New Understanding of the Causes of Miscarriage

Author(s): Maria Leo

The most common complication of early pregnancy is sporadic miscarriage. A less common occurrence is the loss of two or three pregnancies in a row; this is considered a separate disease entity. It is generally accepted that sporadic miscarriages are primarily the result of abnormal embryos failing to develop into viable embryos. Multiple factors, including maternal thrombophilic disorders, immune dysfunction, and a variety of endocrine disorders, are thought to contribute to recurrent miscarriage. However, neither of these conditions is always associated with repeated early pregnancy loss nor is it exclusive to recurrent miscarriage. New theories about the causes of sporadic and recurrent miscarriage have emerged in recent years. In addition to lifestyle factors and changes in sperm DNA integrity, epidemiological and genetic studies suggest a multifactorial background in which immunological dysregulation during pregnancy may play a role. The idea that the decidualized endometrium functions as a biosensor of embryo quality has been supported by recent experimental findings. If this biosensor is disrupted, it may result in the implantation of embryos that are designed to fail. These brand-new insights into the underlying mechanisms of miscarriage raise the possibility of novel and potent preventative measures.