Finding The Cause

More Than One Broken Heart

The heartbreak of a miscarriage takes its toll and nagging questions replace the wonder of the pregnancy.  When this experience is repeated, as it often is, then the questions can become haunting - especially if there are no immediate answers.  Often medical reasons can be found, but since testing is not often done, many lost pregnancies remain a mystery.

Lack of Testing

The greater sadness and problem is that multiple losses may be the result of not testing.  The ACOG (American College of Obstetricians and Gynecologists) guidelines indicate that before testing is done, multiple miscarriages must have taken place; consequently women with treatable conditions are not tested after their first loss.  Often they aren't tested until the third or fourth loss.   Losses might be prevented if testing were done earlier.

Why?

Why are tests not done after the first missed pregnancy?  There are several possible considerations.  Perhaps the guidelines are based on studies, now dated, which were unable to detect early pregnancy losses and therefore the results were underreported.  Another factor may be the lack of money for research.  At present, there is little money earmarked for treatment to prevent miscarriages.   At least two million women a year suffer miscarriage and the funding doesn't seem to be there for testing and research.  Consequently, new treatments and possible answers are left untouched and many couples who go through the pain of this type of loss repeat it.

The Reasons May Not Be What They Think

About half of all early miscarriages are caused by chromosome abnormalities.  The only way to be sure though, is to test the lost pregnancy.  By doing so, accurate information would be provided as to whether further testing is necessary.   Over 60% of women whose tests showed normal chromosomes had been found to have medical causes for the miscarriage.  If the cause of the miscarriage is indeed chromosome abnormalities, then the lost pregnancy is now considered explained.  However, if there are multiple losses, the question arises concerning further testing.  It appears doctors are not in agreement on this issue suggesting that multiple losses can be caused simply by bad chromosomes.   There can be more than one cause for a miscarriage and the woman who has abnormal chromosomes may also be dealing with an underlying problem which contributes to the multiple losses.   Couples who pursue further testing often do find a different cause.

Be Informed

If more testing is required it is important to recognize that the test selections differ from doctor to doctor.  One doctor may suggest three or four tests while another may think many more are needed.  Be informed and know exactly which tests are being done, what they're testing for and the results of the tests.  Many times the answers are available, but it takes diligence to get them.