What is recurrent pregnancy loss?

What is recurrent pregnancy loss and what causes it?

Recurrent pregnancy loss is when a woman suffers a miscarriage two or more consecutive times during pregnancy.  About one in 100 women suffer from recurrent pregnancy loss and, frustratingly, a cause is unable to be determined nearly half of the time. If you have lost multiple pregnancies, there are a few tests the doctors at IVF Michigan Fertility Center can perform to potentially determine the cause of the miscarriages and, hopefully, provide a solution to help you start building a family.

To begin, one of IVF Michigan’s fertility specialists will take a detailed medical, surgical, family and genetic history, followed by performing a physical exam of both partners (if applicable).

Then, typically we use an ultrasound, x-ray, MRI or a hysteroscopy to examine the uterus and the uterine cavity to inspect for any abnormalities that could be causing the miscarriages. Doctors may also test the patient’s hormone function. Some patients need to be tested for clotting factors (Antiphospholipid syndrome) a cause that is thought to reduce the blood flow to the pregnancy. After, the physician may choose to do a karyotype (the chromosomal, or genetic, make-up of a person) analysis of the parents, but it’s not necessary for all patients.

From these tests, our fertility doctor will likely be able to determine if the problem is genetic, related to your uterus or cervix, caused by a chronic or untreated illness, or induced by lifestyle.

Patients diagnosed with genetic issues are generally referred to IVF Michigan’s genetic counseling. If there’s a uterine abnormality or weakened cervix, IVF Michigan’s doctors may recommend a surgical solution.  If a chronic or untreated illness, like thyroid dysfunction or diabetes, is detected, patients may be prescribed medications or lifestyle changes to address the problem. Patients with clotting disorders may need to be treated with blood thinners such as aspirin and heparin. And, finally, any lifestyle choices (alcohol, drug abuse, environmental toxins) that may be causing recurrent pregnancy loss must be avoided in order to continue to assess the viability of successful pregnancies in the future.

New research is emerging in relation to the causes and treatment of recurrent pregnancy loss.  Data from IVF showed that 30 to 70% of human embryos are genetically abnormal. Normally, abnormal embryos fail to implant and, if they do implant, they will result in a miscarriage. According to some researchers, women with recurrent pregnancy loss are actually HYPER FERTILE, meaning the abnormal embryos that are supposed not to implant, will implant and results in miscarriage. One option is to keep trying until a normal embryo implants. Another option is to proceed with IVF with genetic testing to select the normal embryo for implantation. The cost effectiveness of IVF with genetic testing has been questioned, but the doctors at IVF Michigan maintain that there is no doubt that this technology reduces the number of miscarriages. But it is worth noting that women who decide to hold off on IVF may ultimately get the same rate of live birth (as someone who had IVF with genetic testing) but at the cost of higher rate of miscarriage.