What is recurrent miscarriage?

If you have three or more miscarriages in a row, doctors call it recurrent miscarriage. If you have experienced recurrent miscarriage, your GP or midwife will refer you to a gynaecologist. Your gynaecologist will try to identify the reason for your losses.

Having miscarriage after miscarriage may leave you feeling utterly drained of hope. At times, it may be hard to keep trusting in the future. This experience affects every aspect of a woman s life from her mental and emotional health to her physical health and social well-being. 

If you can, try to draw comfort from the fact that most women who experience recurrent losses do go on to have a baby. This is especially the case if tests can find no reason for the losses. Six out of 10 women who have had three miscarriages will go on to have a baby in their next pregnancy.

Treatment of Recurrent Pregnancy Loss

Treatment for anatomic abnormalities of the uterus involves surgical restoration through removal of local lesions such as fibroids, scar tissue and endometrial polyps or timely insertion of a cervical cerclage (a stitch placed around the neck of the weakened cervix) or the excision of a uterine septum when indicated.

A thin endometrial lining has been shown to correlate with compromised pregnancy outcome. Often times this will be associated with reduced resistance to blood flow to the endometrium. Such decreased blood flow to the uterus can be improved through treatment with sildenafil (Viagra), Terbutaline and possibly aspirin.

Sildenafil (Viagra) Therapy Viagra has been used successfully to increase uterine blood flow. However, to be effective it must be administered starting as soon as the period stops up until the day of ovulation and it must be administered vaginally (not orally). Viagra in the form of vaginal suppositories given in the dosage of 25 mg four times a day has been shown to increase uterine blood flow as well as thickness of the uterine lining. To date, we have seen significant improvement of the thickness of the uterine lining in about 70% of women treated. Successful pregnancy resulted in 42% of women who responded to the Viagra. It should be remembered that most of these women had previously experienced repeated IVF failures.

Terbutaline this is a medication that relaxes the muscle in the uterine wall and so permits improved hormone delivery to the endometrium. The use of Terbutaline will often cause an increase in heart rate. It should not be prescribed to women who have irregular heart beats (arrhythmias), and women who have decreased cardiac reserve.

Aspirin this is an antiprostaglandin that improves blood flow to the endometrium. It is administered at a dosage of 81mg orally, daily from the beginning of the cycle until ovulation.

Selective Immunotherapy Using Intralipid, heparin, aspirin and corticosteroid

Many causes of pregnancy loss or failure can be treated with immunotherapy comprising combinations of aspirin and heparin and corticosteroids (dexamethasone or prednisone) and Intralipid (IL) to regulate increased NKa. Achievement of optimal success with Intralipid/corticosteroid therapy requires that the treatment be initiated well before ovulation takes place (about 7-14 days prior to anticipated implantation). Given the fact that only 10-15% of natural cycles (with or without the use of insemination and/or fertility drugs) will result in a pregnancy, it follows that repeated administration of Intralipid will be required in most cases before a pregnancy will occur. IVF achieves pregnancy rates that are often 2-3 times higher. This often makes IVF a treatment of choice in cases of immunologic recurrent pregnancy loss.

Role of IVF

Preimplantation genetic diagnosis (PGD) a procedure whereby the embryo can be tested for genetic or structural chromosomal abnormalities requires the use of IVF to select the best embryo(s) for transfer to the uterus. In cases of structural chromosomal (translocations) egg or sperm donation is often another option worth considering.

In those cases where due to intractable anatomical or alloimmune dysfunction IVF repeatedly is unsuccessful or is not an option, Gestational Surrogacy might represent the only recourse other than adoption.
If a couple with Recurrent Pregnancy Loss is open to all of the diagnostic and treatment options referred to above, a live birth rate of 70%   80% is ultimately achievable.

Recurrent Miscarriage - How to Deal With It?

Endometriosis is a condition where the endometrial tissue lining the womb, grows outside the urethral lining. This can cause severe pelvic pain and a host of other complications, if it is not treated on time. 

Here is everything you need to know about this ailment.


- symptoms: owing to the location of this tissue and its painful protrusion through the lining or walls of the womb, one of the earliest and most painful symptoms experienced may include severe cramps and pain during the menstrual cycle. Also, the patient will experience pain in the lower abdomen region about a week before the onset of the cycle. Heavy bleeding as well as infertility may be experienced in such cases too. Sexual intercourse will also give rise to pain in the region, while discomfort will be felt during the bowel movements. Pain in the lower back will also be experienced throughout the menstruation period. 


- stages: there are several stages of this disease and its progression, each of which will require a different form of treatment. These four stages usually depend on the location, size, depth and number of the endometrial implants within the body of the patient.


