Chapter 22, Page 4

Hormone Imbalance

Patients may miscarry because they have a luteal phase defect - that is, the amount of progesterone hormone produced after the egg has been released is reduced. Progesterone is the hormone which supports the pregnancy. It helps implantation of the embryo in the uterus and if its production is deficient, there can be a problem with the embryo lodging itself in the uterine lining.

A luteal phase defect is suspected if the menstrual cycles are short, especially if the luteal phase (the time of the menstrual cycle between ovulation and the next menstruation) is shorter than 12 days.

This diagnosis can be confirmed by a blood test (a serum progesterone level, done one week after ovulation, is low) and an endometrial biopsy (which will show that the endometrium is "out of phase").

The doctor can help provide luteal support by prescribing progesterone during the last two weeks of the menstrual cycle after ovulation. If the woman is already pregnant, treatment may be done through vaginal suppositories of natural progesterone for the first 12 weeks of the pregnancy; or through progesterone injections intramuscularly. However, this treatment is controversial.

Illnesses

Health problems that can cause repeated miscarriages are:

  • Endometriosis.
  • Uncontrolled thyroid disease.
  • Uncontrolled diabetes.
  • Severe heart, liver or kidney disease.
  • Systemic lupus erythematosus, an illness in which the woman produces antibodies against her own body tissues.

What about TORCH Infections? Certain infections called TORCH - which stands for TOxoplasmosis, Rubella, Cytomegalovirus and Herpes may be a cause for a single miscarriage, but are not a cause for repeated miscarriages. While a number of specialists will carry out these tests, and even start treatment based on the results, these tests are not worthwhile for patients who undergo habitual abortion.

Although infections of the uterine cavity (for example, due to mycoplasma) are frequently thought to be a cause of recurrent pregnancy loss, substantial proof of this possibility is lacking. Studies have, in fact, failed to find a greater incidence of uterine infection in women with a history of miscarriage when compared to normal fertile women.

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Credits: How to Have a Baby: Overcoming Infertility