Currently, in Canada, a thorough workup into the cause of a pregnancy loss isn’t recommended until a woman experiences three or more miscarriages. Recurrent miscarriages are estimated to occur in 1-1.5% of the population, and are defined as three or more pregnancy losses before 20 weeks 1. The trauma of experiencing one miscarriage—let alone three—is significant, and a more thorough workup into the underlying cause of a miscarriage(s) should be considered earlier on.
Identifiable causes of recurrent miscarriage can often be found, such as genetic defects, clotting disorders and autoimmune disease. In up to 50% of cases, however, no underlying causes can be uncovered. In these situations, women are left with very few treatment options and are commonly instructed to continue trying.
An insufficient level of progesterone at the time of implantation or early on in pregnancy has been identified as another possible cause of recurrent miscarriage, and could be treated accordingly1.