- minimal stages: in this stage, usually there will be small wounds and lesions as well as shallow implants on the ovaries. Inflammation in the pelvic cavity can also be felt in this stage.


- mild stage: in this stage, there will also be light lesions and shallow implants which will spread over the ovaries as well as the pelvic lining.


- moderate stage: in this stage, the implants will dig deeper into the ovaries and the pelvic lining, which will result in the growth of even more lesions.


- severe stage: as the name suggests, in this stage the patient will experience deep implants along with lesions in the bowels and the fallopian tubes.


- treatment: there are varied forms of this treatment including pain relief medication for minimal to mild stage patients. Also, hormonal therapy with the help of supplements may be prescribed. Hormonal contraceptives may also be used. In such cases, medication like danazol, medroxyprogesterone, 

Gonadotripin releasing hormone agonists, and other such elements may be prescribed. Conservative surgery and radical surgery may follow, depending on the severity of the condition. Laparoscopy is the preferred form of treatment in such cases. A hysterectomy can be conducted as a final resort where the surgeon will remove the cervix as well as the uterus of the patient. This will make pregnancy impossible for the patient, thereafter. To stem estrogen production, the ovaries will also be removed. 


One must discuss all risks and complications before going in for a certain form of treatment for this ailment.

Symptoms, Stages and Treatment of Endometriosis

Recurrent miscarriage is a condition when there has been three or more successive pregnancy losses. It is different from infertility as, infertility is the inability to conceive. For many cases, the cause of a recurrent miscarriage has not always been found. A number of factors can cause recurrent miscarriages of which some are treatable.It may not always be possible to identify a cause for recurrent miscarriage in a couple, even after extensive research and treatment procedures. Some of the common causes of recurrent miscarriage are described below:
1. Chromosomal abnormalities: Incompatible chromosomes can result into pregnancy losses. When an egg and a sperm meet, of which one of them is faulty, they can't line up properly resulting into chromosomal abnormality. Such conditions lead to miscarriages.
2. Uterine abnormalities or Incompetent cervixes: Miscarriages occur if the uterus is abnormally shaped since the embryo is not properly implanted or even if it gets implanted, it may not get sufficient nourishment to survive. If the woman has a weak cervix, it cannot hold the developing embryo, leading to miscarriage.
3.  Immunologic disorders: Under rare cases, the embryo itself is not accepted by the body. Antiphospholipid antibodies are those, which attack self tissues, such as embryos and prevent them from building up. This leads to recurrent miscarriage.
4. Untreated thyroid problems: Conditions such as thyroid or uncontrolled diabetes result in uterine conditions which make it tough for the embryos to survive.
5. Polycystic ovary syndrome: Women with polycystic ovary syndrome tend to have high levels of male hormones which, result in irregular menstruation and ovulation. This can prevent the lining of the endometrium from maturing that is required for holding the embryo.
6. Bacterial infections: There may be presence of a number of microorganisms inside the reproductive tract that may be harmless for the person. But there may be certain bacteria lined up in the reproductive tract, which can prevent development of embryo, thus leading to miscarriages.
7.  Lifestyle: Smoking and drinking are harmful lifestyle habits, which may increase the chance of miscarriage to a great extent. It is always advised to avoid smoking or drinking when you wish to conceive. Other lifestyle conditions, such as working in certain environments like hospital environments, farms, laboratories, etc, may lead to miscarriages; however, the exact reason has not been identified yet.

Reasons For Recurrent Miscarriage

Every woman desires to experience the sweetness of motherhood but unfortunately, some fail to get it. It is because either they have low fertility or because they have developed a disease or disorder like endometriosis and Polycystic Ovary Syndrome (PCOS) due to which they fail to conceive.

Endometriosis is always associated with infertility. To get relief from troublesome problem is to get pregnant earliest may be by IUI if tubes are patent or by IVF. Endometriosis is conditions which lead the womb cells (endometrial cells) to develop in other parts of the body because of which women experiencing this disease fail to release the menstrual blood and also fail to conceive. But these days nothing is impossible it this medical advancement era. There are many ways and methods by which one can conceive.

So here we are providing a useful set of information on some of the best Fertility treatments.

Intrauterine Insemination or Artificial Insemination: It is a normal process in which the sample of a prepared sperm from the husband or the partner is injected directly into woman s uterine cavity during ovulation.
In Vitro Fertilization: In this process, specific medication is used for the stimulation of the ovaries which lead them to produce more eggs in a while. Then eggs are then removed and fertilized with the husband or partner s sperm in a laboratory. The fertilized eggs are placed for 3-5 days to develop an embryo and then the embryo is transferred to woman s uterus.
It is considered as one of the best and last stop infertility solution which proves to be a boon for a sterile couple. As in this process, fertilization takes place outside the body because of which there is no problem of conception even in the condition of any blockage and also minimizes the risk of endometriosis-related infertility. The endometriotic deposits produce and releases toxin into the uterus, fallopian tubes and ovaries thus the egg gets toxic and fail to fertilize the sperm. 

