Recurrent Pregnancy Loss

Sadly, miscarriage is common

Nearly twenty percent of pregnancies end in miscarriage. For one to two percent of patients, this pattern will repeat itself. The definition of recurrent miscarriage is two miscarriages, but for most people in this situation there is no underlying issue and they will go on to have a normal pregnancy. Most miscarriages are caused by aneuploidy (extra or missing chromosomes). Aneuploidy does increase with maternal age. The more miscarriages you have, the less likely it is to be caused by genetic abnormalities.

Workup for Recurrent Pregnancy Loss

If possible, the doctor will test the embryo to see if there was a chromosomal abnormality. If the embryos is normal, the doctor will investigate other causes. These include: abnormal structure of the uterus, infections in the uterus, blood clotting issues, thyroid disorders, and problems with sugar metabolism. A genetic screening of both parents is also part of the workup. 

Your treatment options

If pregnancy loss is due to the structure of the uterus, chromosomal abnormalities or certain hormonal problems, it can be relatively straightforward for the doctor to diagnose. However, known causes of miscarriage only account for half to a third of all cases of RPL. The majority of couples will not have a clear cause. If this is the case, a doctor will follow the subsequent pregnancy very carefully for two reasons. First, studies have shown that careful monitoring increases the likelihood of live birth in women with a history of miscarriage. Second, there are some causes of pregnancy loss that can only be found if the loss is identified right away. For example, if the fetal heartbeat stops, they can go in and look at the embryo with a camera. Ten to fifteen percent of chromosomally normal embryos will have severe morphological changes that indicate a genetic problem. They can also take placenta cells to see if there is a problem with the placenta.

There are some women who have recurrent miscarriages due to an ]immunological issue.  In this case, immune system treatments can sometimes be helpful. However, there is no evidence that treating the immune system will help with recurrent pregnancy loss if there is no clearly identified immunological problem.

My experiences working with Recurrent Pregnancy Loss

I’ve worked with several women who have had multiple miscarriages. All have gone on to have healthy babies. I can’t know for a fact that the acupuncture played a role in those outcomes, but I do know that the women felt acupuncture treatments were helpful. I will typically see a woman weekly from the time of early pregnancy through the first trimester. I also like to have her do moxibustion at home on her low back—it’s an adjunctive therapy that helps support early pregnancy from a traditional Chinese medicine standpoint.


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