CTfertility.com | Fertility Testing | Recurrent Miscarriages

A miscarriage can be a terrible loss for any couple, but when it happens more than once, it can be devastating. Fortunately, for people experiencing recurrent pregnancy losses, proper diagnosis and treatment of these problems often leads to a successful pregnancy.

There are many causes of recurrent miscarriage. These include:

genetic (chromosomal) abnormalities
hormonal imbalances
structural or anatomical problems, such as fibroids, polyps or scar tissue
autoimmune disorders, such as lupus or diabetes
clotting disorders
environmental factors, including smoking
decreased egg quality (most often as a result of normal aging)

An accurate diagnosis can be made by checking specific blood tests for progesterone levels or abnormal patterns of blood clotting; performing simple x-rays or ultrasounds of the uterus; obtaining a biopsy of the uterine lining to assess its development; looking for pregnancy-related antibodies; or culturing the cervix for infection.

Traditional treatments options, which are often started in early pregnancy and sometimes continued until delivery, may include:

surgical correction of anatomic problems of the uterus through simple outpatient surgery
hormonal (progesterone) supplementation
baby aspirin or other blood thinners
antibiotics

Sometimes, however, evaluation for these factors will be normal, or unexplained. While many of these couples will ultimately have a healthy baby, others will not unless more advanced treatments are used.

In such patients with unexplained miscarriages, in vitro fertilization (IVF) with pre-implantation diagnosis (PGD) can be used to achieve a successful pregnancy. A womanâs ovaries are stimulated with hormones, and some of her mature eggs are removed. The eggs are then fertilized in the laboratory, and PGD is used to sort healthy embryos from genetically unhealthy ones, so that only those healthy ones are transferred back to the patient. This exciting new option is only available at a few centers nation-wide, but fortunately is available to patients in Connecticut.

Still other patients suffer from recurrent pregnancy loss because of their eggs. While the eggs are capable of being fertilized, they cannot lead to a successful pregnancy. For these patients, egg donation is an exciting treatment option. Young female volunteers, who are first extensively screened, donate their eggs to those women (recipients) who cannot remain pregnant using their own eggs. Recipients of donor eggs have extremely high pregnancy rates and can expect to achieve a successful delivery of a healthy child. This exciting technologic advance continues to be a successful treatment option for many patients who suffer from recurrent miscarriage.

While recurrent pregnancy loss is a most difficult challenge personally, new tests and treatments now often lead to successful pregnancies. For many patients, the answer is quite simple. For others, newer technology is needed, including pre-implantatation genetic diagnosis and egg donation. It is indeed an exciting time in the field of reproductive medicine, as virtually all causes of recurrent miscarriage can be diagnosed and overcome.