Understanding Recurrent Miscarriage and How To Naturally Improve Your Fertility
The loss of a pregnancy can deal a devastating blow to expectant parents.
However, spontaneous miscarriage, the loss of a pregnancy before 20 weeks gestation, is very common.
Research estimates indicate one in four pregnancies end in miscarriage, often within the first 12 weeks of conception.
Recurrent miscarriage is defined as having three or more consecutive miscarriages.
What Are The Causes?
Medically recognised causes of recurrent miscarriage include chromosomal problems in either partner, cervical weakness, uterine abnormalities, hormone imbalances, blood clotting disorders, infection and immunological causes such as antiphospholipid syndrome.
Often it isn’t until after a third miscarriage that further investigations will be conducted on the woman to find potential causes of loss of pregnancy. However, in over 50% of cases the cause is likely to remain unexplained.
A number of modifiable health factors can also influence the health and progress of a pregnancy and could potentially contribute to miscarriage.
The most important of these factors are outlined here along with some important suggestions to help you prepare for a healthy pregnancy.
MTHFR Mutations and Homocysteine
Homocysteine is a blood marker associated with a number of disorders including cardiovascular disease through the formation of blood clots and artery damage.
Elevated homocysteine levels have also been found to be significantly associated with recurrent miscarriage, particularly in the presence of folate, vitamin B6 and B12 deficiency as these nutrients are required to regulate homocysteine levels.
MTHFR gene mutations are also a major contributor to high homocysteine levels, and can be easily identified with a genetic test.
Prenatal Activated B vitamins, especially folate (folinic acid) are recommended to help keep homocysteine levels in check, particularly if an individual has an MTHFR mutation.
Read Folic Acid and Fertility – More Harm Than Good to find out the importance of the right folate supplement during preconception.
Maternal obesity
Maternal obesity is associated with a range of reproductive problems including infertility, menstrual disorders and pregnancy complications.
In women with unexplained recurrent miscarriage, obesity has also been shown to increase the risk of future miscarriage by a huge 73% in comparison to risk in women with a normal body weight.
This highlights the importance of women working to achieve a healthy body weight pre-conceptively through healthy lifestyle and dietary measures.
Thyroid Dysfunction and Autoimmunity
Both over and under-functioning thyroid conditions significantly contribute to menstrual problems and miscarriage risk in women. Thyroid dysfunction caused by autoimmunity is an important risk factor for miscarriage and preterm birth.
Thyroid antibodies are usually diagnostic of autoimmune thyroid conditions, however they can also be present in non-thyroid autoimmune diseases and have been found to affect miscarriage risk even with normal thyroid function.
Therefore it is essential that autoimmunity and/or thyroid dysfunction are addressed prior to conception to help increase the chances of a full term, healthy pregnancy.
Find out more about common nutritional and lifestyle factors that can help to improve thyroid health and immune balance.
Toxic exposures
The link between environmental toxins and spontaneous or recurrent miscarriage has long been a matter of controversy.
However concrete evidence now shows that high exposure to certain chemical compounds such as Bisphenol A (BPA) found in most plastics is associated with recurrent miscarriage, possibly through endocrine-disrupting effects or by inducing autoimmunity.
Other common dietary and environmental toxins such as cigarette smoke, alcohol and high levels of caffeine have been linked with miscarriage and are best avoided completely throughout pregnancy.
Oxidative Stress and Inflammation
Oxidative stress occurs when the body’s natural antioxidant defences are overwhelmed by pro-oxidant free radicals, leading to tissue damage and disease. Environmental and dietary toxins contribute to oxidative stress, in addition to free radicals naturally produced by the body itself.
Oxidative stress is known to affect the entire reproductive span of a women and can significantly impact male and female fertility. It is also thought to contribute to impaired placental blood flow and immune dysfunction resulting in placental dysfunction and miscarriage.
Not surprisingly, research shows that important antioxidant nutrients such as CoEnzyme Q10 and selenium are often lower in women who have suffered miscarriages, so nutritional antioxidant therapy may assist in improving fertility in women with significant oxidative stress.
Pregnancy is naturally associated with systemic inflammation which may further contribute to oxidative stress. Higher rates of systemic inflammation are also seen in miscarriage, indicating that keeping inflammation in check throughout preconception and pregnancy is an important health priority.
Diets rich in antioxidants and anti-inflammatory nutrients can be of great assistance, in addition to specific natural supplements such as fish oils.
Your Pre-Conception Health Checklist
Prevention of miscarriage begins with pre-conceptive care for both partners.
This helps to ensure sperm and ovum quality is at an optimal level and that the female has an adequate nutritional status to carry full term.
- Screen yourself for nutrient deficiencies with a Nutrient Status Profile
- Assess your thyroid health as this is imperative for a healthy pregnancy. A well functioning thyroid gland also helps with weight regulation
- Check for MTHFR Mutations and Homocysteine Elevations
- Find out if you have a high toxic burden and work on natural detoxification
- Assess hormone levels and adrenal function with a saliva test to find out if these factors are interfering with your fertility. Hormone imbalance is a common cause of infertility or pregnancy loss. High stress levels throughout this time can also negatively impact on successful conception and pregnancy and may adversely affect hormone balance.
Further Reading:
- Folic Acid And Fertility – Doing More Harm Than Good?
- Making A Healthy Baby (Nutrition Guide)
- Are Environmental Toxins Hampering Your Chances of Becoming Pregnant?
- Top 10 Male Fertility Killers
References:
Lo, W. et al. 2012, The effect of body mass index on the outcome of pregnancy in women with recurrent miscarriage, Journal of Family and Community Medicine, Vol. 19(3)
Mohamed, E.K. et al. 2012, The Role of Homocysteine. Folic Acid, and Vitamin B12 in Primary Unexplained First Trimester Recurrent Pregnancy Loss, Life Science Jounral, Vol. 9(1s)
Sajal, G. et al. 2007, The Role of Oxidative Stress in Spontaneous Abortion and Recurrent Pregnancy Loss: A Systematic Review, Obstetrical and Gynaecological Survey, Vol. 62(5)
Shakila, T. et al. 2011, Association between thyroid autoantibodies and miscarriage and preterm birth: meta-analysis of evidence, British Medical Journal, Vol. 342
Sugiura-Ogasawara, M. et al. 2005, Exposure to bisphenol A is associated with recurrent miscarriage, Human Reproduction, Vol. 20(8)
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