Dr. Pallab Roy | Recurrent Miscarriage Treatment in Kolkata
What is Recurrent Miscarriage?
Recurrent Pregnancy Loss (RPL) is defined as having three consecutive miscarriages before 20 weeks from the last menstrual period.
Prevalence: RPL affects about 1% to 2% of pregnant women. Current methods can identify the cause in up to 50% of couples. Genetic factors are responsible for approximately 2% to 5% of RPL cases.
Types of Recurrent Miscarriages
Miscarriages can be caused by various factors, generally categorized into early and late miscarriages.
Early miscarriages, occurring within the first trimester, are most often because of genetic or chromosomal abnormalities in the embryo, with 50-80% of these losses involving abnormal chromosome numbers. Uterine structural issues can also contribute to early miscarriages.
Late miscarriages, occurring after the first trimester, may result from uterine abnormalities, autoimmune disorders, an incompetent cervix, or premature labor.
Book Appointment
Causes of Recurrent Miscarriage
Most pregnancy losses are due to chromosomal or genetic abnormalities. These abnormalities may originate from the egg, sperm, or early embryo. Approximately 12–15% of clinically recognized pregnancies end in miscarriage. However, it’s estimated that 30–60% of all conceptions end within the first 12 weeks of gestation, often before the woman is even aware of the pregnancy. The risk of miscarriage tends to increase with the number of previous losses but is generally less than 50%.
Advancing maternal age is also one of the reasons for repeated miscarriage, likely due to poor egg quality and chromosomal abnormalities. Occasionally, genetic irregularities in either parent may be present, which can affect the embryo more significantly and lead to miscarriage.
Uterine abnormalities can also cause miscarriages, often due to poor blood supply or inflammation. Some women are born with an irregularly shaped uterus, while others may develop uterine abnormalities over time.
A woman’s immune system, hormone imbalances (such as thyroid disorders and diabetes), and blood clotting abnormalities can also contribute to recurrent pregnancy loss.
Which Tests are Recommended for Couples experiencing Recurrent Miscarriage?
There are some tests for couples experiencing recurrent miscarriage have been stated below.
- Physicians take a detailed medical, surgical, family, and genetic history.
- Performs a physical examination.
- Karyotype analysis of both partners may be done to identify chromosomal abnormalities that could affect offspring.
- This test is often reserved for cases where more common causes of miscarriage are ruled out.
- Ultrasound: Initial test to assess the shape of the uterus and detect fibroids.
- Hysterosalpingogram: X-ray to evaluate the inside of the uterus and check if the fallopian tubes are open.
- Hysteroscopy: A minor surgical procedure where a camera is inserted through the cervix to directly visualize the uterine cavity, allowing removal of polyps, fibroids, or treatment of a uterine septum or scar tissue.
- MRI: Used to assess the location of fibroids and abnormalities in uterine shape.
This test is recommended for women with pregnancy loss at or beyond 10 weeks of gestation with a “normal” appearing fetus or for those with three recurrent losses at any gestational age.
Not routinely recommended unless there is a personal history of blood clots associated with risk factors or a family history of excessive blood clotting.
- Thyroid Function Tests: To check thyroid issues.
- Thyroid Antibodies: Assesses autoimmune thyroid conditions.
- Prolactin Levels: Measures the hormone responsible for milk production.
- Ovarian Reserve Tests: Evaluate ovarian function, as poor function may be linked to chromosomal abnormalities in eggs.
- Diabetes Testing: Conducted if there are risk factors or symptoms of diabetes.
Recurrent Miscarriage Treatment
The treatment of recurrent miscarriage depends on the underlying cause. In some cases, no underlying cause can be identified. However, several treatment options may be recommended based on the potential causes:
Chromosomal Abnormalities
Genetic Counseling may be recommended to discuss options for future pregnancies, such as preimplantation genetic testing.
Hormonal Imbalances
Hormonal imbalances can sometimes be corrected with medications such as progesterone or thyroid hormone replacement therapy.
Uterine Abnormalities
Uterine abnormalities, such as septum or fibroids, can sometimes be corrected with surgery.
Autoimmune Disorders
In some cases, autoimmune disorders may be treated with medications such as corticosteroids or intravenous immunoglobulin (IVIG).
Infections
Recurrent Miscarriages due to infections can be treated with antibiotics.
Lifestyle Factors
Lifestyle Factors such as smoking and excessive alcohol consumption can be addressed by making appropriate lifestyle changes.
Assisted Reproductive Technologies
Assisted reproductive technologies are often recommended to treat issues of recurrent miscarriages. IVF can be combined with preimplantation genetic testing to screen embryos for chromosomal abnormalities before implantation.
It is important to note that treatment options may vary depending on the individual’s specific situation and underlying causes. Women who have experienced recurrent miscarriages should seek medical evaluation to determine the potential causes and decide the best treatment option for their case.
To know more regarding the treatments for recurrent miscarriage, contact Dr. Pallab Roy.
What is Unexplained Recurrent Miscarriage?
Unexplained Recurrent Pregnancy Loss (RPL) refers to cases where a woman experiences multiple miscarriages—usually three or more—without a clear or identifiable cause after a thorough medical evaluation. Despite extensive testing and assessments, no specific reason for the miscarriages is found in these cases.
Frequently Asked Questions
If no specific cause is identified, recurrent miscarriage treatment may focus on supportive care and lifestyle adjustments. Many women with unexplained Recurrent Miscarriage eventually have successful pregnancies. Consulting with the recurrent miscarriage doctor near you may provide additional guidance and options.
Maintaining a healthy lifestyle can support overall reproductive health. Factors such as smoking, excessive alcohol consumption, and being significantly underweight or overweight may affect pregnancy outcomes.
While not all causes of Recurrent Miscarriage can be prevented, addressing identified risk factors and underlying conditions can improve the chances of a successful pregnancy. This may include managing chronic conditions, correcting hormonal imbalances, or addressing uterine abnormalities.
Couples are generally advised to seek medical evaluation after experiencing two or more consecutive miscarriages. If you have experienced recurrent miscarriages, consulting with a recurrent miscarriage gynecologist can provide guidance tailored to your situation.
Though Recurrent Miscarriage can be distressing, many women who experience it go on to have successful pregnancies. The outlook depends on the underlying causes and whether they are addressed.
Though there is no specific diet that guarantees the prevention of miscarriage, maintaining a balanced diet with essential nutrients is important for overall reproductive health.
Recurrent Miscarriage may be associated with certain reproductive health issues, such as uterine abnormalities or hormonal imbalances. Addressing these issues can improve future reproductive health. Regular follow-ups with the gynecologist can help monitor and manage any ongoing concerns.