Common causes of recurrent miscarriage:
Recurrent miscarriages that fall under this area are, unfortunately, an area that natural therapies will most likely have no effect on. If something within the bodily structure is causing miscarriage, this is called an ‘anatomical cause’. Examples of this are a misshaped uterus, incompetent cervix, large uterine fibroids, or severe Asherman’s syndrome.
Sometimes recurrent miscarriages are due to genetic defects in either the egg or the sperm. Women and men over 35 have a greater chance of this problem occurring as the eggs and sperm may not be as healthy as they were in their younger years. Most western doctors will say there is not much you can do about this, but we disagree. While we can not affect all genetic causes, we have seen changes in sperm and egg health in our clients after they changed to a healthier, nutrient dense, natural fertility lifestyle. This included specific supplements and therapies to help protect the egg and sperm DNA as well as provide the ingredients for a healthier reproductive system. We will cover all of this later in this article.
Blood that is overly thick or has a tendency to clot (like in the case of a blood clotting disorder) can cause miscarriages.
As small blood clots begin to develop in the uterus, the placenta can be cut off; leaving the fetus void of the oxygen and nutrient supply it needs to survive. This can induce a spontaneous abortion, otherwise known as a miscarriage. In the event your pregnancy develops past the 24th week before the clotting develops, a stillbirth or premature birth can result. With no warning signs offered by the body that blood clots are forming, the danger often remains unseen until it is too late.
There are some tests that can be done to determine if this may be a problem for you, but they need to be performed prior to pregnancy as part of your preconception health plan. In addition, there are natural therapies that have been shown to be helpful with this type of issue and we will discuss both of these topics below.
High Homocysteine levels
If you have suffered at least one miscarriage, or your doctor has indicated that you are at a higher risk for miscarriage than most women, you may want to find out what your Homocysteine levels are.
Homocysteine is a common sulfar-containing amino acid found in the body. While it is not harmful in normal levels, when those levels get too high (especially during pregnancy), it can cause a condition called hypercoagulability. What does this mean? In general, your blood clots much more easily than it should. Not only can it put you at a higher risk for a heart attack and stroke, but it can put your baby in danger as well.
Researchers in Bergen and Oslo, Norway, studied several thousands of people in Hordaland County in Western Norway and reported that Homocysteine levels higher than 10-10.7 μmol/L increased a woman’s chance of a miscarriage by a whopping 38%.
For reasons unknown to doctors and scientists the body will sometimes attack the fetus or sperm; sometimes caused by elevated natural killer cells or HLA incompatibility. This is called an immunological disorder or immune system based miscarriage. In the past, the only options available for this were the same treatments and medications organ transplant patients receive (which most doctors won’t perform), but thank goodness there are natural therapies that offer some hope in this area that have been shown to be successful through human studies.
There are many links between hormonal imbalances and recurrent miscarriages. The hormonal system is an intricate orchestra of hormones that
runs on a very specific schedule. If one of these hormones is out of balance, it can affect the rest of the cycle, possibly impacting early pregnancy. Some of these imbalances may be:
- Progesterone is necessary for pregnancy for many
- reasons, but one of the main ones is that it preserves the uterine lining so the new embryo can attach and be nourished while the placenta is being formed.
If progesterone is low, the lining will shed, causing menstruation to begin.
If estrogen levels in the body are high, this can cause many issues – specifically it can be a cause of low progesterone.
Prolactin is a hormone in the body that is abundant during lactation. Beyond promoting milk flow for the new mother, prolactin may also repress ovulation.
Insulin resistance (PCOS)
Insulin resistance is a hormone imbalance by itself which causes a greater hormonal imbalance in the body by raising blood sugar, estrogen and testosterone levels, while lowering progesterone levels. This may in turn cause implantation failure and/or miscarriage. If insulin resistance is not addressed, development of diabetes and heart disease may result.
Insulin resistance in women is closely associated with PCOS. Researchers have found that women who are insulin resistant are 4-5 times more likely to have a miscarriage.
Undiagnosed and untreated thyroid disease can be a cause for infertility, recurrent miscarriage and second/third trimester loss. You can easily get testing done to determine if hypothyroidism is causing your miscarriages.
Luteal Phase Defect
The luteal phase is the time period after ovulation in which the embryo is making its way down the fallopian tubes and implanting itself into the uterine lining. If this phase is too short for the embryo to implant and attach properly, a miscarriage could occur. Many women will not know this is happening unless they are fertility charting and can tell how long their luteal phase is.
