Causes of Miscarriage
The three main causes of miscarriage include uterine abnormalities, such as an improperly segmented uterus as in the septate uterus, fibroids and other conditions; genetic causes; or hormonal disorders.
Many uterine abnormalities are diagnosed by conducting a hysterosalpingogram or hysteroscopy. In some cases, uterine abnormalities can be surgically treated. Where successful treatment is not possible, the only option is to use a surrogate.
Miscarriage is associated with genetic abnormalities of the fetus. Although this is a rare cause of miscarriage, couples experiencing recurrent pregnancy loss should have a genetic evaluation. Most chromosomal abnormalities are seen in the fetus and are random occurrences.
Preimplantation genetic diagnosis (PGD) can now be used to rule out many chromosomal abnormalities in the fetus. In PGD, embryos are created using in vitro fertilization (IVF) and a small sample of DNA is taken from a cell in the embryo and tested. If the genetic disorder is present, the embryo will not be transferred to the mother's uterus. PGD does not damage the embryo.
Endocrine abnormalities can be a cause of miscarriage. Thyroid abnormalities, Type I diabetes and elevated prolactin levels have all been associated with recurrent miscarriage. The miscarriage workup should include testing for these conditions.