Why things go wrong

A single miscarriage is extremely common. It’s estimated that up to two-thirds of women will experience a loss in the first trimester.

“In some cases, [you] might not even be aware of the loss if it presents as a late or missed period,” said Dr. Daniel E. Stein, director of reproductive endocrinology and infertility at Mount Sinai West hospital and partner at Reproductive Medicine Associates of New York.

Recurrent losses (two or more) are far less common, probably occurring in less than 5 percent of pregnancies.

“At least half of miscarriages are due to chromosome abnormalities, but may also include other factors, including anatomical defects in the uterus, autoimmune factors for the mom, hormonal abnormalities, bloodclotting disorders and environmental factors,” said Dr. Stein. In the other half, no cause is ever found. “The next pregnancy might be completely normal, without any type of intervention,” he said.

The first course of action is a detailed look at a patient’s medical history, followed by a physical exam, pelvic ultrasound, and lab tests.

“Uterine, autoimmune, hormonal and clotting abnormalities can all be treated. In chromosomal cases, we can often achieve excellent success through in vitro fertilization (IVF),” said Dr. Stein.

If you’ve experienced two or more losses, “See an experienced board-certified reproductive endocrinologist,” said Dr. Stein. “There may very well be interventions that are highly successful. Don’t assume your issue is not treatable.”