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National pregnancy and infant loss awareness month—Part 2

October is national pregnancy and infant loss awareness month.    Read my blog “National pregnancy and infant loss awareness month-Part 1” to read about my personal infertility journey and pregnancy losses.  You will also learn how you can help a friend to grieve the loss of their pregnancy or infant.  You will learn what you can actively do to bring more awareness to pregnancy and infant loss in the month of October each year. 

The following is part 2 of this blog. In part 2, you will learn what may cause a pregnancy loss but also what does NOT cause a pregnancy loss.  Learn about some health conditions you can investigate and address to prevent a future miscarriage.  Finally, learn what you can do to improve your overall health and egg quality to prevent another pregnancy loss. 

Causes of miscarriage:

Abnormal genes or chromosomes

Most miscarriages occur because the fetus isn’t developing normally. About 50 percent of miscarriages are associated with extra or missing chromosomes. Most often, chromosome problems result from errors that occur by chance as the embryo divides and grows — not problems inherited from the parents.

Maternal health conditions

In a few cases, an unknown health condition might lead to a miscarriage.  Some examples to investigate with your doctor may include hormonal imbalances, uterus or cervix issues (ie weak or incompetent cervix), thyroid conditions, infections, Polycystic ovary syndrome (PCOS), uncontrolled diabetes, stress and lifestyle factors. 

What increases your risk for miscarriage?

So many of my patients, worry that they caused their own miscarriage.  Most often, as you read above, miscarriages are due to extra or missing chromosomes within the egg.  When your body chooses an unhealthy egg, and a miscarriage happens, this is because the embryo is unhealthy and doesn’t develop properly.  This is often as a result of maternal age or conditions that can result in poor egg quality such as endometriosis and Polycystic Ovary Syndrome (PCOS).   This is not your fault! 

Women older than age 35 have a higher risk of miscarriage than do younger women. At age 35, a woman has about a 20 percent risk of miscarriage. Over age 40, 50% of all pregnancies end in miscarriage.  

Some other factors that may increase your risk of a miscarriage due to their effect on egg quality include smoking (50% increased risk), paternal age over 40 (increases risk by 60%), uncontrolled diabetes, excess alcohol (over 5 drinks per week increases risk by 4 times), excess caffeine (more 150mg) and illicit drug use. 

What does NOT cause a miscarriage?

Routine activities such as these do NOT cause a miscarriage; exercise, including high-intensity activities such as jogging and cycling, lifting, sexual intercourse, working, provided you’re not exposed to harmful chemicals or radiation.   

Intense exercise may affect your fertility is if you have PCOS and you are working out so hard that you delay your ovulation, or you get too thin and develop Hypothalamic amenorrhea and then stop ovulating all together!  And in these circumstances, you may not be able to get pregnant in the first place.  

Note though, that when you become pregnant it may be advisable to reduce the intensity of your exercise, not because it will reduce your chance of a miscarriage but because it will reduce your chances of injury.  When you are pregnant, your ligaments become more flexible to accommodate a growing belly and you don’t want to get injured with high intensity exercise!  It’s also best to not begin a new exercise in pregnancy if you have never done that exercise before…again because of risk of injury, not because of increased risk of miscarriage. 

What can you do to improve your egg quality and therefore reduce your chance of miscarriage?

Make sure you are a healthy weight

Being underweight or overweight increases your risk of a miscarriage. Get as close to a healthy Body Mass Index (BMI) range of 20-25 as possible.  Toxins tend to be fat-soluble; and therefore those with higher body fat percentages will likely have higher toxic loads affecting their egg quality. In women, excess weight and toxins may contribute to problems with ovulation due to hormonal imbalances.  Being underweight and having a BMI that is too low can cause hypothalamic amenorrhea (H.A.) and result in lack of ovulation and insufficient hormones to menstruate regularly and conceive.  Being too thin can also increase the risk of miscarriage if you get pregnant.  So find your healthy weight. It’s all about finding a healthy balance.

Improve your egg quality

The best thing you can do to reduce your chances of a miscarriage is start trying for a family when you are younger and your egg quality is healthier!  I understand sometimes, this is out of our control but do your best.  Your career will always be there, your egg quality may not. Consume a healthy diet rich in nutrients, including lots of organic fruits and vegetables.  The best diet for fertility includes a non-processed one, with an emphasis on low glycemic index (GI) foods. A study published in the Journal of Human Reproduction in April 2015, found that pesticides on fruits and vegetables are linked with poorer semen quality.  Pesticides are endocrine disrupting chemicals (EDCs).  This means that they affect your reproductive organs, hormones and pathways in a harmful way.  Another study published in the Journal of Human Reproduction in April 2012 found that women who had higher levels of EDCs in their follicular fluid had less follicles properly mature to eggs and less mature embryos at the end of the IVF process.  So eat organic, pesticide free foods and avoid chemical products on your body and in your home to lessen your toxic load to your eggs and sperm.  

Consider taking anti-oxidants through supplementation such as ubiquinol if you have age related infertility and myo-inositol if you have PCOS. Ask your naturopathic doctor for more information on a healthy diet and supplementation routine tailored for your individual needs.   For more information on nutrition, supplementation and egg quality, consider reading the chapter I wrote for the book written by Dr. Belej Rak, MD entitled “Embrace Your Fertility, Empowering you with the tools to succeed”

Improve your insulin sensitivity and find out your methylation status

For women with Polycystic Ovary Syndrome (PCOS) who are trying to conceive, increased clotting, inflammation and insulin resistance is associated with miscarriage, ovulatory dysfunction and lower egg quality. Improving methylation status can increase the health of the baby during development by exposing them to less inflammation and insulin resistance. To find out more about this, click HERE to read “PCOS and MTHFR: Miscarriage, Insulin Resistance and Heart Health” written by my wonderful and intelligent friend; Dr. Fiona McCulloch, ND.

Address your stress levels

Stress itself is unlikely to cause a miscarriage but it may impact egg quality prior to getting pregnant.  There is a lot we don’t know around stress hormones and their impact on fertility and pregnancy.  Regardless of this, working on stress reduction is going to improve your general health through conception and pregnancy will make the journey an easier one. Once you’ve had one miscarriage it can significantly increase your anxiety and stress through your next pregnancy and around conceiving again since you may worry about having another miscarriage. 

The good news, is that just because you had one miscarriage definitely doesn’t guarantee another. The chance of you having a second miscarriage is quite low, around 4 percent. 

Ensure you have stress management techniques in place for your next pregnancy and a healthy social support network.  Try yoga, meditation, acupuncture, finding a creative outlet like singing and dancing or something as simple as deep breathing exercises.  For myself, I wrote a lot of poetry, sang a lot of songs, danced until my feet hurt, worked out hard and saw joy through my patients successful pregnancies. I avoided people who didn’t understand how to support me while I grieved my losses or who didn’t understand the infertility journey, itself. Instead, I surrounded myself by friends who understood me and knew my darkest secrets and sadness which allowed me to be me and enjoy life to the fullest. Finding your tribe is essential.

Thank you for reading. Please share with someone who may be suffering and gain a little hope from reading these two blogs.

~Dr. Tanya Wylde, ND

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