Pregnancy failure is one of the most common obstetric complications. You have a 15% to 20% chance of your pregnancy ending in miscarriage. Repeated pregnancy failure is when you have two or more miscarriages in a row. This usually happens in the first trimester or early second trimester and occurs in about 5% of couples trying to conceive. Many happen before you even know you are pregnant. In the past, a woman with recurrent miscarriages might never know why it happened. Today, more and more women are finding out the causes of their Repeated pregnancy loss(RPL).
The risk for repeated pregnancy failure goes up with age. If you are age 40 or older with previous repeated pregnancy loss, you have a much higher risk compared with younger women.
Causes for Recurrent Pregnancy Loss
- Genetic Abnormalities
A considerable proportion of Pregnancy failure is due to genetic abnormalities. Indeed, over 50% of early pregnancy losses have been associated with chromosomal abnormalities.
One set of chromosomes is inherited from the mother, while the other is inherited from the father. When one (or both) pairs of chromosomes are defective, the chromosomes may not line up correctly, leading the developing embryo to be deformed and abort spontaneously.
- Cervical Insufficiency
Cervical insufficiency is a painless opening of the cervix that results in the delivery of the baby during the 2nd trimester of pregnancy.
Pregnancy complications, such as cervical insufficiency, are problems that occur only during pregnancy. To prevent early delivery, doctors may stitch the cervix closed (cerclage).
- Immunological Disorders
Sperm is a foreign substance to a woman’s body, just like the fertilized egg. Unless a signal is sent across the body, the immune system can reject sperm or embryos. The immune system, on the other hand, does not always grasp this information, which leads to pregnancy failure.
- Polycystic Ovarian Syndrome
PCOS is a condition in which a woman produces too much testosterone, resulting in irregular ovulation and menstruation. It also causes insulin resistance, which slows endometrial lining maturation. Recurrent pregnancy failures are typical as a result of this condition.PCOS is unfortunately becoming more widespread in India. Up to one out of every ten failures is caused by PCOS. As a result, medicines and regular monitoring are required.
- Endocrine Problems
Some endocrine problems have been linked to pregnancy loss. These include diabetes (that is not controlled), severe thyroid problems, or luteal phase defect. As a result of these circumstances, the embryo has a difficult time surviving. These difficulties must be addressed before any future attempts to conceive a child.
- Environmental factors
Cigarette smoking is suggested to affect the trophoblastic function and is linked to an increased risk of RPL. Obesity is independently associated with an increased risk of recurrent pregnancy loss in women who conceive naturally. Other lifestyle habits such as alcohol consumption (3 to 5 drinks per week), cocaine use, and increased caffeine consumption (more than 3 cups of coffee per day) are also associated with an increased risk of spontaneous miscarriages.
Treatment for Recurrent Pregnancy Loss
Studies have shown that several health behaviour modifications may improve the chance of a subsequent healthy pregnancy after previous abortions. These include weight loss in overweight women and cessation of smoking and limitation of alcohol intake in women planning a pregnancy.
For women having recurrent miscarriages your doctor will advise investigations based on your age, pregnancy history, family history, and previous investigations/treatment to search for an underlying cause that can be identified in several cases. This includes thyroid hormone levels, blood tests to detect antiphospholipid antibodies (APLA), ultrasound to look for any abnormality in the uterus, and genetic tests of the parents or even surgery. The treatment varies according to the causes.
If a chromosomal problem is found, the doctor might recommend genetic counselling. While many couples with Chromosomal rearrangement eventually conceive a healthy baby naturally, your doctor might suggest fertility treatments, such as IVF. During IVF, eggs and sperm are mixed outside of the body in a laboratory. After IVF, before the embryos are returned to the uterus, they can be tested (preimplantation genetic screening). This allows embryos without genetic abnormalities to be chosen to increase the chance of a healthy pregnancy.
Conclusion
Recurrent pregnancy loss carries a tremendous negative emotional and psychological impact on couples. The loss of any pregnancy is the loss of hopes and dreams invested in that unborn child. For couples who have to go through this trauma again and again provision of information and appropriate testing is necessary so that if a problem is identified adequate treatment can be given.
Speak with our experts to know more about Recurrent pregnancy loss treatments.
Ferticare can help you on your way to becoming pregnant. Ferticare will assist at every step of the process. It starts from the initial consultation to determining the best fertility therapy for you. We provide patients with tailored, cost-effective treatment plans and link them with the best physician for their requirements.
Meet with one of our fertility specialists if you are having difficulty becoming pregnant. We can help if you have any more questions regarding the procedures.
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