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?

Haematuria refers to a medical condition where blood is passed out with urine. Blood can ooze out in tiny droplets or in large volume, often causing discomfort and pain.

Urine mostly has a reddish hue when you have this condition, and can be colored anything ranging from pink to a darkish brown. While in many cases this disease may be caused by trivial underlying issues, there may be major complications at work too. Hence, you should consult a doctor right away if you locate any symptoms such as abdominal pain, frequent urination, etc.

Causes of haematuria

Haematuria may be caused by factors both minor and severe. These include-

Urinary tract infection (UTI) - UTI is caused when foreign bodies like viruses or bacteria get accumulated in the urinary tract. This causes haematuria, as the kidneys may be affected leading to leakage of red blood cells into the urine.

Cancer - There are various types of cancer that may cause blood to come through the urine. These include prostate, renal and bladder cancer. This is a symptom visible during advanced stages of the cancers when treatment becomes difficult.

Kidney or gallbladder stones - This is another type of serious ailment that may cause haematuria as a symptom. The key difference from the other causal factors of haematuria is that in this case bleeding is very painful.

Traumatic injury to kidneys - A sharp hit or blunt attack to the kidneys you may sustain while falling down or a vehicle crash may cause internal injuries in the kidney and make blood show up in your urine.

Treating haematuria: What are the different approaches?

To treat haematuria, most doctors generally treat the underlying disease that is causing it as a symptom. The treatment entails-

Several types of anti-bacterial or antifungal agents are used to treat urinary tract infections. These medicines can both be prescribed by a doctor or bought over the counter.

Kidney and bladder stones may heal if you drink a lot of water. However, in very severe cases, you may need a surgical procedure called lithotripsy. Lithotripsy involves using ultrasound shock waves that break kidney stones into tiny particles and passes them out of your body.

For cancers, the extent of spread determines the treatment course recommendable. In general, chemotherapy, radiation therapy and surgery are the treatment modes used.

When the traumatic injury is the underlying factor, drugs or bandages may help, but you should also not ignore large injuries. In such cases, surgery may be required to set things right.

Haematuria is the medical name for the condition in which either small or large amounts of blood become visible in your urine. While this condition may be developing in you due to a number of reasons that may be minor, you should get yourself checked anyway.

Haematuria - Causes & Treatment Of It!

Many studies have shown that excessive caffeine intake affects your chances of conceiving by influencing the ovulation, hormone, and the fallopian tubes but the opinions on this issue are divided. However, research on this topic mostly indicates that, though caffeine can give you a kickstart in the morning, it can have quite a reverse effect on your efforts to conceive.

How intake of excessive caffeine reduces your chances of conceiving?

The fallopian tubes are responsible for carrying the eggs from ovaries to the uterus by rhythmic movements and too much caffeine can affect this movement and cause disruption in the journey of the eggs. Moreover, consuming more caffeine has also been associated with baby's growth restriction, miscarriages, and weight issues. It is preferable to get rid of caffeine altogether from your diet when you are trying to conceive but if you are an avid coffee drinker then you might want to cut back or replace your caffeine intake with milk and syrup which is far more healthy and beneficial.

Which foods and beverages do you need to avoid?

There are so many caffeinated foods and beverages, that it is almost impossible to avoid them. But it is better to take note of them so that you can regulate your caffeine intake. Coffee, tea, soft drinks, energy drinks are obvious sources of caffeine as they are supposed to give you energy. Some herbal teas also contain caffeine. Chocolate, ice creams and candies with coffee flavors, over the counter drugs for allergies, cold and headache also contain caffeine so it is important to read the ingredients list before consuming any of them.

To higher your chances of getting pregnant, it is important to cut back on caffeine. Most doctors are of the opinion that exceeding 50 mg of caffeine intake daily can seriously hamper your chances of conceiving.

How Excessive Caffeine can Stop you from Becoming Pregnant

Vaginitis is a vaginal disorder, which is characterized by pain, itching and inflammation. It is usually caused due to an imbalance of the bacteria in the vagina. It may also occur because of low estrogen levels after menopause.

Vaginitis is classified into four types:

Yeast Infections: These infections are caused by a fungus known as candida albicans.
Bacterial Vaginosis: This disease results from an imbalance of bacteria in the vagina.
Vaginal Atrophy: Vaginal atrophy (vaginal inflammation resulting from tissue shrinking and thinning) occurs due to low estrogen levels in the body.
Trichomoniasis: This disease is caused by a parasite and is usually transmitted through sexual intercourse.
The symptoms of this disorder are:

Itching in the vagina
Abnormal bleeding from the vagina
Intense pain while having sexual intercourse
Vaginal discharge that changes in color and amount
Intense pain while urinating
Note: The cause of the disorder depends on the type of vaginitis you have; bacterial vaginitis results from an imbalance of the bacteria in the vagina. Yeast infections result from an overgrowth of fungi in the vagina. Trichomoniasis is caused by a single celled parasite 'Trichomonas vaginalis'.

Vaginitis - 4 Common Types

4 Things that Cause Vaginal Dryness

Vaginal dryness is an uncomfortable and painful condition that usually occurs during or after menopause. The estrogen level in your body gets reduced during this time which eventually leads to vaginal dryness. However, there are other factors that can trigger this condition including certain medications and immune disorders. This is a problem that can affect women at any age but it is visible more frequently in older women.

Here are some common factors that may lead to vaginal dryness:

1. Hormonal changes - A decrease in estrogen level that occurs during menopause is one of the most common causes of vaginal dryness. The decrease in estrogen may also occur during perimenopause, during breastfeeding or after childbirth. Radiation and chemotherapy for cancer treatment may also result in a decrease in vaginal lubrication.

2. Irritants - Chemicals present in soaps, dyes, hygiene products and perfumes may cause allergy in some women. Irritants present in underwear or towels and other allergens like objects and lubricants that are placed in the vagina may also cause vaginal dryness.

3. Insufficient arousal - Low libido or other sexual problems may also lead to vaginal dryness. Poor sexual performance and early ejaculation may also contribute to it.

4. Anxiety - Sexual desire can be affected by emotional and psychological factors such as anxiety and stress that may eventually lead to vaginal dryness. High anxiety level in women results in insufficient flow of blood, causing vaginal dryness.

How can vaginal dryness be treated?

Topical estrogen therapy is a common method of treating vaginal dryness caused by low estrogen level. Topical estrogen helps in inserting some hormone that your body is no longer producing. This controls the vaginal symptoms to a certain extent but it does not replace as much estrogen as oral hormone therapy, in your blood stream. Lubricants and moisturizers may also be applied to reduce vaginal dryness and make sex less painful and uncomfortable.

Word of Caution

Please get a PAP Smear done before starting local estrogen and keep a follow up with your doctor.



4 Things that Cause Vaginal Dryness

Daljindar Kaur's inspiring story of motherhood: How IVF became her savior

The success of In vitro fertilization continues in India as a septuagenarian woman gives birth to a baby boy. Even after 46 years of marriage, the couple from Amritsar was childless. Daljinder Kaur, along with her 79-year-old husband, Mohinder Singh Gill, had been visiting National fertility and the Test Tube Baby Centre in Hisar since 2013 and did not give up even after two failed IVF cycles. They had faced ridicule for their inability to have a baby and yet they kept their hopes up.
On the 19th of April, the couple was blessed with a baby boy who is nothing less than a miracle. The groundbreaking achievement of the embryologists from Hisar has been an inspiration and a beacon of hope for couples all across the country. Once again, IVF has proved to be one of the most successful procedures to have babies for couples with fertility issues. Following are some of the advantages of In vitro fertilization, which you should know about-
1. It can be used by anybody
In-vitro fertilization is not necessarily used by the going to be a mother. It can be used by gestational carriers or by a surrogate as well. So it depends on whether the parents want to take the help of a surrogate or themselves want to be involved in the pregnancy. IVF gives an opportunity to single women and same-sex couples to become parents.
2. Use of donated eggs and sperms
There might be circumstances when the doctor can recommend using donated sperms or eggs. In that case, the eggs can be fertilized manually in the lab and the fetus developed can be used for in vitro fertilization. This increases the chance of pregnancy by a fair amount.
3. Control over timing
In vitro fertilization is a solution for couples who have a very engaging professional life, and can be an option for people who want to have babies after a certain point of time. Eggs and embryos can be preserved for future use. It is also helpful for couples who already have a child and plan to have another later.
4. Decreases chances of miscarriage
Genetic abnormality is one of the primary causes of miscarriage. The technique of preimplantation genetic diagnosis (PGD) is used to ensure the viability of the embryo much ahead of time so that the mother can have an uncomplicated pregnancy and carry her baby full term.



Daljindar Kaur's inspiring story of motherhood: How IVF became her savior

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