Testing for Causes of Recurrent Miscarriages
There are many tests that can be done to help determine the cause for recurrent miscarriages. It can be both scary (not finding the cause) and hopeful (getting a diagnosis) to get testing. Just remember you may find the cause of the miscarriages and be able to move forward with treatment and the knowledge of how to take care of yourself during pregnancy. If no cause is found – know that 70% of couples who experience recurrent miscarriages without a known cause do go on to have a healthy successful pregnancy.
Make sure to find a reproductive endocrinologist that is supportive of testing and up to date with all the research being done for recurrent miscarriages, even before your third miscarriage. I have listed the most common tests below. This list is not conclusive, rather a general guide to help you begin your learning.
This is an x-ray test of the uterus. A dye is injected into the uterus and x-rays are taken to see the shape of the uterus, blockages of the tubes, growths and other abnormalities that could cause infertility or miscarriages. This is a painful test, but a very revealing one. HSG’s are generally the first test that is done when you go to see an RE (Reproductive Endocrinologist).
Antiphospholipid syndrome (APS) is an autoimmune imbalance which causes the body’s immune system to react to certain normal substances in the blood which can increase the chance of forming blood clots. It is estimated that 10% – 25% of women with recurrent miscarriages have APS, making testing very important. Speak to your doctor about referring you to a specialist for an antiphospholipid antibody (APA) test. A positive test result for any part of this test indicates there may be other immune problems and according to Dr. Alan Beer, “…there is a 50% likelihood of elevated NK cells or Th1:T2 cytokine ratios.”
Doctors will generally treat this condition with low-dose baby aspirin and injections of heparin (blood thinner) during pregnancy.
This is a test to see how fast the blood clots.
Hypothyroidism has been linked to miscarriages during all trimesters. Not all doctors will do a thyroid panel test, make sure to ask and work with a doctor that is supportive and up to date on thyroid issues. In the Journal of Medical Screening (Sept. 2000) doctors reported that by screening for thyroid problems before and during pregnancy, miscarriages could be reduced. Women with hypothyroidism have 4 times the risk of a second trimester miscarriage.
Understanding Thyroid (TSH) numbers
- 3 to 3.0 TSH levels are considered the narrower normal range that many experts are using for diagnosis and management of hypothyroidism. Some endocrinologists believe that a percentage of women may find it difficult to get pregnant — or maintain a pregnancy — at a TSH level above 2.0. This is one condition that is best treated with thyroid hormone medication. You will also need to be monitored throughout pregnancy to make sure your levels are within range and medication is adjusted regularly. The medications used to treat hypothyroidism are safe to be taken during pregnancy.
Adequate progesterone levels are critical for maintaining a healthy pregnancy. Low progesterone levels have been linked to miscarriages. Generally you are tested around day 21 of a 28 day cycle to determine what your progesterone level is at. You can get blood testing done by visiting an RE or by saliva testing through an online lab.
A type of test to examine chromosomes for genetic issues. This test is best performed on both parents.
Fetal Tissue Testing
- If you are currently going through a miscarriage and choose to have a D&C, you can have karotyping done on the tissue that is collected to rule out genetic issues. Doctors can perform this test from the following samples: blood, amniotic fluid, or placental tissue.
5 Steps to Decreasing the Chance of Recurrent Miscarriages
Natural therapies are a great option for helping to support your body and prepare for pregnancy. As with any approach to trying to decrease the chance of miscarriage there are no guarantees, but these steps will help to nourish and support the body, inviting a healthy pregnancy to occur.
Preparing ahead of time for your pregnancy is also important for decreasing the chances of a miscarriage, these steps must be in practice for at least 3 months before you become pregnant again. If you are currently experiencing a miscarriage contact your doctor or midwife right away.
1. Prepare for Conception
The first step is to prepare your body with fertility cleansing. Fertility cleansing helps to support the liver in cleansing the body of old toxins and excess hormones while encouraging the uterus to cleanse itself of ‘old’ contents, increasing uterine circulation and tone.
2. Eat a Nutrient Dense Fertility Diet
The next step is to nourish and build up your body to be a healthy, baby-friendly body. This can easily be done through eating a nutrient dense Fertility Diet. What you eat has an impact on:
- The health of your eggs
- Your hormonal balance
- Creating a healthy placenta
- Decreasing chances of a miscarriage
- Building nutrient storage for baby
- Creating a healthy reproductive system
You will want to make sure you are eating a fertility diet consistently for at least 90 days before you begin trying to conceive for your best chances of creating a healthy pregnancy.
