Repeated miscarriages

Repeated miscarriages

Miscarriages – Repeated abortions 

We use the term repetitive abortions to refer to 2 or more consecutive miscarriages in a woman’s life with the same partner.

Abortion means the spontaneous termination of an intra-uterine pregnancy for which we have evidence of the existence of beta HCG and / or ultrasound. we exclude biochemical pregnancy and extra-uterine pregnancy from the definition.

Fortunately, it affects a small percentage of the population, i.e. 1-3%.

What are the risk factors?

The first factor is age. After 40, the risk of miscarriages is greater. This is because the risk of chromosomal abnormalities increases.
Chromosomal anomalies means anomalies in the number and / or composition of chromosomes (Chromosomes are those genetic structures where our genetic heritage is hidden).

We have observed that after the age of 40 chromosome problems occur more often during conception and divisions.

The stress factor is under discussion.

Environmental pollution and exposure to toxic substances during work can stop a pregnancy.

Endometritis is an important risk factor for an abortion. Cases of late abortions have been confirmed (after the 14th week of pregnancy) due to chronic endometritis.

What exams to take?

We have observed a connection between thrombophilia and miscarriages, after the 10th week of pregnancy.

Thyroid problems (hypothyroidism, when the thyroid gland functions poorly, such as Hashimoto’s thyroiditis and hyperthyroidism when the thyroid gland functions too much, such as Graves’ disease) put pregnancy at risk and can lead to miscarriage.

The messages of the studies are clear .

TSH must be less than 2.5 before conceiving.
We must check anti-thyroid antibodies.

Insulin resistance is very common in patients with polycystic ovary syndrome and must be controlled. In addition, uncontrolled diabetes leads to a 68% increased risk of miscarriage.

Also, we must measure prolactin.

Measuring progesterone during the second phase of the cycle is not helpful.

Anti-cardiolipin, lupus anticoagulant, anti-ß2-glycoprotein I or other antiphospholipid antibodies are measured

The doctor must perform hysteroscopy in cases of recurring abortions for several reasons.

1. To exclude anatomical anomalies such as the presence of a septum.
2. To exclude the presence of small polyps that are not seen on transvagina ultrasound.
3. Exclude endometritis.

The study of the HLA typing system and NK (natural killers) cells to date have not shown their usefulness.


  • We start from the assumption that in 80-90% we will not find the cause.
  • If we do not find the cause we can discuss the possibility of proceeding for IVF with or without PGS as appropriate.
  • If the patient does not want to undergo IVF and is young, we recommend that as soon as she becomes pregnant she must start an empirical treatment approved by ESHRE (progesterone, heparin, aspirin and cortisol).
  • The use of intralipids is useless.

Share This Story: