Recurrent miscarriage defined as three or more consecutive pregnancy loss.
Majority are due to genetic defects & chromosomal abnormalities.
Advanced maternal age- As women ages quality of eggs reduces, which result in poor quality of embryos formation leading to repeated miscarriage.
Anatomical defects of uterus– In conditions like fibroid, polyp, adhesions, scarring, & septum which may be present by birth, results in impaired growth & development of embryos.
Infections seen in ≈ 15% of early pregnancy loss.
Endocrine/ Hormonal factors– Thyroid problems, uncontrolled diabetes.
Immunological Factors– Sometimes make a lady more prone to clotting can result in miscarriage.
In spite of all these conditions there is still very good chance of conceiving & having baby.
Treatment depends on cause detected during initial evaluation:
• Anatomical defects– Surgical removal of polyp, fibroid, septum, scarring is done.
• Immunological factors– In such cases we put the patient on Aspirin, blood thinning, injections like heparin.
• Endocrinal problems– Patient are put on medicines to correct endocrinal defects first.
• Advanced maternal age/ genetic defects– We use IVF technique in which embryo selection is done in laboratory. In few cases where embryo quality is too poor, we have to use donor egg.
IVF is a process in which egg & sperms are fertilized in the lab, resulting embryos is grown for few days in lab so the best embryos is selected & transfer in uterus. This helps in reduction of miscarriage rate.