3. Apply Fertility or Abdominal Massage
Another important element of promoting a healthy conception is to increase circulation to the uterus. Modern lifestyles are often high stress and busy, but lack in exercise and usually have us sitting at a desk all day (the left leg and the uterus share the same major artery, so avoid sitting with your legs crossed), which can decrease circulation to the uterus. High stress levels leave us living in a state of fight or flight which signals our bodies to send all the blood to the muscles and brain in preparation for running away or fighting, the results of which are decreased circulation to the uterus.
There are three options for massage when it comes to supporting reproductive circulation. You can find a massage therapist who specializes in abdominal massage (or better yet a fertility massage therapist), you can book a consultation with a Maya Abdominal Practitioner, or you can learn how to apply Self Fertility Massage™ at home.
Through applying a simple massage method called Self Fertility Massage™ you are able to increase the circulation to the uterus, clear adhesions and congestion (if you have endometriosis, PCOS, clotty and dark periods, and heavy cramps during your period, I am talking to you). You will want to add this technique to your program. Build a Healthy Foundation
One of the major foundational steps to increasing your chances of having a healthy pregnancy is to take some basic vitamins, minerals, and EFA’s. There are specific vitamins and minerals that are necessary for a healthy reproductive system, hormonal balance, and ovulation.
Building a healthy foundation is a two punch step. You will want to be taking a multivitamin and an omega-3 supplement, but the key here is not to just take any multivitamin. The best multivitamin to take for fertility and pregnancy is a prenatal multivitamin. But be careful when you are choosing which one to take. NOT ALL SUPPLEMENTS ARE CREATED EQUAL. Make sure you are taking a whole food prenatal multivitamin. You also need to make sure your prenatal vitamin contains B6, B12 and folic acid (folate). This combination has been shown to help prevent miscarriages due to high homocysteine levels.
Essential fatty acids are also extremely important for miscarriage prevention. EFA’s, specifically omega-3’s, are responsible for regulating inflammation response, improving cellular integrity and maintaining hormonal balance, all key factors in helping the body prevent miscarriage.
5. Herb & Supplement Program for Recurrent Miscarriage
*Note: These are traditional therapies for miscarriage. There are no guarantees being made that they will stop a miscarriage. Most miscarriages are meant to happen due to issues with the fetus. These herbs will not stop a miscarriage that is meant to happen. They are helpful with miscarriages that are caused from stress, poor diet, trauma, weak uterine muscles, or low progesterone levels. Herbs help to provide extra nourishment and strength needed to nourish a depleted body. Please consult with your doctor or midwife when using these natural options, especially if you are under treatment for recurrent miscarriage already. If you think you are having a miscarriage consult your doctor right away.
General tips for preventing miscarriage…
- Bed rest and removal of stress factors is the most important first step to take. Get off of your feet.
- Vitamin E in amounts up to 600 IU per day (use only 50 IU if you have high blood pressure, heart disease, or diabetes).
If your recurrent miscarriages are due to any of these three reasons, there are natural remedies that have been shown to help decrease the chances recurrent miscarriages.
- Hormonal (low progesterone)
- Chromosomal (you could have some impact, it matters if it is the egg)
The supplements are:
* These products work best when taken for a minimum of 3 months in preparation before conception.
- Vitex (Chaste Tree berry) has been traditionally used by midwives and herbalists in the first trimester of pregnancy to prevent miscarriage associated with low progesterone due to corpus luteum insufficiency. It can also be used in conjunction with progesterone cream.
Is it safe to take vitex during pregnancy?
Dr. Aviva Romm states in her wonderful book Botanical Medicine for Women’s Health, “Placebo-controlled studies for teratogenicity and mutagenicity were conducted in rats, and even when the animals were administered [Vitex agnus-castus] 74 times the dosage typically consumed by humans, no toxicity nor aberrations in fetal development were seen… In addition, the Botanical Safety Handbook provides no contraindications for use of vitex during pregnancy.”
Rated under category B1 for safety of use in pregnancy, The Essential Guide to Herbal Safety (Mills & Bone, 2005) states, “Use cautiously in pregnancy, and only in the early stages, for corpus luteal insufficiency.”
While Vitex can be used to help with a threatened miscarriage due to low progesterone levels, it is best to begin taking it at least 3 months prior to conception. Also, we feel it is best to consider progesterone cream use to help maintain stable progesterone levels once pregnancy has occurred. Working with a healthcare practitioner once you are pregnant to help you keep your progesterone levels up is the wisest option at that point. Should you desire to continue using Vitex into pregnancy, please only do so under the supervised care of a skilled herbalist or midwife trained in herbal medicine.