In such condition, many patients rush for many other infertility treatments like fertility medications, intrauterine insemination, etc and when they lose hope of getting the desired result then they find a ray of hope by this ultimate treatment. There are five times more chances of conceiving by this method regardless of the age of women and the stage of endometriosis. The treatment is a boon not only for woman grappling with endometriosis but also for other critical issues like severe male infertility factor, blocked fallopian tubes, and reduced ovarian reserves. In such cases instead of wasting the money on other treatments doctors advice for IVF.

IVF minimizes the chances of miscarriage and also increases the chances of having a healthy baby. So if you are grappling with any such infertility issue than this informative guide may aid you in the journey from infertility to hearing child squeal at your home.



Endometriosis - How IVF Is Beneficial In This Case?

Intracytoplasmic Sperm Injection i.e. ICSI is different from conventional IVF i.e. In Vitro Fertilization because a single sperm is selected by the embryologist to be injected by a needle into the egg rather than a dish with many sperms placed near the egg so that the fastest swimming sperm enters it. Once the sperm is injected directly into the egg, it fertilizes, after which the embryo is transferred into the womb or uterus. 

Your doctor might recommend ICSI treatment for you if you have an extremely low sperm count resulting in infertility or other medical sperm conditions such as poor motility or poor morphology. It may also be suggested if prior attempts at IVF procedures have failed in fertilizing the egg or the fertilization rate is extremely low. You must also consider ICSI treatment if you resort to embryo testing or if the sperm needs to be collected from the epididymis or testicles surgically. 

However, you must keep in mind that if your partner has a genetic problem resulting in low sperm count, it could be passed on to your child, if you decide to use your husband's sperm for this process.

Success Rates of ICSI:
The success rate of ICSI treatment depends on your age and your fertility problem. Your eggs are healthier when you are young and as you age, chances are that they will become less healthy.
1. 35 per cent if you are under 35 years of age
2. 29 per cent if you are between 35 to 37 years of age
3. 21 per cent if you are between 38 to 39 years of age
4. 14 per cent if you are between 40 to 42 years of age
5. 6 per cent if you are between 43 to 44 years of age
6. 5 per cent if you are above 44 years of age

Advantages of ICSI Treatment:
Intracytoplasmic Sperm Injection gives you a chance to conceive a child genetically when most other options are exhausted. Males may be unable to ejaculate on the day the eggs are collected due to anxiety. ICSI proves to be advantageous because sperm may also be surgically extracted for this process. It is extremely helpful for those couples who suffer from unexplained infertility. However, one of the most important factors is that ICSI treatment does not affect your child's physical or mental health.

Intracytoplasmic Sperm Injection (ICSI)

Our digestive system is made up of a complex set up of organs, enzymes, secretions and much more. In order to ensure that they all function in tandem with each other so that our digestion works properly, we need to take many measures. Solid food and liquids both go hand in hand when it comes to digesting your food properly. Water is one of the main elements that one must ingest regularly during the day so that the body remains hydrated and the stool also softens. It is also a digestive aid. Yet, there are two varied schools of thought when it comes to drinking water during one s meals. While some people say that it is good, there are others who say that it should not be practiced. So let us find out whether having water during your meals is a good thing or not.

Stomach Acids: If we are to look at water during a meal from the perspective of our stomach acids, then most doctors will tell you that there is no problem in having water with your food. The main doubt here is whether or not the acidic fluid flowing through our stomach may become too diluted with the consumption of water. However, this does not happen. Various medical studies conducted by reliable hospitals and sources under a controlled environment have shown that the stomach s oH balance is not affected by the consumption of water during a meal.
Digestive Process: While the stomach acids may not suffer due to consumption of water during a meal, there are other schools of thought where people refrain from drinking water with food so that better digestion may be achieved. But this is also not entirely true. Digestion is well-known for being a complicated process where many elements need to work together for its proper functioning. This function includes a comfortable and healthy body and state of mind after one has a meal. Therefore, it is more important to have the right kind of food at the right time in a proper environment instead of rushing through one s meals and eating junk all the time.
Constipation and Overeating: Drinking water during the meal can help in curbing constipation as it helps in softening the stool. It also helps in clearing the food from the digestive track in a better and timely manner so that the toxins and stool do not remain there. This is due to the fact that drinking water during meals keeps the digestive track well-lubricated. Also, when you drink water with your meals, you tend to avoid overeating as water fills up substantial portion your stomach. Further, water has important nutrients that can suffice for your nutritional requirements along with food.

Drinking Water During Meals: Good or Bad?

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