Recurrent Pregnancy Loss (RPL) and Miscarriage


The definition of Recurrent Pregnancy Loss is three or more miscarriages prior to 20 weeks gestation.    However even one miscarriage takes it emotional toll.  Even though the statistical chances of carrying a baby to term are much more favorable than having another miscarriage it is probably better to take the necessary preventative health steps before trying to conceive again.    In Chinese Medicine and Functional Medicine recurrent miscarriage shows that there is an underlying imbalance, either with the mother or father.   This imbalance is a reason the pregnancy is not taking hold and should be corrected.  Yes if your only goal is to have a baby then you can use IVF. But for the sake of the baby’s health and your health during pregnancy and postpartum it is wise to correct the underlying imbalance before getting pregnant.

The cause of miscarriage are multifaceted.  There can be genetic factors for example a trisomy is found.  There can be endocrine disorders such as a deficiency of progesterone or thyroid disorders.  There can be immunological factors such as food sensitivities or autoimmune issues such antiphospholipid syndrome. There can be circulatory issues whereby there is an inadequate supply of blood to the uterus.  Many of these causes can be subtle and may not picked up via routine testing.  However Chinese medicine and Functional Medicine can uncover many of these issues with careful diagnosis and proper treatment.

Chromosomal Abnormalities: Functional Nutrition and Chinese Medicine can play a large supportive role in helping prevent future chromosomal abnormalities, usually trisomies on 13,16,18,22.   This results when a pair of chromosomes are copied instead of just one.    This cause of miscarriage occurs early in pregnancy and is most often this is seen in women over 35, but it can show up at any age.   Taking steps to bring the body into balance and using specific antioxidant nutraceutical support and time proven Chinese Medicine can correct the improper cell division in future pregnancies.   Adding in stress reduction techniques for both partners can be helpful.   Using acupuncture or shiatsu as an energetic medicinal treatment can help deeply relax and heal any stress response causing greater oxidation.

The Male Factor: The burden of miscarriage falls on the woman in almost every case.   But there are a couple of well known studies that show the paternal age plays a role in miscarriage with increasing risk of men over the age of 35:

  • Kleinhaus K, Perrin M, Friedlander Y, Paltiel O, Malaspina D, Harlap S. Paternal age and spontaneous abortion. Obstet Gynecol 2006; 108: 369-377
  • Slama R, Bouyer J, Windham G, Fenster L, Werwatz A, Swan SH. Influence of paternal age on the risk of spontaneous abortion. Am J Epidemiol 2005; 161: 816-823

So it is important for the father to also be evaluated especially if he is over 35.   Often standard sperm analysis can not pick up on subtle pathologies that Chinese Medicine can easily uncover. Chinese Medicine and Functional Nutrition can improve sperm health within 3 months.

Endocrine Imbalances: PCOS, Hypothyroid and Luteal Phase Defects (LPD) can all contribute to miscarriages.   Chinese Medicine and Functional Nutrition can all safely correct these endocrine disorders to greatly increase the chances of carrying to term.

  • PCOS – Polycystic Ovarian Syndrome is an imbalance in a woman’s hormones where she has a high percentage of androgen hormones.   Sometimes it can cause an LH (Luteinizing Hormone) elevation which disrupts the eggs maturation and is thought to lead to chromosomal abnormalities causing a miscarriage.  Read more about how acupuncture and Functional Nutrition can treat PCOS.
  • Luteal Phase Defects (LPD):   The luteal phase is the final phase of a cycle (the others being menstruation, follicular, ovulatory)  that lasts from ovulation until the first day of your period. A normal luteal phase should be 12-14 days giving a fertilized egg enough time to implant.  A shortened luteal phase  less than 12 days does not allow for proper implantation so the uterine lining begins to slough off before a fertilized egg has  a chance to implant. However in Chinese Medicine it is seen as a problem with the entire cycle as each of the 4 cycle phases support the next.  LPD are typically easy to correct with Chinese Medicine.  In most cases within 3 cycles the luteal phase is lengthened to allow proper implantation.    Here is a study using Chinese Medicine for LPD: Lian F., TCM treatment of luteal phase defect–an analysis of 60 cases., J Tradit Chin Med. 1991 Jun;11(2):115-20
  • Hypothyroid:  Inadequate thyroid function has been linked to miscarriages.  A study from 2000 linked 2nd and 3rd trimester miscarriage to low thyroid function. This study estimated that 6 out of every 100 miscarriage may be related to undiagnosed thyroid condition.  True thyroid dysfunction should be treated both naturally and with medication.  However many thyroid conditions are autoimmune in nature which seems to have become more prevalent in the toxic world we live.   Any autoimmune condition should be evaluated with Functional Nutrition as many times the autoimmune symptoms can be reduced by balancing T-helper cells.

Autoimmune Disorders: A woman with antiphospholipid antibodies can have blood clots develop in the placenta.  This sadly often causes a 2nd or 3rd trimester miscarriage. Often aspirin or blood thinner will be prescribed by doctors which is a similar approach that would be used by a Chinese Herbalist and acupuncturuist in that we want to get the blood moving.  However the side effects of using Chinese Medicine are most often very positive and help bring the body back into balance.    There can also be autoimmune conditions such a Hashimotos thyroiditis that can be treated by balancing the immune system with complementary medicine.   Women that have antithyroid antibodies that are treated with western thyroid medication have much improved pregnancy outcomes:  Negro R, Formoso et al. Levothyroxine treatment in euthyroid pregnant women with autoimmune thyroid disease: effects on obstetrical complications. J Clin Endocrinol Metab 2006; 91: 2587-2591

Environmental Factors: The world we live in now is very different than the one from 100 years ago.  Chemicals causing ill health problems and hormone disruption are ubiquitous.   Each person is a bio-accumulator of fat soluble chemicals, some harmless, but many deleterious.  In terms of fertility some of these chemicals are hormone mimics known as xenoestrogens or foreign estrogens.  Women with high blood levels of a class of chemicals called “organochlorine compounds”, have problems with infertility, stillbirths, and miscarriages.   Men may have low testosterone and reduced sperm counts.  A body burdened in this case requires long treatment of detoxification and strict adherence to an organic food diet.   Also nutraceuticals and supplements need to be used for detoxification.   This type of imbalance and toxicity can take time to resolve.

Anatomical Abnormalities: Both congenital and acquired anatomical abnormalities can be a cause of miscarriage.  Congenital abnormalities such as a bicornuate uterus probably requires Western ART treatment.  Many acquired abnormalities such as cervix not closing in  or fibroids can be helped with Acupuncture and Herbal Medicine but will probably require Western medical assistance.

Conclusion: Acupuncture, Herbal Medicine and Functional Nutrition are safe and effective choices for improving overall health thereby preventing miscarriages. These treatments improve endometrial differentiation by improving immune function;  they can reduce or eliminate blood clotting;   normalize serum progesterone levels and luteal phases;   they can balance the immune system to sequester an autoimmune response and improve  male factors such as sperm counts and morphology.  If you have suffered from miscarriage and are trying to conceive please call our office.  978 461 2001.

Yours In Health,

George Mandler CNS LDN LicAc

Licensed Dietititan / Nutritionist

Licensed Acupuncturist

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