Topic : Repeated Pregnancy Loss
This is my medical history: I got married 3years ago, and I immediately took in, not knowing there was nothing growing in there. It ended 4wks and some days after a faint positive line on the pregnancy strip, I waited for some months and I took in again, it happened like the first again, then I went to a specialist who gave me a 4 days injection for another pregnancy, we timed sex and I took in again, and it happened like the previous ones too, I have experienced this for 5times in the past 3years. I went for hsg, and all was ok, hubby went for semen analysis, the count was 30million, no bacteria, and he decided to go on fertilaid for men, we still don’t know the next step of action, please help doctor.
I can only imagine how awful you feel. But, hang in there and Press on!
You likely have a condition called repeated pregnancy loss or habitual abortion.
This is defined as three or more consecutive pregnancy losses before 20 weeks of gestation and affects 1% of couples trying to conceive. It is a complex condition with a number of possible underlying causes: uterine, infectious, genetic, endocrine, metabolic, immunologic, and environmental.
The truth is that the loss of a baby, no matter how early or late in the pregnancy is a tough emotional and physical burden. To make it worse, repeated pregnancy loss only compounds these feelings and can lead to increasing stress, anger, frustration, a feeling of loneliness and despair, emptiness and a feeling of a lack of self-worth and failure. I know you have seen it all.
It is very important; you consult with a high risk specialist before your next pregnancy. The chances of having a repeat occurrence are very high. This special doctor will evaluated the repeated pregnancy loss.
The evaluation should be complete and involve the following four categories:
2. Alloimmune – the couple against each other
3. Autoimmune – the woman against herself
4. Non-immune – physical reasons for pregnancy loss
A trained specialist will conduct all these to find out what is causing the losses.
Treating Habitual Abortion
This is a sophisticated process and involves lots of work-up for pregnancy loss to identify the cause(s) of why a woman is continuing to lose her pregnancies. Treatment is aimed at correcting any of the immune/ non-immune problems; and if they are all normal, then treating the autoimmune problems with low dose prednisone, low dose heparin and baby aspirin.
The low dose heparin, injected right under our skin, only interferes with clotting at a microscopic level. All medications are started prior to attempting pregnancy and continued until the end of the 12th week of pregnancy when the pregnancy blood vessels are large enough and are not affected by the micro-clotting.
At that point, heparin is discontinued, you taper off prednisone over the next three weeks and baby aspirin is continued until 34 weeks of pregnancy. None of these medications have any adverse risks to the pregnancy or the baby. If the likely cause of recurrent pregnancy loss can be determined treatment is to be directed accordingly. In pregnant women, with a history of recurrent miscarriage. There are currently no treatments for women with unexplained recurrent pregnancy loss. The majority of patients are counseled to try to conceive again.
There is currently one drug in development which is in clinical trials for the treatment of unexplained recurrent miscarriage. In certain chromosomal situations, while treatment may not be available, in vitro fertilization with preimplantation genetic diagnosis may be able to identify embryos with a reduced risk of another pregnancy loss which then would be transferred.
However, in vitro fertilization does not improve maternal-fetal tolerance imbalances.Close surveillance during pregnancy is generally recommended for pregnant patients with a history of recurrent pregnancy loss.
Please see a specialist in your location.
Keep us posted.
~ Dr Chudi
American Pregnancy Association