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Recurrent Pregnancy Loss
by Samuel Thatcher, MD, Ph.D.

Sam Thatcher, MD, Ph.D.Q. I have been having miscarriages (8 of them) over the past 7 years. I live in Edmonton Alberta, and the doctors here don't know why. I went to Florida for a vacation and went to a hospital with another miscarriage. The doctor said that I rejected the fetus. The doctors in Edmonton don't agree, and say it very unlikely.

A. My list of reasons of miscarriage in the first trimester in order of occurrence and with percent of occurrence follows. This is only my own estimate. 1) Endocrine/genetic 70% 2) anatomic/ structural 2O% 3) inherited genetic 5% 4) other include infection, immunologic, and chronic maternal medical problems 5%. Your case is much too complicated and I have much too little information about the pregnancy losses to even guess at a cause or quote a statistics for the risk for an additional pregnancy. I am not a large proponent of the immunologic causes (rejection) of pregnancy loss. I am sure that it occurs, but I believe it is very uncommon. I mostly favor hormonal causes related to egg quality and structural causes that are usually diagnosed by ultrasound and hysteroscopy.

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