Recurrent Pregnancy Loss
What is recurrent pregnancy loss?
Recurrent pregnancy loss is a condition characterized by 2 or more pregnancy losses in a row. A pregnancy loss is a clinically-identified pregnancy that fails within 20 weeks of gestation. Before making a diagnosis, your doctor will ensure that your pregnancy was visualized on an ultrasound or that pregnancy tissue was identified after the loss.
What are the causes of recurrent pregnancy loss?
Pregnancy losses are usually random events that arise due to genetic abnormalities. They occur in about 12% to 15% of clinically identified pregnancies. They sometimes take place without a woman even realising she is pregnant. Advancing age can result in poor egg quality. Pregnancy loss may also be attributed to structural abnormalities or growths within the uterus, an abnormal immune response or medical conditions such as diabetes, thyroid disease and clotting disorders.
What tests will your doctor perform to identify the cause?
Your doctor will review your medical history and family history in detail and conduct a physical examination. Imaging studies such as an ultrasound or MRI may be performed to examine your uterus and reproductive tract. Your doctor may perform a minimally invasive procedure called a hysteroscopy in which a narrow viewing tube is passed through the vagina and cervix to examine the uterus. Corrective procedures such as removal of fibroids, scar tissue or septum tissue may be performed during this procedure. Your doctor may also perform tests to evaluate clotting, hormone and ovarian function. If a cause for pregnancy loss cannot be identified, you and your partner may need to undergo a gene analysis to look for chromosomal abnormalities.
How is recurrent pregnancy loss treated?
Women with recurrent pregnancy loss have a fair chance of conceiving with or without treatment. If a uterine abnormality is identified, it may be surgically corrected. Medical conditions such as thyroid disease or diabetes may be treated with medications. If gene abnormalities are identified, genetic counselling is recommended, to discuss your likelihood of having a normal baby. Your baby’s genetic makeup may be tested while in the womb. Your doctor may recommend in vitro fertilisation where your eggs are extracted and fertilized in a laboratory. The embryos are genetically tested for abnormalities before implanting one or more of them in your uterus. Certain cases of recurrent pregnancy loss remain unexplained, but the chances of successful pregnancy in such cases are still good.
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