Recurrent Miscarriage

A spontaneous abortion is a miscarriage occurring before the 20th week of a pregnancy. These early miscarriages occur in about 15 percent of pregnancies, and the risk of miscarriage increases with the number of previous miscarriages -- a woman who has one such miscarriage is more likely to have another. Unfortunately, researchers have so far been unable to isolate a cause for these miscarriages. Over the years, they have simply been accepted as a “normal” (albeit tragic) risk associated with pregnancy. In the past five to ten years, however, doctors have developed a more aggressive approach toward preventative diagnosis and treatment of these miscarriages and the women who suffer them. Medical experts now recognize a recurrent pregnancy loss syndrome defined by two or more consecutive spontaneous miscarriages. Women who suffer two spontaneous miscarriages are now fully evaluated and preventative measures are undertaken. Experts also now recognize a link between miscarriages and general infertility.

Rather than assuming they are a normal risk of pregnancy, modern science has come to understand that all miscarriages are caused by something going wrong with the body's natural processes. These bodily dysfunctions may be genetic, hormonal, physical, immunological, or related to microbial infections. The challenge now is to accurately diagnose these causes and develop effective ways to treat them.

The Creighton Model predicts a woman's fertility based on her "mucus cycle" -- monthly variations in her vaginal secretions. According to this model, women who suffer miscarriages are likely to exhibit a "limited mucus cycle." Her secretions before ovulation will show less estrogen than normal and her secretions after ovulation will have less estrogen and progesterone. Ultrasound monitoring will typically show that the woman's ovarian follicles (pockets in the woman's ovary which each contain a single egg) are very small.

The Creighton Model measures hormone levels in a woman's vaginal secretions to identify the time during a woman's cycle when she is most fertile -- this is her "Peak Day." Studies have shown that if a woman's period comes too soon after her Peak Day, she is more likely to miscarry. Fortunately, this condition can be easily determined by charting a woman's menstrual and mucus cycles, at which point treatment (and prevention of the miscarriage) is easily accomplished.

Another typical cause of miscarriages is endometriosis, a condition in which uterine cells are found outside the uterus -- typically in the ovaries. Eighty-five percent of women who suffer multiple miscarriages have this condition, but without a diagnostic laparoscopy (a procedure in which a camera is inserted through incisions in the belly to view the internal reproductive organs), it is typically unidentified. Many such procedures have shown the presence of endometriosis and have been followed up with treatment leading to successful outcomes.