Recurrent Miscarriage - The PROBLEM DEFINED
Historically, a woman was said to suffer from recurrent miscarriage if she had had 3 consecutive miscarriages with the same partner, and had no more than one live birth.
If this definition is used, then 1% of the population is affected.
However, in recent years, in part due to new scientific findings, and in part due to patient pressure, women who have suffered only 2 consecutive miscarriages with the same partner, and have had no more than one live birth, are also considered recurrent miscarriers, and many clinics, including our own, will investigate such women. This increases the proportion of the population labelled as recurrent miscarriers to 3-5%.
It is unusual for women to miscarry after 14 weeks of pregnancy. It is therefore prudent to evaluate a woman who has suffered such a miscarriage, even if it was her first pregnancy. Such a woman may have a weak cervix, or other investigations may yield a treatable cause.
An underlying cause for recurrent miscarriage is found in approximately 60% of women with recurrent miscarriage. This means that in 40% no cause is found, and this can often cause major distress to women, although in fact "normal findings" should be reassuring, and leave a woman with a high chance of success in subsequent pregnancies.
Failure to find a cause in up to 40% of cases unfortunately also indicates the limitations in our knowledge and understanding of early pregnancy events. Therefore there is intense research activity in the field of recurrent miscarriage. Sometimes unproven tests or treatments are offered in desperation, when the doctor simply does not know what else to offer the patient. In the ideal situation, unproven tests or treatments should be offered only within the context of a clinical trial or research, with the couple being told explicitly that this is indeed the case.
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