Recurrent Miscarriages and Hope

Pregnancy after miscarriage is same for most women

(RxWiki News) Experiencing recurrent miscarriages (RM) is devastating for women and their partners. A new study from Europe offers these couples hope.

Research from the Netherlands finds that given time, most women with RM will acheive conception after miscarriage at about the same rate as women who don't have a history of miscarriage.

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Dr. Stef Kaandorp, from the Centre for Reproductive Medicine, Academic Medical Centre, Amsterdam, The Netherlands, believes that this study can ensure women with RM be reassured that their time to the next conception is not significantly longer than fertile women with no history of miscarriages.

In an offshoot of the ALIFE study, 251 women who had at least two unexplained miscarriages were randomly placed on one of three treatment regimens: Aspirin alone, aspirin with heparin or a placebo. Researchers observed the live birth rate in women with unexplained RM and at the length of time from the first day of last menstruation before the subsequent pregnancy.

Two-hundred and thirteen women became pregnant during the the five year study period. Of these conceptions, 139 had a live birth, 69 had a miscarriage, two had an ectopic pregnancy, two had an abortion and one had an intra-uterine fetal death.

The median time to the next pregnancy, irrespective of outcome, was around 5 months. The cumulative incidence of natural conception was 56 percent after six months, 74 percent after 12 months, and 86 percent after 24 months. Of those that achieved a subsequent pregnancy, 65 percent resulted in a live birth.

The outcome remained the same regardless of which treatment they received. Other factors such as the number of previous miscarriages, maternal age, BMI, and the presence or absence of a previous live birth did not alter the outcomes.

Interestingly, the presence of the Factor V Leiden gene mutation did significantly predict a shorter time to conception. Factor V Leiden is a specific gene mutation that results in a tendency to form abnormal clots. Dr. Kaandorp explains that Factor V Leiden mutation is associated strongly with recurrent miscarriages.

It is a puzzling and unexpected result that 64 percent of the 11 women in the study who had this factor achieved pregnancy in a shorter period of time than those without the factor.

Based on this study's findings, Dr. Kaandorp doesn't advise the use of aspirin or heparin when treating women with RM. The evidence clearly shows these medications aren't helpful.

The doctor acknowledges that RM is extremely disappointing for women wanting to start or add to their family and he hopes the study provides these women encouragement to keep trying to have a pregnancy with a successful outcome.

Dr. Kaandorf presented this research on July 2011 at the annual conference of the European Society of Human Reproduction and Embryology in Stockholm, Sweden.

Results are considered preliminary until published in a peer-reviewed journal.

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Review Date: 
July 24, 2011