Recurrent Abortions: Investigations Offer a Path to Future Fertility

Recurring Miscarriages Aren’t Inevitable, Local Doctor Explains

Râmnicu Vâlcea, Romania – Experiencing multiple miscarriages can be devastating, impacting women not only physically but also emotionally. Though, a local obstetrician-gynecologist is urging women to seek professional medical evaluation rather then relying solely on online searches, emphasizing that recurring miscarriages are frequently enough treatable.

Dr. cosmina Brummer Le roux stresses the importance of accurate diagnosis, stating, “Many patients panic and turn to ‘Dr. Google,’ but the correct answer comes only in the doctor’s office.”

The causes of recurrent miscarriage are diverse, ranging from genetic and hormonal factors to uterine abnormalities, immunological disorders, and infections. Lifestyle choices like smoking, chronic stress, and excessive caffeine intake can also play a role.

Dr. Le Roux highlights that conditions like thrombophilia and chromosomal or genetic issues are frequently underlying causes, but crucially, these can be identified through readily available testing. “Genetic tests and blood coagulation investigations are essential,” she explains, noting they can be completed quickly, with results available within days.

This identification allows for a personalized medical plan designed to improve the chances of a prosperous future pregnancy. Dr. Le Roux advises couples to avoid rushing into another attempt, recommending a waiting period of at least one month, ideally three, after a loss. Planning, such as oral medications for conditions like thrombophilia, can significantly increase the likelihood of a healthy pregnancy.

“It’s good to do a specialized medical control and not to look for the ‘Google doctor’,” Dr.Le Roux advises, “We can take measures in time to help the patient for future pregnancies.”

Dr. Cosmina Brummer Le Roux’s office is located at Str. Rapsodiei 14, bl. D1-3,sc. B, ap.3 in Râmnicu Vâlcea.Appointments can be scheduled by calling 0250 744 151 or 0746 106 325.

What are the typical diagnostic investigations performed too identify the cause of recurrent pregnancy loss?

Understanding Recurrent Pregnancy Loss (RPL)

Recurrent pregnancy loss (RPL),often referred to as recurrent miscarriage or recurrent abortion,is defined as two or more failed pregnancies ending before 20 weeks gestation. This is a deeply distressing experience for individuals adn couples trying to build a family. While a single miscarriage is relatively common, affecting around 10-20% of known pregnancies, RPL affects approximately 1-5% of couples.Understanding the potential causes and available investigations is crucial for improving the chances of a triumphant future pregnancy. Terms frequently searched alongside RPL include “multiple miscarriages,” “failed IVF pregnancies,” and “pregnancy loss specialist.”

Common Causes of Recurrent Miscarriage

Pinpointing the exact cause of RPL can be challenging, as frequently enough multiple factors are at play. Here’s a breakdown of the moast frequently identified contributors:

Genetic Factors: Chromosomal abnormalities in either partner or in the developing embryo are a critically important cause, accounting for approximately 50% of RPL cases. These can include balanced translocations, inversions, or numerical abnormalities.

Uterine Abnormalities: structural issues with the uterus, such as a septate uterus (a wall dividing the uterus), fibroids, polyps, or asherman’s syndrome (scar tissue within the uterus), can hinder implantation and fetal advancement.

Hormonal Imbalances: Conditions like Polycystic ovary Syndrome (PCOS), thyroid disorders (hypothyroidism or hyperthyroidism), uncontrolled diabetes, and luteal phase defect (insufficient progesterone production) can negatively impact pregnancy.

Antiphospholipid Syndrome (APS): An autoimmune disorder where the body produces antibodies that attack phospholipids, increasing the risk of blood clots in the placenta.

Thrombophilias: Inherited or acquired conditions that increase the risk of blood clotting, perhaps disrupting blood flow to the placenta. Examples include Factor V Leiden mutation and prothrombin gene mutation.

Unexplained RPL: Despite thorough investigation, a cause remains unidentified in approximately 30-50% of RPL cases. This is often termed “unexplained recurrent pregnancy loss.”

The Investigative Process: what to Expect

A thorough evaluation for RPL typically involves a series of tests for both partners. The goal is to identify any underlying factors contributing to the losses.

For the Woman:

1. Medical History & Physical Exam: A detailed review of your medical history, including previous pregnancies, medical conditions, medications, and lifestyle factors.
2. Hormonal Evaluation: Blood tests to assess thyroid function (TSH, T4), prolactin levels, and potentially other hormones depending on individual circumstances.
3. Uterine Evaluation:

Hysterosalpingogram (HSG): An X-ray procedure to assess the shape of the uterus and patency of the fallopian tubes.

Saline Infusion Sonohysterography (SIS): An ultrasound procedure where saline is injected into the uterus to visualize the uterine cavity.

Hysteroscopy: A minimally invasive procedure where a small camera is inserted into the uterus to directly visualize the uterine lining.

1. Genetic Testing:

Karyotype: Analysis of your chromosomes to identify any structural abnormalities.

Testing for Inherited Thrombophilias: Blood tests to identify genetic predispositions to blood clotting.

1. Autoimmune screening: Tests for antiphospholipid antibodies (aPL), lupus anticoagulant, and anticardiolipin antibodies.

For the Man:

1. Semen Analysis: Evaluates sperm count, motility, and morphology.
2. Karyotype: Chromosome analysis to rule out genetic factors.
3. DNA Fragmentation Testing: assesses the integrity of the sperm’s DNA.

Treatment Options Based on Diagnosis

Treatment strategies are tailored to the specific cause identified during the investigation.

Genetic Abnormalities: Preimplantation Genetic Testing (PGT) during IVF can screen embryos for chromosomal abnormalities before transfer. Donor eggs or sperm may be considered in some cases.

Uterine Abnormalities: Surgical correction of uterine abnormalities (e.g., hysteroscopic resection of a septate uterus or fibroids) can improve implantation rates.

Hormonal Imbalances: Hormone therapy (e.g., progesterone supplementation, thyroid hormone replacement) can definitely help optimize the uterine surroundings.

antiphospholipid Syndrome (APS): Treatment typically involves low-dose aspirin and heparin injections during pregnancy to prevent blood clots.

Thrombophilias: Similar to APS, treatment may involve low-dose aspirin