF and ICSI has a small, if any, increased risk of miscarriage in itself as a treatment. The usual risks are a women’s age, partner’s age, and previous pregnancy history.

What is a chemical pregnancy?

Chemical pregnancy (also called biochemical pregnancy) is a term used to describe a very early pregnancy loss. This kind of loss happens just after the embryo implants, giving you a positive pregnancy test, but before you can see anything on an ultrasound scan. This happens usually before 5 weeks of pregnancy.

How common is a miscarriage? Why does a woman keep miscarrying repeatedly? Does this mean she will never be able to carry a baby to full term?

Sadly, 1 in 4 pregnancies ends in a miscarriage (1 in 5 if we only count women who realised/reported the miscarriage).

Women who have had a single miscarriage have a good prognosis for having a live birth with their next conception.

A small minority of women, approx. 1 in 100 in the UK, experience recurrent miscarriages (3 or more in a row). If you have experienced more than two miscarriages, you should see your GP or take medical opinion for further investigations. More than 50% of women who have a history of recurrent miscarriage will go on to have a successful pregnancy.

Is there anything the woman could have done to avoid a miscarriage?

Unfortunately, the majority of miscarriages cannot be prevented.

The incidence of miscarriage increases with advancement in parental age specifically maternal age. However, there are some things you can do to reduce the risk of a miscarriage.

Stop smoking

Stay active with moderate exercise

Eat a healthy and well-balanced diet

Lose weight before pregnancy if you are overweight

Manage your weight gain if you are overweight in pregnancy

Avoid certain foods in pregnancy such as shellfish.

Do not drink alcohol or use illegal drugs in pregnancy

Limit your caffeine intake before and during pregnancy.

Does one miscarriage increase the risk of yet another miscarriage?

The risk of another miscarriage does increase with a history of previous miscarriages. With the history of a previous single miscarriage, the increase is not very significant; therefore, we do not recommend any further intervention at this stage.

How soon can you start another round of IVF following a miscarriage?

We advise you to wait for at least 1 normal menstrual period before starting another round of IVF. We may advise you to wait longer in certain circumstances where further investigations are indicated. It is also important to consider whether you are emotionally ready to start trying to conceive again. Many clinics, like us at Manchester Fertility, offer a counselling service which can be accessed if you feel you need extra support and advice at this time.

Is there a test a woman can have to ensure it won’t happen again? What can you do to make sure it will not happen again?

The tests to identify any underlying cause are indicated after 3 consecutive miscarriages. Most of the women in this group will still have no underlying cause found.

If any underlying cause is identified, targeted treatments can be undertaken to minimise the risk of miscarriage.

If you have had a miscarriage and need some support, you can reach out to the following trusted organisations that are available online:

Share Pregnancy and Infant Loss Support.

International Stillbirth Alliance (ISA) 

The Miscarriage Association

Sands

Tommy’s 

Dr. Anamika completed her Obstetrics and Gynaecology training both in India and the UK, and has been a member of the Royal College of Obstetricians and Gynaecologists since 2005. She has special interest in recurrent embryo implantation failure and miscarriage. You can read more about Anamika here

Have you suffered a miscarriage? How did you cope? Did you go on to have a successful pregnancy? We would love to hear from you. Will you drop us a line? info@ivfbabble.com

 

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