tag:blogger.com,1999:blog-10528990.post570985616815525787..comments2024-02-29T18:17:24.038+05:30Comments on The IVF Specialist's Blog for IVF patients: Why do women who miscarry feel they need surrogacy ?Dr Aniruddha Malpanihttp://www.blogger.com/profile/05693466221743076739noreply@blogger.comBlogger7125tag:blogger.com,1999:blog-10528990.post-43955333144184480882014-05-19T19:05:34.368+05:302014-05-19T19:05:34.368+05:30Dear Lauren,
Thanks for your comments.
I agree ...Dear Lauren,<br /><br />Thanks for your comments. <br /><br />I agree it's unfair to generalise, and there will always be exceptions, but lots of studies show that most women who have miscarried do suffer from low self-esteem . They feel their bodies have let them down. <br />Dr Aniruddha Malpanihttps://www.blogger.com/profile/05693466221743076739noreply@blogger.comtag:blogger.com,1999:blog-10528990.post-83082657624117838892014-05-19T17:48:50.340+05:302014-05-19T17:48:50.340+05:30'A woman who has had recurrent pregnancy losse...'A woman who has had recurrent pregnancy losses has very low self-esteem.'<br /><br />Please... this is a very narrow minded view. I have now had 6 miscarriages and one ectopic. We also have a very healthy 5 yr old girl. And I have a very healthy self esteem. It is rude and ignorant to suggest that women who've had recurrent miscarriages have a low self esteem. I think if you are working with women who have had these experiences you need to be more respectful. <br />Laurenhttps://www.blogger.com/profile/10631401587876692062noreply@blogger.comtag:blogger.com,1999:blog-10528990.post-33774493334719382902012-11-26T13:12:51.708+05:302012-11-26T13:12:51.708+05:30Hello Dr.Malpani,
I am a 33 year old woman from Ba...Hello Dr.Malpani,<br />I am a 33 year old woman from Bangalore. I have suffered 3 recurrent miscarriages in the last 7 years because of autoimmune disorder that showed in blood tests for Lupus Anticoagulant being highly positive although I do not have any SLE. In all 3 pregnancies I the fetal growth was retared by 18 weeks due to very high blood flow resistence in both the uterine arteries although I was on high dose fragmine 5000 units twice a day in the third one. Now we have decided to try surrogacy as the final attempt. I would like to know that because I coud concive naturally first 3 times, is the chance of IVF cycle being sucessful be high . Request your opinion on this.Arunanoreply@blogger.comtag:blogger.com,1999:blog-10528990.post-19155156565980604692011-03-08T22:16:17.084+05:302011-03-08T22:16:17.084+05:30I agree that a better option for these patients is...I agree that a better option for these patients is to use donor gametes, rather than to use a surrogate.<br /><br />It's complex and confusing issue - and causes a lot of heartburn for doctors and patients as well. <br /><br />We all have our personal worldviews - and the prisms we look at the world sometimes distorts reality, so we end up seeing only what we want to see !<br /><br />Dr Aniruddha Malpani, MD<br />Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba<br />Bombay 400 005. India<br />Tel: 91-22-22151065, 22151066, 2218 3270, 65527073<br /><br />Helping you to build your family !<br /><br />PS Watch our infertility cartoon film at http://www.ivfindia.com<br /><br />Read our book, How to Have a Baby - A Guide for the Infertile Couple,<br />online at www.DrMalpani.com !<br /><br />Read my blog about improving the doctor-patient <br />relationship at http://doctorandpatient.blogspot.com/Dr Aniruddha Malpanihttps://www.blogger.com/profile/05693466221743076739noreply@blogger.comtag:blogger.com,1999:blog-10528990.post-45195801216090294492011-03-08T21:36:43.285+05:302011-03-08T21:36:43.285+05:30Yes, thankfully the percentage of repeat late misc...Yes, thankfully the percentage of repeat late miscarriers is indeed tiny.<br /><br />But I think once you move into the second trimester, where organogenesis has been completed, the chance of a genetic abnormality driving the loss becomes really minuscule, especially if the in-depth ultrasounds they do at week 16 and 20 show that organ development did indeed occur normally, and you find that the chromosomes are normal by karyotype.<br /><br />The exception where genetics can drive loss in the 2nd and 3rd trimesters, is often in the case of a genetic mismatch between the mom and dad- I attended a fascinating journal club (a paper in the Journal of Clinical Investigation) which basically showed that certain rare HLA (I think) pairings between the mom and dad create a very high risk scenario for pre-eclampsia and also pregnancy loss, and that is NK cell driven. The study was basically talking about genetic screening for risk. If it is identified, an egg or a sperm donor might be considered.Anonymoushttps://www.blogger.com/profile/15553205805046479504noreply@blogger.comtag:blogger.com,1999:blog-10528990.post-23768153766966372722011-03-08T12:12:35.438+05:302011-03-08T12:12:35.438+05:30I agree that the option should be offered . My poi...I agree that the option should be offered . My point is only that this group ( women with recurrent pregnancy loss who really need surrogacy for medical grounds) is very small !<br /><br />Also, a normal chromosome report for the products of conception does NOT rule out a genetic problem. Lots of genetic problems are very subtle and will not show up on a chromosome study.<br /><br />The rule, " If you hear hooves, think of horses, not zebras ", still applies !<br /><br />Dr Aniruddha Malpani, MD<br />Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba<br />Bombay 400 005. India<br />Tel: 91-22-22151065, 22151066, 2218 3270, 65527073<br /><br />Helping you to build your family !<br /><br />PS Watch our infertility cartoon film at http://www.ivfindia.com<br /><br />Read our book, How to Have a Baby - A Guide for the Infertile Couple,<br />online at www.DrMalpani.com !<br /><br />Read my blog about improving the doctor-patient <br />relationship at http://doctorandpatient.blogspot.com/Dr Aniruddha Malpanihttps://www.blogger.com/profile/05693466221743076739noreply@blogger.comtag:blogger.com,1999:blog-10528990.post-68582621991104946522011-03-08T11:37:04.271+05:302011-03-08T11:37:04.271+05:30This is true for the most part, However, as an imm...This is true for the most part, However, as an immunologist, I would have to point out that a small subset of women with a healthy uterus and a normal embryo still can be at risk for significant pregnancy complications if they suffer from autoimmunity.<br /><br />While NK cell and Th-1 mediated to pregnancy is still controversial, nobody can argue anymore that certain autoantibodies are most definitely linked to pregnancy loss. For example, anti-phospholipid antibodies that often result in second trimester loss, or anti-ro/la antibodies linked to congenital heart block in babies. While a lot of this is treatable and can be managed in unarguably high risk pregnancies, there are some women where possibly the battle against their immune system cannot be won. I know a couple of cases of women who have had 4-5 losses between 12 and 20 weeks. In such women, it is unlikely to be chromosomally abberent eggs, especially when a products of conception test establishes that the embryos were chromosomally normal.<br /><br />Such women should be given the option of surrogacy IMO, but these are, thankfully, a rare group.Anonymoushttps://www.blogger.com/profile/15553205805046479504noreply@blogger.com