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Introduction

One in five pregnancies in women will result in a spontaneous miscarriage during their child-bearing years and this occurs randomly and at no fault of the involved individual. It is such a common occurrence that doctors don't regard a single miscarriage as a pathological problem, the cause of which needs no further investigating.

Women who do experience recurrent miscarriages though will need to be assessed and investigated further to determine the cause of the miscarriages. This is important as different causes of miscarriages will need to be managed and treated in different manners.

Causes of miscarriages

Abnormal chromosomes or genes

Most miscarriages occur because the fetus isn't developing normally. Around half of the miscarriages are associated with missing or extra chromosomes and occur as a result of errors that take place when the embryo is dividing and developing and doesn't have to do with the genes inherited from the parents.

These chromosomal abnormalities can cause the following issues:

  • A blighted ovum - where no embryo forms.
  • Molar pregnancy - where both sets of chromosomes come from the father.
  • Intrauterine fetal demise - the embryo forms but stops developing and dies before any symptoms and signs of pregnancy loss can occur.

Maternal health issues

In some cases, health conditions affecting the mother can lead to miscarriages. These may include:

  • Infections.
  • Uncontrolled diabetes.
  • Thyroid diseases.
  • Problems affecting the uterus and/or cervix.
Miscarriages cannot be caused by routine activities such as sexual intercourse, physical activities such as cycling or jogging, and working (unless exposed to toxic chemicals or radiation).

Progesterone supplementation

One of the main causes of miscarriages is an inadequate production of progesterone during the second half of the menstrual cycle after ovulation. This is the part of the cycle where progesterone levels would increase to make the uterus more viable for implantation of the fertilized egg (embryo). 

For more than 50 years now, progesterone supplements have been recommended for women who have been struggling to conceive but there hasn't been a lot of research on how it can benefit those women who get pregnant but then have a miscarriage. 

A recent study has demonstrated that up to 65 percent of women who had at least two previous miscarriages and who were administered progesterone supplements before becoming pregnant, carried their pregnancies to term and successfully delivered babies. The progesterone supplements were administered vaginally, twice a day during the second half of the participants' menstrual cycles and up until 10 weeks into the pregnancy.  

The conclusion was that progesterone supplementation is a safe and relatively inexpensive treatment for preventing miscarriages in women who previously experienced recurrent or multiple miscarriages. Further research needs to be performed to validate the findings made by the study though.

How does it work?

The function of progesterone is to stabilize the endometrium (inner lining of the uterus) so that the embryo has an adequate area to implant on and develop further.

The researchers were of the impression that how the progesterone supplements worked was that they stimulated the endometrium of the uterus to produce and release more nutrients which served as a "food source" to the developing embryo.

Women who have had recurrent miscarriages are advised to speak to their doctors about the possible use of progesterone supplementation to aid in carrying a pregnancy to term. 

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