Here is the scanario. You get pregnant quickly the first time and have a healthy baby. Then you have many miscarriages before another successful pregnancy. That’s the scenario in an op-ed article in the New York Times, “We Were Ready to Give Up on a Second Baby Until a ‘Miracle’ Arrived“. In this article the couple just keeps trying and as you would expect, go through a gut-wrentching emotional journey.
But it does not have to be like that. There is help for couples suffering with recurrent pregnancy loss. According to the American College of Obstetricians and Gynecologists, 10 percent of all pregnancies end in miscarriage — and that number jumps up to more than 30 percent for women over 40. So the chances of experiencing one miscarriage is pretty high. But when you get to two or more, it’s time to visit a reproductine endocrinologist to get the ball rolling on starting an evaluation to see if there is a treatable repeated cause of the pregnancy losses.
The most common cause of miscarriage is an abnormality in the chromosomes of the embryo. So that evaluation should look at both partners’ chromosomes to make sure one of you is not a carrier of a chromosomal translocation which can result in a loss rate up to 80% of pregnancies. A test to check to see if there is a malformation in the shape of the uterus should be performed. A problem with the proper development of the endometrial lining of the uterus can be tested by a timed endometrial biopsy performed in an office visit. Less common and somewhat controversial causes include abnormalities of blood clotting, heredity thrombophilia, other immunological issues or infection in the gential tract with an organism called ureaplasma.
If all the tests your doctor orders are normal, there is still help. Doing IVF with preimplantation genetic screening (PGS) for chromosomes assuring they are normal and transfering those embryos in as controlled environment as possible should result in the best chance of a successful pregnancy. Or like the couple in this article you can keep trying and hope you will get your miracle.