Miscarriage is the most common complication of pregnancy, affecting 15 percent of all women, mainly in the first trimester. Of this 15 percent, miscarriage becomes a heartbreaking recurrence for 2–5 percent of women who will suffer from the loss of two more pregnancies.
This two-part series will examine the causes and treatments for recurrent miscarriages from both Western and traditional Chinese medicine (TCM) perspectives.
Western medicine recognizes several causes of recurrent miscarriage.
Fifteen percent of recurrent miscarriages are due to anatomical abnormalities, which include growths such as uterine polyps, fibroids, and malformations of the uterine cervix (the lowest part of the uterus where it attaches to the vagina).
Acupuncture and herbs will not help these conditions. They may require minor surgery to remove the growths (hysteroscopic resection) or the placement of sutures within the cervix to reduce the risk of miscarriage.
Sixty percent or more of early miscarriages may be caused by a random chromosomal abnormality (meaning there is an extra, missing, or irregular DNA structure), which is frequently associated with advanced maternal age.
Western medicine has no effective intervention for this; however, Chinese medicine can successfully treat older mothers with acupuncture and Chinese herbs to improve egg quality and reduce the risk of miscarriage.
Recurrent miscarriages may be due to endocrine deficiencies such as polycystic ovary syndrome (PCOS), a health problem where women have many small fluid-filled sacs in their ovaries and high levels of masculine androgen hormones (women also naturally make androgens).
Other endocrine deficiencies include inadequate progesterone in the later stage of the menstrual cycle after ovulation (also known as Luteal Phase Defect) and thyroid diseases (hypothyroidism, hyperthyroidism,
Western medical approaches rely on hormone replacement therapy, which has attendant risks. In my practice, I have found TCM to be highly effective at helping women rebalance their endocrine systems and conceive naturally.
During pregnancy, the mother’s normal immune response is blocked so that it won’t eliminate the “foreign” paternal material in the fetus. This maternal-fetal tolerance protects the fetus from rejection.
Recurrent miscarriages may occur when tolerance fails to develop. In the past, Western medical therapies sought to suppress the maternal immune system, but this approach put mother and fetus at risk of infection and has not been effective. TCM can help prevent recurrent miscarriages due to immunologic reactions, which will be discussed in Part 2 of this series.
Another immunologic disorder is antiphospholipid syndrome, in which the body inappropriately blocks the fats in blood that play a key role in regulating clotting. The disorder may lead to inappropriate clotting and miscarriage.
Western medicine uses aspirin or heparin for anticoagulation to prevent miscarriages due to clotting; however, such therapy is complex, expensive, and carries significant risk of side effects.
A third immunological problem can arise when there is an excess of natural killer (NK) cells. NK are white blood cells that are critical in the immune system, but an excess of NK cells is suspected to interfere with the formation of the placenta.
Two Western treatments to block NK cells—immunoglobulin G (IgG) therapy and leukocyte immunotherapy—carry significant risks of side effects. Furthermore, recent research suggests that NK cells are important in restructuring the uterus during pregnancy, and blocking them may disrupt fetal implantation.
Other factors influencing miscarriage include body mass index (BMI), psychological stress, infection, smoking, and poor nutrition. Women under psychological stress are three times more likely to miscarry, and women who smoke more than 20 cigarettes a day are twice as likely to miscarry as non-smokers.
Low folate—vitamin B9—levels have been linked to neural tube defects and miscarriage; however, many foods today are fortified with folate, significantly decreasing the risk of this deficiency.
This is Part 1 in a series. Coming: Causes and treatments for recurrent miscarriages from the perspective of Chinese medicine.
Xiu Juan Yang, Ph.D., M.D. (China), is a licensed acupuncturist based in Manhattan and Long Island. With 11 years of full-time training in Western and Eastern medicine and over 30 years of experience, she specializes in infertility and recurrent miscarriage, IVF support, pain management, depression, and vertigo. Dr-Yang-Acupuncture.com