Recurrent miscarriages are one of the main reasons why patients visit a fertility specialist.
Approximately 20-25% of pregnancies end in miscarriage. Recurrent pregnancy loss is the loss of three or more consecutive pregnancies before week 20 of gestation.
Spontaneous miscarriage is defined as a miscarriage that occurs before the 20th week of gestation. When these happen, what we know as recurrent abortions appears. However, some experts maintain that miscarriages may not be consecutive.
Having had a live new born, before or between miscarriages, does not seem to decrease the probability of having a micarriage again. In addition, there is no consensus as to the number of miscarriages that justify the beginning of a study.
At IVF-Life we believe that the patient must avoid this painful loss. For this reason, we believe it is necessary to carry out studies that anticipate the problem or prevent its repetition.
Most miscarriages occur before 12 weeks gestation, that is to say, during the first trimester. They can be classified according to when they occur:
When a patient has had a miscarriage twice, the probability of having a miscarriage again is between 24-30%. After the third miscarriage the percentage rises to 30-33%. There are two types of causes of repeat miscarriages: known causes and unknown causes. Known causes are:
The causes are due to the genetics of the embryo, alterations in the karyotype of the parents, chromosomal alterations related to advanced maternal age or semen with pathologies. There is a growing number of studies linking the increased incidence of miscarriage to paternal age.
Immunological or coagulation disorders in the mother, such as antiphospholipid syndrome, are one of the main causes of miscarriages of known origin.
Infections during the first trimester, such as cytomegalovirus infection, toxoplasmosis or rubella, can be a trigger for miscarriage. Other reasons for repeated miscarriages can be uterine malformations, cervical incompetence or even the presence of myomas in the uterine cavity.
As for unknown causes, we know that a large percentage of recurrent miscarriages will not reveal any cause.
There are other factors that put the outcome of a pregnancy at risk and increase the rate of recurrent miscarriages and complications during pregnancy.
Examples of these are: maternal obesity, associated pathologies such as arterial hypertension or diabetes, and also multiple pregnancies. That is why at IVF-Life we have the technology and experience to transfer a single embryo without affecting our success rates.
Patients frequently ask us about causes such as quality of life and stress, and although studies are not conclusive, it seems that lifestyle does have a direct influence on pregnancy loss.
In order to prevent further miscarriages, we must carry out different studies and evaluate all the factors. We will study the blood karyotypes of the parents beforehand. Sometimes the Preimplantational Genetic Test can be performed to rule out structural alterations. Some of these chromosomal abnormalities compromise the viability of the embryo, leading to implantation failure or miscarriage, and others would lead to a disease in the future baby.
We can also carry out the pre-implantation genetic test for aneuploidy (PGT-A). We carry out a genetic study for the detection of aneuploidies associated with advanced maternal age or pathological semen. In this way, we can select the embryos with the greatest capacity to implant and give rise to a viable pregnancy.
Serologies are also necessary at the beginning of treatment to rule out pathologies already mentioned in this article such as rubella, cytomegalovirus and toxoplasmosis.
We will perform an ultrasound or hysterosalpingography (HSG) study. This test evaluates the shape of the uterus and checks if the fallopian tubes are permeable. This will help us to rule out uterine malformations or fibroids.
It is important to carry out a study of thrombophilias, or blood clotting disorders, as they tend to form clots or thrombus.
IVF-Life's assisted reproduction specialists recommend having as healthy a lifestyle as possible, both physically and psychologically, during the first weeks. It is important to do this after the transfer and once the implantation of the embryo and pregnancy have been confirmed.
During this period, it is also advisable to control risk factors. Avoiding the consumption of tobacco and alcohol is fundamental, as well as ensuring adequate levels of vitamins such as folic acid and vitamin D.
At IVF-Life we believe that our capacity to provide a reproductive response to each patient is born thanks to the individualisation of each process. For this reason, we are committed to offering patients a treatment plan that meets their needs.