Repeated Miscarriages
Women are typically reluctant to discuss miscarriages or unplanned pregnancy losses. While one pregnancy loss may warrant a visit to the doctor, two or more may necessitate a full assessment for reproductive disorders.
Major advances in reproductive medicine have helped to uncover the causes of recurrent pregnancy loss. In the past, a woman might never have known why she lost two or more babies in a sequence. However, accurate diagnoses are now available in approximately 60% of cases. The most prevalent causes include uterine issues, hormone imbalances, and genetic abnormalities.
The Yale Medicine Recurrent Pregnancy Loss Program is the state's only dedicated program of its kind. It brings together experts from a multitude of professions to evaluate and treat women in a holistic way.
What is recurrent pregnancy loss?
Recurrent pregnancy loss refers to two or more failed pregnancies. Pregnancies confirmed via pregnancy test or confirmed in the clinic via ultrasound are included in the definition of "loss".
How often is a repeated pregnancy loss?
Approximately 15% to 20% of pregnancies result in miscarriage. Pregnancy loss is often unplanned and does not indicate a hereditary or reproductive problem.
According to the American College of Obstetricians and Gynecologists, recurrent pregnancy loss affects roughly 1% of reproductive-aged women. Following two or more losses, a thorough medical examination is recommended.
What are common causes for recurrent pregnancy loss?
Problems in a woman's uterus might cause complications during pregnancy. Uterine abnormalities may include fibroids, polyps, or adhesions. The most frequent uterine defect that causes pregnancy loss is a septate uterus, which has a wall of tissue dividing the uterine cavity.
Hormonal problems, such as uncontrolled diabetes and thyroid illness, may lead to recurrent pregnancy loss. Because adequate hormone levels are required for a successful pregnancy, high prolactin levels can also help.
In almost half of cases, pregnancy loss can be ascribed to an abnormal number of chromosomes in the embryo. These difficulties normally arise during conception, however they can occasionally be inherited from parents.
Other probable causes of recurrent pregnancy loss include infections and sperm abnormalities, which are less well understood. Lifestyle issues such as smoking, drug use, caffeine and alcohol consumption, toxin exposure, and obesity should be addressed as they can all contribute.
How is recurrent pregnancy loss evaluated?
We provide couples who have experienced recurrent pregnancy loss with a detailed and methodical analysis of each loss. We take into account the period of the loss as well as developmental milestones that occurred prior to the loss. If accessible, we do a genetic examination of the pregnancy loss tissue (conception products).
Couples are first evaluated with a detailed history and physical examination. This is followed by a battery of diagnostic testing, including blood work for both spouses and an examination of the uterus, usually with a specialized ultrasound study to look for fibroids, scar tissue, or polyps that could jeopardize implantation.
Additional evaluations may include infection tests, a biopsy, and sperm analysis.
We also provide couples with genetic testing for disorders that could subtly limit their reproductive success. If we can acquire tissue from the pregnancy loss, we will conduct genetic investigation to determine the genetic cause.
How is recurrent pregnancy loss treated?
After two or more pregnancy losses, we begin a complete medical assessment, which includes the aforementioned diagnostic tests.
Because there are so many potential underlying causes, we assemble a multidisciplinary team of experts, including geneticists (if a genetic cause is suspected), high-risk pregnancy specialists, and pathologists.
If the reason of the recurrent loss is determined, such as a polyp, it can be surgically removed. Alternatively, if a genetic link is discovered, a woman could undergo in vitro fertilization and screen embryos for the genetic issue.
If we can't detect anything wrong, we suggest the tender-love-and-care protocol, or TLC, which entails weekly prenatal monitoring, beginning with blood tests and progressing to ultrasounds every week.
We also provide support with lifestyle issues that may affect pregnancy, such as smoking, alcohol intake, caffeine use, hazardous exposures, and obesity. Even with advances in technology, recurrent pregnancy loss is not always explained.
Even if a precise cause is never found, the outlook remains quite promising. In most circumstances, a woman's subsequent pregnancy is healthy and successful. Multiple studies have shown that simply monitoring this situation and receiving emotional support can increase the likelihood of a healthy pregnancy.
New Concept Clinic Note
At New Concept Clinic, we have the top gynecologist in Dubai, who provides comprehensive care, from first consultation and diagnosis to treatment and surgical procedures. Call now to schedule an appointment.
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