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Recurrent Pregnancy Loss: Is IVF The Answer?

Recurrent pregnancy loss can be devastating for couples. The significant emotional and physical impact of pregnancy loss can be long-lasting. We will be discussing recurrent pregnancy loss and its causes. Additionally, we will explore whether IVF may be the solution for this diagnosis.

What is Recurrent Pregnancy Loss?

Recurrent pregnancy loss is defined as two or more miscarriages. Typically, the definition includes pregnancies that were confirmed via pregnancy test or in the clinical via ultrasound. It is estimated that approximately 1 percent of women will experience repeated miscarriages.

What Are the Causes of Recurrent Pregnancy Loss?

There are several possible causes of recurrent pregnancy loss. These include:

  • Chromosomal causes: Chromosomal structure issues are potential causes of recurrent pregnancy loss. In approximately 4 percent of couples with a history of recurrent pregnancy loss, there is an abnormality in chromosomal structure in one or both partners. Chromosomal testing of both partners is often performed to rule out this issue.

  • Immunological causes: In 15 percent of couples with recurrent pregnancy loss, there are antibodies that interfere with the function of the placenta. In many cases of recurrent pregnancy loss, anti-phospholipid antibody testing is performed to rule out immunological causes of miscarriages.

  • Anatomical causes: Abnormalities in the uterine cavity may also contribute to recurrent pregnancy loss. In approximately 15 percent of cases of recurrent pregnancy loss, uterine abnormalities may be the cause. Potential abnormalities include fibroids, polyps or a uterine septum. Potential anatomical causes are diagnosed using ultrasound, hysterosalpingogram or laparoscopy/hysteroscopy.

  • Blood clotting disorders: In some cases, blood clotting disorders may increase the risk of recurrent pregnancy loss. Thrombophilia is a condition which can increase blood clots. There are several tests that can be performed to rule out thrombophilia as a cause for recurrent pregnancy loss.

  • Hormonal issues: Women with untreated thyroid issues and uncontrolled diabetes may be at a greater risk of miscarriage. During the workup for recurrent pregnancy loss, your provider will often include these tests.

  • Fetal chromosomal issues: Up to 70 percent of miscarriages are due to abnormalities in the number of chromosomes in the fetus. Although the likelihood increases with maternal age, abnormalities in chromosomal number can happen at any age.

Is IVF The Answer?

Increasingly, couples with recurrent pregnancy loss are turning to IVF. Since the majority of miscarriages are believed to be related to fetal chromosomal issues, preimplantation genetic testing can help screen for potential chromosomal issues prior to implantation. Transferring chromosomally normal embryos decreases the likelihood of miscarriage. Although many couples with recurrent pregnancy loss do not have fertility issues, IVF has become an increasingly common treatment which is aimed at improving the chance of a live birth.

Takeaway Message:

Recurrent pregnancy loss can take a significant toll on couples. There are many potential causes of recurrent pregnancy loss, with fetal chromosomal issues being the most common cause. In recent years, IVF has been used to screen embryos prior to transfer, thus improving the likelihood of live birth. It is important for couples with recurrent pregnancy loss to discuss their diagnosis and treatment options with their provider.

Have you been diagnosed with recurrent pregnancy loss? Have you considered IVF as a potential treatment? Please share in the comments below.

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