Recurrent Miscarriage

Being pregnant one day and then not the next can be an emotionally devastating experience. Repeating it time after time is almost unbearable for those who are going through it. Today there are many causes that can be addressed and corrected based on your symptoms. At Inovi we want to find answers to these problems so you can move toward a pregnancy with a great outcome.

recurrent-miscarriageWhat is Recurrent Pregnancy Loss (RPL)?

Often known as recurrent miscarriages, RPL applies if you have experienced 3 consecutive multiple miscarriages prior to 20 weeks from the last menstrual cycle.

Did you know that it is a relatively common occurrence with approximately 15% of all pregnancies resulting in miscarriage? And even more widespread is the fact that only 30% of pregnancies end in a live birth. Being able to evaluate and accurately diagnose the underlying causes and treat them with the appropriate therapies and interventions is what we do to help you get back course to a normal and full-term pregnancy. 

What Causes Recurrent or Spontaneous Miscarriage?

While we do know many of the related factors and diagnoses that can lead to RPL, there are still as many as half which occur that are unexplained. The most important thing you can do to find answers is to have a fertility evaluation. During this visit you will discuss your recurrent or spontaneous miscarriage(s) with your fertility specialist and team. The causes that are currently identified with a direct link to RPL will be discussed and scheduled for testing. These can include the following:

Known factors for recurrent miscarriage

  • Parental Chromosomal Abnormalities
  • Untreated Hypothyroidism
  • Uncontrolled Diabetes
  • Certain Uterine Abnormalities
  • Antiphospholipid Antibody Syndrome (APS)
  • Endocrine Disorders
  • Inherited or Acquired Thrombophilias
  • Immune System Disorders
  • Infections
  • Environmental Factors

In the following table, you will see the potential source of the cause of recurrent miscarriages, then parallel the diagnostic testing appropriate to determine if you have these conditions.

Suggested Diagnostic Evaluation of Recurrent Pregnancy Loss Based on Source of Cause

 

Source Suggested Diagnostic Evaluation
Genetic Parental karyotype
Anatomic HSG or office hysteroscopy 2D or 3D ultrasound Saline-infusion sonohysterography
Endocrine TSH
Possible testing for insulin resistance, serum prolactin level, ovarian reserve testing, antithyroid antibodies
Infectious No evaluation recommended unless patient has evidence of chronic endometritis/cervicitis on examination, or is immunocompromised
Autoimmune Anticardiolipin antibody levels (IgG and IgM)
Lupus anticoagulant
Non-APS thrombophilias Homocysteine, factor V Leiden, prothrombin promoter mutation, activated protein C resistance
APS APS, antiphospholipid antibody syndrome; HSG, hysterosalpingography; IgG, immunoglobulin G; IgM, immunoglobulin M; TSH, thyroid-stimulating hormone

 

What Recurrent Miscarriage Treatments Are Available?

Once the source of your problem can be identified, there are certain steps and treatments that can help you have a pregnancy that ends with a birth of your baby. These treatments below are some that your fertility specialist and team may use to help correct your RPL.

At Inovi we have the skills, experience and fertility team to help you solve your miscarriage problems and get you on the path to your new family.

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