Recurrent Miscarriages and pregnancy losses

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It can be heart-breaking to miscarry one baby after another. Each new pregnancy brings both hope and anxiety. And each new loss may be harder to bear, especially if you feel that time is running out. The experience can place great strain on even the strongest relationships. You and your partner might react differently from each other and that can cause great tension. Family and friends may find it harder to support you with each miscarriage; they may even think you’re getting used to loss and able to cope. And all the time there may be a sense that your life is on hold while you try – and try again – for a baby.

Miscarriage is defined as the spontaneous loss of pregnancy before the fetus reaches viability. The term therefore includes all pregnancy losses from the time of conception until 24 weeks of gestation. There are number of causes for recurrent abortions which can varied from genetic causes, abnormal uterine cavity to certain disorders as APLA. To know more meet our specialist.

What Tests are Done for Couples with Recurrent Pregnancy Loss?

First, a physician will take a detailed medical, surgical, family, and genetic history and perform a physical examination.

1. Ultra sound or hystrosalpingography to rule out uterine cavity or cervical problems.

2. Genetic testing , which includes karyotyping of couples and abortus if possible.

3. Serology testing : Antiphospholipid antibodies, particularly anticardiolipin antibody and lupus anticoagulant, will likely be checked. These antibodies are related to the antiphospholipid syndrome, which may be related to pregnancy loss.

4. Hormonal assay: such as thyroid testing, prolactin levels and AMH to check the ovarian reserve.

5. Test for diabetes

TREATMENT

The treatment recommendations for patients with recurrent pregnancy loss are based on the underlying cause of recurrent pregnancy loss. No matter what the results of the work-up are, the chance for a successful future pregnancy is high: 77% if the work-up showed no abnormalities, and 71% if an abnormality was found.

If a uterine abnormality is found, surgery may be performed depending on the defect. If antiphospolipid syndrome is diagnosed, certain medications that reduce blood clot formation may be given. If thyroid dysfunction or diabetes are diagnosed, specific medications can be prescribed.

In case of genetic cause IVF with PGD can be offer or can go for donor eggs.

Over one-half of patients with recurrent pregnancy loss will have unexplained recurrent pregnancy loss, which means that no specific cause could be identified in the work-up. Various treatments may be offered to these patients, but there is no universal recommendation for treatment of these patients. Despite this, the overall chance of pregnancy is good, more than 50%, without any intervention at all.