Repeated Abortions

Experiencing repeated abortions, or recurrent miscarriages, can be a deeply distressing and challenging situation. Recurrent miscarriage is generally defined as having three or more consecutive pregnancy losses before 20 weeks of gestation. If you or someone you know is facing this issue, it’s essential to approach it with a comprehensive understanding and appropriate medical support.
Causes of Recurrent Miscarriages

**1. Genetic Factors:

Chromosomal Abnormalities: The most common cause is chromosomal abnormalities in the embryo, often due to errors during cell division. These are usually random and not inherited.
Parental Chromosomal Issues: Structural chromosomal abnormalities in one or both parents can increase the risk.

**2. Anatomical Issues:

Uterine Abnormalities: Conditions like a septate uterus, fibroids, or polyps can affect implantation or sustain pregnancy.
Cervical Insufficiency: Weakness of the cervix that leads to premature opening and miscarriage.

**3. Hormonal Imbalances:

Thyroid Disorders: Both hypothyroidism and hyperthyroidism can impact pregnancy.
Polycystic Ovary Syndrome (PCOS): Hormonal imbalances associated with PCOS can affect miscarriage rates.
Luteal Phase Defect: Insufficient progesterone to support the pregnancy.

**4. Autoimmune Disorders:

Antiphospholipid Syndrome (APS): An autoimmune disorder that increases blood clotting, affecting the placenta.
Systemic Lupus Erythematosus (SLE): Another autoimmune condition that can impact pregnancy.

**5. Infections:

Chronic Infections: Certain infections can impact pregnancy, although they are less commonly a cause of recurrent miscarriages.

**6. Lifestyle Factors:

Smoking and Alcohol Use: Both are associated with an increased risk of miscarriage.
Excessive Caffeine Intake: High levels of caffeine may be linked to miscarriage risk.

**7. Underlying Health Conditions:

Diabetes: Poorly controlled diabetes can increase miscarriage risk.
Obesity: Obesity can be associated with an increased risk of miscarriage.

Diagnostic Approach

**1. Medical History and Physical Examination:

Comprehensive review of your medical, reproductive, and family history.

**2. Genetic Testing:

Karyotyping for both partners to identify any chromosomal abnormalities.

**3. Hormonal Assessments:

Blood tests to check thyroid function, hormone levels, and other relevant parameters.

**4. Ultrasound and Imaging:

Hysterosalpingography (HSG): To assess the uterine cavity and fallopian tubes.
Sonohysterography: An ultrasound with saline infusion to check for uterine abnormalities.

**5. Autoimmune Testing:

Testing for conditions like antiphospholipid syndrome and lupus.

Management and Treatment

**1. Addressing Underlying Causes:

Treatment tailored to the specific cause, such as managing thyroid disorders or correcting anatomical abnormalities.

**2. Hormonal Treatments:

Progesterone Supplements: For luteal phase defects or other hormonal imbalances.
Thyroid Medication: If thyroid dysfunction is identified.

**3. Lifestyle Modifications:

Smoking Cessation: Avoiding tobacco and alcohol.
Healthy Diet and Weight Management: Maintaining a healthy weight and balanced diet.

**4. Medical Interventions:

Surgical Corrections: For anatomical issues like a septate uterus.
Anticoagulant Therapy: For antiphospholipid syndrome or other clotting disorders.

**5. Support and Counseling:

Psychological support to address the emotional impact of recurrent miscarriages.
Genetic counseling if chromosomal abnormalities are identified.

Additional Considerations

Consultation with a Specialist: Contact the President of Indian Fertility Society (Prof) Col Dr. Pankaj Talwar, MD, VSM and the best reproductive endocrinologist or a fertility specialist to provide advanced diagnostic and treatment options.