Recurrent miscarriage over age 40

Dear Lord Winston,
I would just like some advice and a possible explanation as to what is happening to me at the moment. I am extremely thankful to have three children aged 9, 7 and 6. I have been trying to get pregnant again (with the same partner) since February 2014 and was successful last November however it ended in a missed miscarriage in January 2015 at 11 weeks. I then was pregnant again in May but miscarried at 7 weeks and again in July which ended at 6 weeks. I had my three children without any miscarriages but now have had three miscarriages this year. I use ovulation sticks and have a luteal phase of 12 days. I am 44 and have an underactive thyroid which is treated with 100mg of Levothyroxine. What should I do? THANK YOU for reading. A.

Dear A,

Whilst all this may be due to your thyroid problems, my suspicion is that this is not very likely. Much of the time an underactive thyroid does not cause infertility – and if it does it is usually failure of ovulation rather than miscarriage that is the problem. Your experience is, sadly, normal for a healthy woman over 42. Approximately half of all pregnancies will miscarry at this age and by 44 there chances are even higher, with a greater risk of a chromosomal problem in the foetus, such as Downs Syndrome. Whilst it is often very hard to be unable to conceive again, particularly after losing a pregnancy by miscarriage there eventually will come a point where you may need to come terms with what is really a normal biological outcome. Apart from anything else, I imagine that if you have already had three miscarriages, it is possible these were due to some chromosomal problems. So perhaps nature is suggesting to you, admittedly rather harshly, that you may need to consider to move on with your hopes and aspirations.

I am sorry to feel that I have to give you such uncomfortable advice,

With best wishes
Robert Winston