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Recurrent early miscarriages (within the first trimester) are most commonly due to genetic or chromosomal problems of the fetus or structural problems of the uterus.
Late miscarriage can be the result of uterine abnormalities, autoimmune problems, and incompetent cervix or premature labor. Recurrent pregnancy loss is defined as the loss (miscarriage) of three or more consecutive pregnancies. Our laboratory workup is designed to identify possible causes for a woman's recurrent pregnancy loss. Anatomical factors: Uterine abnormalities are a possible cause of recurrent pregnancy loss. Genetic factors: Approximately 70 percent of early spontaneous miscarriages are associated with fetal chromosomal abnormalities.
Infection: Any severe maternal infection that leads to bacteria (or viremia) can cause sporadic miscarriage. Immune factors: There is a well-established association between recurrent miscarriage and antiphospholipid antibodies (aPL) a€” a class of proteins that in some cases appear to attack an early developing pregnancy. Endocrine factors: Systemic maternal endocrine disorders such as diabetes mellitus and thyroid disease have been associated with miscarriage. Unexplained factors: For a number of women, the recurrent episodes of pregnancy loss will remain unexplained despite careful investigation. IHR has treatments for a variety of conditions, including ovulatory dysfunctions, endometriosis, immunological infertility and many others. Perhaps less known is our work with individuals and couples who are considering assisted reproduction, but who are uncertain of their next step. The American Society for Reproductive Medicine defines recurrent pregnancy loss as two or more pregnancy losses that occur before the 28th week of pregnancy. Because recurrent miscarriage is uncommon, we understand how isolating this condition can make you feel.
Our goal at Texas Fertility Center is to quickly ascertain whether or not there are underlying anatomical or congenital problems with the uterus, or other correctable factors to address. Identifying treatable factors such as autoimmune disorders, adhesions or a septate uterus can bring a sense of relief to women, restoring confidence that the next pregnancy will progress and flourish.

These numbers total more than 100%, indicating that some patients have multiple causes for their miscarriages. You can learn more about all of the causes of recurrent miscarriage on adjoining web pages that address the most common reasons women experience pregnancy loss. Contact us at Texas Fertility Center to speak with a caring and understanding physician who specializes in resolving recurrent miscarriage. However, 60 percent of all women who are diagnosed with unexplained recurrent pregnancy loss achieve a successful pregnancy with minimal treatment.
These factors include: anatomical factors, genetic factors, infection, immune factors, endocrine factors, and unexplained factors. In addition, 30 percent of second trimester miscarriages and 3 percent of stillbirths have abnormal chromosomes. The live birth rate may be as low as 10 percenet in women with recurrent miscarriages attributed to aPL. But well-controlled diabetes is not a risk factor for recurrent miscarriage, nor is treated thyroid dysfunction. It is important for these women to know that the prognosis for future pregnancy with counseling alone is approximately 75 percent.
Texas Fertility Center physicians reassure women who have had two or more miscarriages that they have good cause to hope for a positive outcome. If your recurrent miscarriage falls under the category of unexplained, you are not left without options. This picture of parental chromosomes uncovers many clues about underlying factors that cause half of all early miscarriages. Unfortunately, following the completion of a thorough evaluation for recurrent pregnancy loss, 40% of couples with recurrent pregnancy loss will still not have a definitive diagnosis for their problem. Although this condition can seem insurmountable, the overwhelming majority of patients with recurrent pregnancy loss will successfully deliver a healthy child. If you have had two or more pregnancy losses you may want to look closely at possible reasons. The rate of success improves to over 75 percent for women who suffer recurrent loss as the result of an identifiable cause and undergo appropriate treatment.

Surgery to correct uterine abnormalities is an effective and low-risk outpatient procedure. In most cases, the couple is chromosomally normal and the fetal chromosomal abnormality is a random event.
The live birth rate significantly improves to 70 percent when aPL is treated with low dose aspirin together with low dose heparin. Inadequate secretion of progesterone during the menstrual cycle and in the early weeks of pregnancy is considered a possible factor in many cases of recurrent miscarriage.
Only 5% of women experience two or more pregnancy losses and less than 1% of women experience three or more. We also rely on diagnostic blood tests, a pelvic exam and in-office procedures to assess hormonal balance and reproductive organs. This risk rises steadily with age, increasing to 11 percent by age 30 and reaching 33 percent in women age 40.
Preimplantation genetic diagnosis (PGD), can be performed in conjunction with IVF and allows genetic testing to be done on embryos prior to transfer. Another possible endocrine factor is the prevalence of polycystic ovaries (PCO), a condition of the ovaries where there are many medium-sized follicles around the rim of the ovaries, often seen with the ovulation disorder polycystic ovary syndrome (PCOS). The IHR repeated pregnancy loss experts work closely with couples undergoing the many different types of assisted fertility treatments available. We are renowned for our specialized knowledge and high infertility success rates even in difficult cases. IHR's expertise in repeated pregnancy loss lies in our willingness and ability to individualize our approach to best suit each and every one of our patients. If you have any questions as you review the material on repeated pregnancy loss, please contact us for a FREE Repeated Pregnancy Loss E-Mail Consultation.

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