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I’m in my early 30s and I recently had a miscarriage at 6 weeks. What usually causes a miscarriage? Will I still be able to get pregnant in the future or will it be harder because I’ve had a miscarriage? My mom had several miscarriages before she had me. Are miscarriages hereditary?

Written by our medical expert Dr. Stephen Hudson, Director of the Victoria Fertility Centre in British Columbia, Canada. 

First of all this miscarriage was not your fault. Miscarriages are very common, in fact approximately 1 in 4 women will experience a miscarriage. For a variety of reasons women offer suffer in silence after a miscarriage. A pregnancy invokes a multitude of emotions in a woman, triggered by instinct, love, expectation, as well as by the physical changes such as nausea, fatigue, breast tenderness and so on. Losing a baby (and let’s not kid around, a miscarriage is just this) is an awful thing to endure both physically and emotionally, so let’s be sure that guilt doesn’t creep in there too.

In the majority of cases a miscarriage occurs because the embryo had some fault. This can come from either a defective sperm or egg – although it is more commonly egg related, the egg being the bigger player in making a baby. A miscarriage is one of nature’s filters.

There may be many other factors/causes, which I will list below:

  1. Maternal and paternal age. As we age the risk of miscarriage goes up due to higher numbers of defective eggs and sperm.
  2. Problems with the female reproductive tract. Common things here include uterine fibroids and septums, amongst others (A septum is a fibromuscular wall of tissue which divides the uterus in to two sections. If you can imagine the normal uterine shape being like an upside down triangle, with a septum the uterus has an exaggerated heart shape. Shallow septums are of little concern – however if the septum descends more than 1/3 into the uterine cavity it may cause reproductive problems and can be surgically resected).
  3. Hormone imbalances, such as a thyroid deficiency, insulin resistance, and insufficient levels of progesterone.
  4. Inherited tendency to clotting, known as a thrombophilia.
  5. Weight. Women with a BMI greater than 30 are more likely to miscarry.
  6. Social habits such as smoking may increase miscarriage risk.
  7. Some medications, such as non-steroidal anti-inflammatory drugs (e.g., voltaren), certain antidepressants, and also a medication called cytotec which is used to prevent stomach ulcers, all may increase the chance of a miscarriage.
  8. Chronic stress may play a role in some miscarriages.
  9. Injuries to the abdomen may be a factor later on in a pregnancy.
  10. Maternal chronic illness such as diabetes or lupus may increase miscarriage risk.

There should be no reason why you can’t get pregnant again, and the fact that you have conceived once is a positive thing. What we do know from this pregnancy is that you ovulated, that the fallopian tube did its part, that the sperm was able to fertilize the egg, and that your uterus facilitated implantation – which are all very good things to know. Based on having been pregnant once, your chance of getting pregnant again is excellent.

That said, given your Mum’s history, I would suggest you see your doctor to explore your Mum’s medical and obstetrical history further, so that you can have any relevant investigations done to ensure that you don’t have an inherited risk factor for miscarriage. My basic approach to any woman who has had a miscarriage is to review her history, do an adequate physical examination and pelvic ultrasound, and check her hormone levels.

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