Taking a deeper look at miscarriage risk
Written by Dr Kelsey Duncan ND.
1 in 4 couples experience a miscarriage. 25% of pregnancies end in loss. This stat can be both sadening and also comforting.
It can be comforting to know that if you’ve had a miscarriage, you aren’t alone. With more and more awareness coming to social media about loss the topic is starting to be less tabu. It’s important to talk about miscarriage and get whatever support you need personally during the grieving process.
When it comes to miscarriage, it can often be what we call ‘idiopathic’ – which means no known cause. Women aren’t usually assessed for miscarriage risk until they’ve had 3 consecutive losses. This doesn’t need to be the case. If you experience 1 miscarriage, your risk of having another increases and you likely will miscarry the second and third time for the exact same reason you did the first.
When it comes to assessing risk, there are many avenues you can take. If you’ve experienced one miscarriage during your time trying to conceive, it’s important to look at these basic labs to start.
Low levels of vitamin D have been associated with increased miscarriage risk. It’s still a bit of mystery if it’s low vitamin D that can cause miscarriage, or if women who have had miscarriages also have low vitamin D. If you don’t live near the equator, your exposure is minimal. Couple that with wearing hats, clothes and sunscreen when we are exposed to the sun and your chances of having good vitamin D status are even more slim. Things that impact your miscarriage risk, like having PCOS or autoimmune disease, are also associated with low vitamin D. So basically – you want good vitamin D status when you’re trying to get pregnant and who really cares why.
Vitamin D is not covered by OHIP unless you have a genetic reason to need vitamin D assessed. It is still extremely valuable to pay for and have done.
If your progesterone doesn’t rise the way it should after implantation, your body will not be able to maintain the pregnancy. It can be very valuable to get your progesterone checked before you get pregnant at 7-days post ovulation. Treating with vaginal progesterone suppositories is often first-line therapy if you’ve had a previous miscarriage, regardless of testing. This may be something you’ll want to talk to your healthcare provider about.
It’s important to note that not all Naturopathic Doctors can prescribe appropriate dose Vitamin D or progesterone suppositories. You will need to find a practitioner who has completed the appropriate courses and examinations to gain prescription rights in their province. Some good news is both our fertility practitioners here at HHA are licensed to prescribe.
Homocysteine can be used as a marker for nutrient status and genetic issues leading to poor methylation. When we take in folate through our diet we need to methylate it to the activated form, methyltetrahydrofolate. Women who have a gene mutation called an MTHFR mutation are poor methylators. Meaning their body won’t do the job to activate folate, or anything else for that matter, and this can be impacting your chances of conceiving and carrying a healthy baby.
Autoimmunity has a huge impact on fertility and I’m finding it often going left out of the picture, especially when it comes to miscarriage. The tricky part with autoimmune disease is you can have an overactive immune system for years before any symptoms actually show up. The symptoms can also be super vague, and basically attributed to anything. If you’ve had a miscarriage, it’s important to make sure a silent or undiagnosed autoimmune condition isn’t at play. Getting things like your ANA, Anti-TPO, and Anti-TG tested is a good start.
There are other potential reasons for a miscarriage to occur, and more extensive testing may be necessary to get answers.
To book an Insight Session with one of our Cared For Wellness Practitioners to find out how we can help you on your fertility journey, click here.