Maca is a nourishing food for the endocrine system, aiding the pituitary, adrenal, and thyroid glands (all involved in hormonal balance.) Maca has the ability to affect key hormones in both women and men without containing hormones itself.
Maca helps to stimulate and nourish the pituitary gland, acting as a tonic for the hormone system. When the pituitary gland functions optimally, the entire endocrine system becomes balanced, because the pituitary gland controls the hormone output of the adrenals, the thyroid gland and gonads (sex organs in men and women).
In women, maca works by controlling estrogen in the body. Estrogen levels that are high or low at the wrong time can keep a woman from becoming pregnant or keep her from carrying to term. Excess estrogen levels also cause progesterone levels to become too low. Taking maca may help to increase the progesterone levels which are essential to carrying a healthy pregnancy.
Low progesterone during pregnancy may be a common cause of recurrent miscarriages. Progesterone is responsible for creating a healthy environment in the womb by creating and maintaining a healthy uterine lining. It also may reduce the chances of blood clots and immune system responses to the fetus as a foreign substance. It is the pregnancy hormone.
If you feel this might be your situation try to get your hormone levels tested before using progesterone cream, then get tested again to make sure your levels are high enough.
There has been great success from people I have personally worked with and have heard of many midwives swearing by natural progesterone. Progesterone cream is used from right after ovulation until your menstrual cycle, or if you get pregnant continue use and contact your healthcare provider right away.
Make sure to have at least two bottles on hand, because running out could cause a big drop in progesterone which may cause the menstrual cycle to begin.
Systemic Enzyme Therapy
For recurrent pregnancy losses caused from either immunological response or blood clotting, Systemic Enzyme Therapy may be an affective option. In a five year study women who had experienced a recurrent miscarriage due to immunological response (more than 30% of miscarriages) were put on a systemic enzyme supplement before and during their pregnancies(6). 79% of the women carried out their pregnancies to term and gave birth to healthy babies. This is an amazing discovery. The only options available before this study were anti-immunological agents similar to the type used in transplant patients, but most doctors will not use them due to there toxicity during pregnancy. Systemic Enzyme Therapy is a major part of a miscarriage prevention support program.
Uterine Calming Herbal Formula
The following herbs, when combined in a liquid extract, may greatly help prepare the uterus for implantation and support the uterus in sustaining pregnancy, thus helping to prevent miscarriage. It is suggested that this formula should be started 3 months prior to conception and continued until at least 2 weeks past the last week of pregnancy of the previous miscarriage. For example, if the previous miscarriage occurred at the 8th week of pregnancy, continue the formula until at least the 10th week of pregnancy.
Cramp Bark(Viburnum opulus)
- Used traditionally as a preventative for recurrent miscarriage, this herb has been shown to reduce spasm of the uterine muscles and ovaries. Cramp bark works to relieve uterine irritation, relax the muscles, with specific action on the uterus. This herb slowly relaxes the nervous system as well. This combination of actions may help prevent miscarriage in women with a history of miscarriage.
Black Haw (Viburnum prunifolium)
This herb is one of the best herbs to have on hand at all times for any sort of menstrual pain. Another beneficial use may be for threatened miscarriage. It has been used for hundreds of years to help prevent miscarriage. If there is uterine cramping without cervical dilation, Black haw and Cramp bark have been used to help stop uterine spasm, contractions, bleeding and nervous tension in early pregnancy. Black haw has also been reported to help strengthen a weak cervix.
Both of the above herbs have a mild sedative action, aiding the body in reducing anxiety, nervous tension, and irritability, while promoting a sense of calm and well being.
Partridgeberry (Mitchella repens)
Partridgeberry is an excellent uterine tonic that has been traditionally used to help strengthen a weak uterus. Partridge berry is very safe to use in pregnancy where miscarriage is concerned. It has been used for hundreds of years by Native Americans, traditional midwives and physicians for prevention of miscarriage. Partridgeberry is helpful when the woman is experiencing painful cramping, uterine spasm, bleeding, and/or passing of blood clots in the first trimester of pregnancy. Partridgeberry is a tonic for both the nervous system and the uterus.
Oat Flowers (Avena sativa)
The fresh milky tops of the oat plant are extremely nourishing to the central nervous system. Only the fresh tops of the Avena sativa plant bring about real change in the body. This plant is great support for stress related fertility issues. It has been shown to help support function and health of the central nervous system. This herb is really one of the best herbs for long-term stress support.