One of the most difficult things a woman can perhaps experience is the loss of a fetus. But it is an occurrence experienced by many women who conceive. The statistics are sketchy, but most cited references confirm that 10 to 25% of pregnancies result in a miscarriage. But perhaps the more painful experience is to lose an unborn child more than once.
Causes for miscarriage
Anatomical Reasons:Sometimes a woman's uterus is built in a way that makes a successful pregnancy a difficult if not impossible task. Abnormal uterine shape or weak cervixes are predominant anatomical causes that lend to recurrent miscarriages. In some cases, uterine abnormalities may be treated by surgery.
Chromosomal Abnormalities: Doctors are increasingly able to identify chromosomal abnormalities with the fetus that prevent it from developing beyond a certain stage resulting in the miscarriage or abortion of the fetus. These chromosomal abnormalities might be derived from the mother or the father and even though fertilization occurs, this abnormality prevents the fetus from growing beyond a certain stage.
Hormonal Causes: Various hormones including progesterone play a key role in the fertilization process and in the development of the embryo. Low levels of progesterone have been noted to cause recurrent miscarriages. Certain disorders such as Polycystic Ovarian Disease create an imbalance in the body's hormones and have been known to have an adverse effect on fertility and pregnancy. Various thyroid-related disorders may also contribute to recurring pregnancy loss.
Immunological Causes: Our immune system is built to protect our bodies from foreign and harmful elements. Sometimes, this system does not function in out best interest. Recurrent miscarriages have been caused by a woman's immune system that treats a growing fetus as a harmful foreign body and destroys vital tissues in the uterus, resulting in a miscarriage. Also, blood clotting issues due to excessive anti-phospholipid antibodies in the bloodstream contribute to recurring miscarriages.
Other reasons that may contribute to recurrent miscarriages include maternal age, lifestyle choices such as heavy smoking and drinking, drug abuse, diabetes, and exposure to X-rays or chemical/industrial toxins.
Luteinizing Hormone LH is another important hormone for reproduction. In men, LH promotes secretion of testosterone. In women, LH surge in the second part of the menstrual cycle triggers ovulation. LH is released when a woman is ovulating, and causes the ovaries to release an egg. LH and FSH are closely linked. At the beginning of the menstrual cycle, FSH and LH are secreted to stimulate ovarian follicles. Mid-cycle, the growing follicle will inhibit FSH secretion and increase estrogen. This is a trigger for sudden release of LH that leads to release of the mature egg.
The LH Surge is vital for pregnancy - as it causes the matured egg to be released. The next 24 - 36 hours are the fertile window when a woman can get pregnant. Ovulation Predictor Kits that are available measure LH level in the urine - identifying the best time to conceive. Reduced levels of LH in females indicate ovarian hyperfunction.
LH and PCOS
In females suffering from PCOS - Polycystic Ovarian Syndrome, the LH levels are already elevated when compared to FSH. Since there is no LH surge, ovulation does not take place. Elevated LH levels cause release of androgens from the ovaries leading to acne and Hirsutism. Infertility and miscarriage are common. Studies have shown that there is a direct relation between insulin resistance and elevated LH levels.
In females, the LH levels in the blood can vary based on stage of menstrual cycle, age, pregnancy and other pituitary gland disorders. It can be measured by a blood test or urine test. Usually this test is prescribed for women with irregular periods trying to get pregnant or assessing if a woman has entered menopause. Men with low testosterone levels or having very late puberty are asked to take the LH test.
High levels of Luteinizing hormone are most often caused by ovarian tumors or improperly-developed ovaries. Thyroid or Adrenal disease can elevate LH levels. PCOS and Autoimmune disorders also cause the levels of Luteinizing hormone to rise. Low levels of Luteinizing hormone indicate ovarian failure or primary testicular failure. This can happen due to viral infections such as mumps, autoimmune disorders, radiation exposure and tumors.
Early phase of menstrual cycle: 0.5 to 16.9 IU/L
Peak of menstrual cycle: 8.7 to 76.3 IU/L
Using contraceptives: 0.7 to 5.6 IU/L
Pregnant: less than 1.5 IU/L
Menopause: 15.9 to 54.0 IU/L
Between 20 years and 70 years: 0.7 to 7.9 IU/L
Over 70 years: 3.1 to 34.0 IU/L
hCG blood test
hCG blood test or pregnancy blood test measures the accurate amount of pregnancy hormone, human chorionic gonadotropin (hCG) in the bloodstream. Pregnancy hormone hCG is produced by the placenta. It can be assessed in the blood and urine of a woman within 10 days of fertilization. hCG can be measured by:
Quantitative pregnancy blood test: This test measures the accurate amount of hCG in the blood of a woman and plays a vital role in assessing the age of the fetus. This test also helps in checking if the pregnancy is developing normally.
Qualitative pregnancy blood test: This test can only tell if there is hCG present in the blood and can give no further information. This test result is like the home based pregnancy test kit just giving a 'yes' or 'no'.In men and non pregnant women, the typical levels of hCG is less than 5 international units per liter (IU/L). In pregnant women, it is about 5 - 100 during 24 to 28 days after last menstrual period (LMP). During 4 to 5 weeks after the LMP, the hCG is about 50-500 IU/L and peaks to about 12,000 - 270,000 IU/L during 14 - 16 weeks of pregnancy. High levels of hCG can signify multiple pregnancy or molar pregnancy or Down's syndrome. In non-pregnant women and in men, it can signify cancerous or non-cancerous tumor of the testicles or ovaries. Low values of hCG in pregnant women can signify ectopic pregnancy, death of baby or that the pregnancy is not proceeding the way it has to. It can also indicate a spontaneous miscarriage.
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Bibliography / Reference
Collection of Pages - Last revised Date: November 17, 2019