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This section is written in partnership with UR Vistahermosa experts from Spain.

Recurrent Miscarriages

Comprehensive study and solutions for the possible causes

We want a child… Will we be able to have one? Can we avoid having another miscarriage?

Recurrent miscarriages have a strong impact on a couple’s emotional state and are a disappointing situation for medical professionals, as well as a challenge. Miscarriage is the most common complication in pregnancies, as 15 to 20% of all pregnancies end in miscarriage. However, the likelihood that a couple will have two or more repeated miscarriages is less than 5%, and this requires a study of the related and predictive factors of a new miscarriage.

Many factors influence recurrent miscarriages, but a woman’s age is critical, doubling the initial risk starting at 40 years, nearing 40 to 80%. In other words, more than half the pregnancies in women over 40 may end in a miscarriage.

The recommendation is to initiate a miscarriage study after two have occurred, but we must individualize each case, considering the age, personal and family history, circumstances surrounding gestational losses, and the couple’s emotional state.

Possible causes of miscarriage include genetics, immune, uterine disorders, thrombophilia, microbiome alteration, infections, endometritis, etc., and treatments vary depending on the condition.

Alterations in the embryo

Up to 70% of embryos in patients with recurrent miscarriages have chromosomal alterations. In vitro fertilization with preimplantation genetic testing (PGT-A) carries out a chromosome analysis of embryos before transfer, which helps prevent miscarriages.

Endocrine diseases:

thyroid disorders or diabetes

Their treatment, together with healthy lifestyle habits, may improve chances of completing the period of gestation.

Alterations in coagulation:

thrombophilia testing

When confirmed, it may be treated with heparin.

Immune causes:

Am I compatible with my partner?

These are difficult to prove, but may be treated with corticosteroids or the transfer of a single embryo.

Alterations of the uterine cavity

A hysteroscopy is the best way to assess the uterine cavity to confirm a pathology and treat it at the same time. It also allows us to take samples for an endometritis study, for example.

Alterations in the sperm

A link between sperm DNA fragmentation and miscarriage has been established. In this regard, antioxidants and treatments such as annexin columns or MACS allow us to select the best sperm. In other cases, the result of the sperm FISH analysis is not within range and performing preimplantation embryonic genetic testing (PGT-A) may decrease the likelihood of miscarriage.

Psychological factor

Psychological support and care during the first few months of pregnancy are very important in these couples.

At the UR HLA Inmaculada, we conduct a comprehensive study of miscarriages

We advise and offer solutions for each of the possible causes, to achieve the best uterine receptivity and chromosomally tested embryos, thus lowering the likelihood of a miscarriage and increasing your chances of bringing a healthy child home.

Article source:
This article has been published in Creando Familias magazine by UR Vistahermosa clinic from Spain.

Dr. Bárbara Romero
Dr. Bárbara Romero
Gynecologist, UR HLA Inmaculada

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