When pregnancy loss happens more than 2 or 3 times, at any stage, patient needs evaluation.

Causes :

1.  Chromosome abnormality : 60% MISCARRIAGE is due to abnormal fetus. The blood of father and mother can be tested for abnormality (karyotyping)
2. PCOS: poor quality egg and abnormal hormones can result in miscarriage.
3. Anti phospholipids Syndrome : the formation of blood clot at placenta causes miscarriage in Antiphospolipid. These patients have tendency for increased blood clot. This can be treated with aspirin and heparin injections to avoid clotting and has 90% success with treatment.
4. Antithyroid antibody(ATA): the presence of ATA can be treated with steroids like prednisoloue to avoid miscarriage.
5. Infection: bacterial vaginosisand cervical infections can cause permanent delivery or premature leaking causing miscarriage. They can be treated with antibodies locally or systemic. The infections or commonly overlooked and undiagnosed mostly.
6. Cervical incompetence: when cervix is open the sac or even baby parts can prolaps out and cause miscarriage.
7. Uterine abnormalities:

A. Bicorn ate uterus has apple shaped uterus with 2 cavities. Good Luteal support with medicines good luteal support with medicines can be helpful.

B. Separate uterus:When a wall separates the cavity into 2, this septum (wall) can be divided by hysteroscopic surgery to avoid miscarriage

C. Unicorn ate uterus : The tubular shaped cavity has tendency to abort, supporting medicines can help.

D. other abnormalities like polyp (growth), fibroids etc can be treated surgically.

1.Fibroids/polyps:Growth affecting the cavity can result in miscarriage.
1.Diabetis :Can be controlled well to avoid abortion

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Authored by Dr. Anitha Mani - Infertility Specialist & Laparoscopy Surgeon