Pregnancy loss fact file

Pregnancy loss is a tough topic to approach; it’s highly personal and emotional. Preparing to get pregnant, or during pregnancy, can be intense periods with lots of things to think about. So, the importance of staying informed about the facts may be useful.

Women’s health expert Mr Mahantesh Karoshi, rated as one of the best gynaecologists in London, has put together a detailed fact file that utilises esteemed scientific research about pregnancy loss. Read on to find out more.

What emotions are involved in pregnancy loss? How common is it?

Loss of pregnancy is a sad and terrible event for the woman and/or couple involved. There’s a void which is hard to fill; anger, frustration and a sense of failure and the body being let down.

But, in real terms, pregnancy loss is common. Following are some facts from scientific published articles.

Early pregnancy loss

• Most pregnancy losses are unrecognised.
• Spontaneous pregnancy loss is, in fact, the most common complication of pregnancy.
• Approximately 70 per cent of human conceptions fail to achieve viability.
• An estimated 50 per cent of human conceptions are lost before the first missed menstrual cycle.
• Studies using sensitive assays for human beta chorionic gonadotropin (Beta- hCG) indicate that the actual rate of pregnancy loss after implantation is 31 per cent.
• Loss occurs in 15 per cent of pregnancies that are clinically recognised before 20 weeks of gestation from last menstrual period.

Recurrent pregnancy loss

Recurrent pregnancy loss (three or more) occurs in approximately one in 300 pregnancies.

Clinical investigation of pregnancy loss, however, may be initiated after two consecutive miscarriages, especially when foetal heart activity is identified before any of the pregnancy losses, when the women is older than 35 years of age, or when the couple has had difficulty conceiving.

Even with a history of recurrent pregnancy loss, a patient is more likely to carry their next pregnancy successfully to term than to miscarry.

For patients with a history of recurrent pregnancy loss, the risk of subsequent pregnancy loss is estimated to be 24 per cent after two clinically recognised losses, 30 per cent after three losses, and 40 per cent to 50 per cent after four losses.

This data makes clinical study of recurrent pregnancy loss and its treatment difficult, because very large groups of patients must be studied to demonstrate the effects of any proposed therapeutic intervention.

Source information

1. Edmonds DK, Lindsay KS, Miller JF, et al. Early embryonic mortality in women. Fertil Steril 1982;38:447–453.
2. Wilcox AJ, Weinberg CR, O'Connor JF, et al. Incidence of early loss of pregnancy. N Engl J Med 1988;319:189–194.
3. Alberman E. The epidemiology of repeated abortion. In: Beard RW, Sharp F, eds. Early pregnancy loss: mechanisms and treatment. New York: Springer-Verlag, 1988:9–17.
4. Warburton D, Fraser FC. Spontaneous abortion risks in man: data from reproductive histories collected in a medical genetics unit. Am J Hum Genet 1964;16:1–25.
5. Practice Committee of the American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss. Fertil Steril 2008;90(Suppl 3):S60.
6. Jaslow CR, Carney JL, Kutteh WH. Diagnostic factors identified in 1,020 women with two versus three or more recurrent pregnancy losses. Fertil Steril 2010;93:1234–1243.
7. Regan L, Braude PR, Trembath PL. Influence of past reproductive performance on risk of spontaneous abortion. BMJ 1989;299:541–545.

Mr Karoshi specialises in ovarian cysts, heavy menstrual bleeding, infertility alongside fibroids and adenomyosis. To arrange an appointment with this leading gynaecological consultant, visit his Top Doctors profile.