What you need to know about recurrent pregnancy loss
Cases of spontaneous pregnancy loss are commonly found in our society. On the other hand about 15% of pregnancies which are clinically recognized, result in casual or spontaneous pregnancy loss and only 30% of conceptions lead to a successful birth. Well, the numbers are not encouraging. Why do we find the percentage of pregnancy loss so high? Let us try to understand about Recurrent Pregnancy Loss (RPL) and the reasons thereof. Any couple suffering spontaneous pregnancy loss faces an enormous amount of physical and emotional stress and the recurrent pregnancy loss is all the more painful. We also call it as recurrent miscarriage or habitual abortion. Three consecutive pregnancy losses before attaining 20 weeks from the last menstrual period are termed as recurrent miscarriage. Epidemiologic studies, however, suggest that 1 - 2% of women suffer the RPL.What causes recurrent pregnancy loss?
Most of the pregnancy losses are due to chromosomal abnormalities or genetic problems. They are random occurrences. The abnormality may be attributed to the quality and formation of the egg, sperm, or the premature embryo. Clinically recognized pregnancies to the extent of about 12-15% lead to miscarriage. But the estimate suggests that approximately 30-60% of all conceptions will get aborted within the first 12 weeks of gestation. As a matter of fact, in many cases, a woman doesn't even realize that she has conceived. Here, the risk of abortion is high. Growing maternal age is also related to an increase in the risk of miscarriage. This is attributed to poor egg quality resulting in chromosomal abnormalities. In some cases, either of the partners may have a sort of irregularity in their genes in which case the offspring is likely to be seriously affected, which ultimately ends in miscarriage. In certain cases, abnormalities are observed in the uterus which results in miscarriage. This happens because of inadequate blood supply to the pregnancy. In some women, there is an inherent problem of the abnormal or irregularly shaped uterus. Whereas in some cases a woman may develop an abnormality in her uterus over a period of time. The poor immune system of a woman is another cause of recurrent loss of pregnancy. Hormonal imbalance or abnormality also plays a role in abrupt pregnancy loss. This may occur because of thyroid and diabetes.
Another cause of RPL is observed because of a woman's blood clotting.
Other general causes which are equally significant, for the recurrent pregnancy loss are environmental factors, occupational hazards, injury due to a minor or major accident, and excessive stress.What type of tests are conducted for recurrent pregnancy loss?
Initial testing involves detailed medical & surgical examination, family history, and genetic history. Other tests include karyotype analysis of both the partners. This involves chromosomal or genetic make-up of a person and it is carried out to find out abnormalities in the partners which are likely to be inherited by the offspring, leading to miscarriage. These types of abnormalities are rare; nevertheless, the doctor may opt for it, only when they would find the reports of other general tests normal. One more test involves the evaluation of the uterus or the womb. Here the uterine cavity inside the womb is evaluated. This is done by adopting different methods including the ultrasound test, saline ultrasound, X-ray of hysterosalpingogram, or MRI.
Proper treatment in such a case depends on the basic cause of RPL and depending on the results of the diagnostic examination the success rate of future pregnancy is as high as 77% if the diagnostic test shows no abnormalities. It is 71% if any abnormality is found. Partners who show abnormality in karyotypic tests is quite often recommended having genetic counseling. Here, the specialists have detail discussions with the partners to ascertain the kind of genetic abnormality and its likely effect on future pregnancies. In some cases, the affected partners may go for prenatal genetic studies during the pregnancy in order to verify the genetic make-up of an offspring and to ascertain defects (if any) of an unborn baby. This is called Chorionic Villus Sampling (CVS). This process involves biopsy of the placenta, late in the first trimester, or in the early days of the second trimester. Similarly, a process called amniocentesis is done in which some of the amniotic fluid (fluid surrounding the baby during the pregnancy) is removed for analysis. Another process is about IVF with Pre-implementation Genetic Diagnosis, better known as PGD. In this process, the woman takes shots for many days to allow the growth of eggs in her ovaries and these eggs are subsequently retrieved from the ovaries through a minor surgical procedure. The sperm is subsequently injected into each egg and the embryo is allowed to develop. In the case of uterine abnormality, surgery is recommended, depending upon the nature of the defect. Certain medications are prescribed in case the syndrome called antiphospholipid is diagnosed. These medications are given in order to reduce blood clot formation. In the event of thyroid dysfunction or diabetes, specific medications are recommended.
These are some highlighting aspects of Recurrent Pregnancy Loss. The purpose is to give you fair idea about it. However, it is always advisable to meet the doctor in person and have proper advice. In Pune, we have fertility IVF Specialist in Pune Dr. Mamta Dighe from Xenith Advanced Fertility Center, Pune who guides partners suffering from RPL and help them attain successful pregnancy.