The focus of IVF is to help infertile couples get pregnant. However, there are times when we have women coming in for consultation, who have had no trouble getting pregnant, but have suffered recurrent miscarriages ( pregnancy losses) . Typically, a recurrent miscarriage is said to have occurred when a woman loses 2 or more pregnancies. In most instances, these losses occur in the first trimester.
For those who are wondering what this has to do with infertility and why these patients are consulting an IVF doctor, when their problem isn’t with getting pregnant, it’s with keeping the pregnancy- read on.
Reasons for Recurrent Miscarriage
There are a number of possible reasons for recurrent pregnancy loss, but in almost 50% of cases, a specific cause isn’t identified. The most common causes of miscarriages include:
• Chromosomal abnormalities in 1/both the parents
• Cervical incompetence
• Anatomic abnormalities of the uterus
• Blood clotting disorders
• Systemic diseases (e.g. Lupus)
Another contributing factor in miscarriages is maternal age. Women who are 35 years and older tend to have significantly higher recurrent pregnancy loss rates compared to younger women. The reason why age is a factor is because the chances of older women having chromosomally abnormal eggs are much higher. These abnormalities impact the development of the embryos negatively.
However, there are a range of possible treatments for couples who have suffered recurrent miscarriages. These treatments effectively reduce the risk of miscarriages in future pregnancies. The different treatments include:
• Structural abnormalities within the uterus can be surgically corrected
• Often, hormone abnormalities, autoimmune factors and blood clotting disorders can be treated with medications
• Currently, in IVF, there isn’t any technology that can be used to alter chromosomes either in the sperm or eggs, we are able to distinguish which embryos are chromosomally normal and which aren’t. This is called IVF with PGS (preimplantation genetic screening). Using this technique, our embryologist selects the embryos that are chromosomally normal and should be transferred to the woman’s uterus . The others which are genetically abnormal are discarded, as they would have led to a miscarriage.
IVF- The Best Option
Today IVF has high success rates, when carried out at a credible and reputed clinic. I hope this clears your doubts about why a lot of couples who have been suffering recurrent miscarriages come to us for treatment.
For older women with recurrent miscarriages, often the best option is to use donor eggs. Since the eggs are younger, the embryos are much more likely to be normal, which means that the risk of a miscarriage goes down dramatically. Of course, this can be a very emotionally difficult decision to make.
Lots of women who have had recurrent miscarriages come to us because they want us to do surrogacy for them. While we do have an active surrogacy program, this is actually not a useful option for them. The problem with them is not their uterus, but their embryos, which means that changing the uterus will not help them to have a baby.
Need more information? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !