A miscarriage also referred to as a spontaneous abortion, is defined as the termination of pregnancy in the first 23 weeks. It is much more prevalent than commonly believed. Approximately 1 in 8 known pregnancies result in a miscarriage and even more occur before a woman realizes she is pregnant. For many women, the loss of a pregnancy through a miscarriage can be extremely distressing, causing genuine feelings of grief and mourning. (1)
What are the signs of a miscarriage?
A miscarriage can manifest differently for each woman. Some may experience menstrual-like pain and bleed, while others may have no symptoms and the loss of pregnancy is only detected during a routine ultrasound.
In some instances, an ultrasound may reveal issues with the pregnancy, and further examination by a fertility expert may be necessary. To verify a healthy pregnancy, it’s recommended to have an early dating scan. If this is confirmed, the likelihood of a miscarriage decreases significantly. (2)
How to most effectively prevent miscarriage?
Although most miscarriages cannot be prevented, there are some steps you can take to minimize the risk. These include avoiding smoking, drinking alcohol, or taking drugs, maintaining a healthy weight before getting pregnant, reducing the risk of infection from diseases such as rubella, and eating a balanced diet.
Being overweight increases the risk of miscarriage, but there is no evidence to suggest that losing weight during pregnancy is more effective than before pregnancy. As for physical activity, continue with your normal routine unless it is very intense, in which case you should reduce the intensity. If you are not used to exercising, it is advisable to consult with a medical professional before starting a new fitness regimen. (3)
Could miscarriage be genetic?
You may be worried if your family history of recurrent miscarriages means that you will also have one. Although it is common for multiple family members to have miscarriages, it is not always due to a genetic factor. There can be a variety of reasons for a miscarriage, such as individual and family medical history, the timing of conception, and when the miscarriage happened. In some cases, it may be hereditary, but it can also occur randomly. (4)
How does partners’ age increase the risk of miscarriage?
The risk of miscarriage increases with age in women due to the decline in the quality of their eggs as they get older. Indeed, the more advanced woman’s age is, the more likely chromosomal abnormalities (monosomies or trisomies) will occur. the time a woman is 43, there is a 50% chance of a pregnancy resulting in a miscarriage. This decline in egg quality is caused by exposure to oxidative stress and affects the health and quality of the eggs and the embryo.
On the other hand, while a man’s age does not have the same impact on his fertility as a woman’s, the quality of his sperm does decline with age, particularly after 40, which can increase the risk of infertility and miscarriage. A man’s sperm is also affected by oxidative stress as he ages, leading to a decline in the quality of the embryo. The risk of miscarriage is twice as high for women whose male partner is over 45 compared to those whose partner is under 25. (5)
Can Intralipid prevent miscarriage?
According to various studies, women with a history of recurrent miscarriages or failed embryo implantation tend to have increased natural killer cell activity. Intralipid infusion is a treatment option to improve implantation success in such patients with high natural killer cell activity.
Intralipid is an IV infusion that provides essential fatty acids needed for women who have experienced multiple miscarriages. It is typically given once or twice before attempting pregnancy, and the frequency may increase by one dosage per month after conception. Tests are performed at the clinic prior to and during conception to determine if Intralipid infusion is necessary. If you are allergic to eggs, soya beans, or peanut oil, you must inform your consultant as this treatment may not be appropriate for you.
Typically, a brief course of steroids results in minimal side effects, while longer or repeated courses are more likely to cause them. The risk of side effects increases with higher doses and longer periods of use. If you’ve been taking steroids for several weeks, do not stop taking them abruptly as this may lead to withdrawal symptoms. These symptoms can appear within a few days after discontinuing steroid tablets.
How soon after a miscarriage should you try to get pregnant again?
Medical professionals typically suggest allowing your body to recover for one or two cycles before attempting to conceive again. This is also advantageous for determining a pregnancy due date. However, it is crucial to only try again when both partners feel physically and emotionally prepared. It’s necessary to consult with the doctor who treated the abortion, depending on the reason for the miscarriage and the treatment received. (6)
Sunkara, S. K., Khalaf, Y., Maheshwari, A., Seed, P., & Coomarasamy, A. (2014). Association between response to ovarian stimulation and miscarriage following IVF: an analysis of 124 351 IVF pregnancies. Human reproduction, 29(6), 1218-1224.