Recurrent pregnancy losses happen to a very small fraction of the population. Only 1% of couples are affected by it. Nevertheless, it is a very difficult and serious process to deal with due to the sensitivity of the issue. A woman is said to have recurrent pregnancy losses if she has lost 3 or more of her pregnancies. Although the exact reason for recurrent pregnancy losses are not known, there are several suggested reasons.

Reasons why it may happen 

Anomalies in the uterine lining such as polyps (abnormal tissue growth, usually in the cervix), or fibroid tumors can result in miscarriages if left untreated.
Hormonal factors such as thyroid malfunctions or pituitary problems can cause an imbalance in the luteinizing hormone (a hormone which triggers ovulation) resulting in miscarriage.
Age is also an issue one must keep in mind while addressing pregnancy losses. Women over the age of 35 are more likely to experience recurrent pregnancy losses. As women get closer to menopause, their bodies produce reduced levels of hormones and eggs which cater to a pregnancy. Therefore, due to the reduced levels of hormones, an older woman is susceptible to losing a baby as they have elevated levels of hormones and therefore are more fertile.
Lifestyle factors also have been linked to recurrent pregnancy losses. Constant exposure to toxic chemicals can result in pregnancy problems. Along with that, constant drug use, smoking and excessive consumption of alcohol are some of the lifestyle choices that can cause recurrent pregnancy losses.
Infections such as syphilis, malaria, measles, herpes simplex etc. can cause recurrent pregnancy symptoms if left untreated as they can obstruct and complicate the growth of the baby, resulting in premature development or pregnancy loss.
Management of Pregnancy Loss

Polyps and fibroid tumors are complicated disorders which should be given immediate medical attention. Although surgical methods are available, the best way to treat polyps and fibroid tumors is through the intake of progestin hormone pills which shrink the size of the polyps/cysts.
Eating a healthy diet to ensure the prevention of diabetes is highly recommended. Fruits, leafy green vegetables and whole grain cereals are a prerequisite for the complete growth of the baby as well as arming the body with the necessary strength it needs for pregnancy transitions as well as a stronger immune system.
A regular workout routine is also advised for pregnant women as it ensures a healthier and stronger immune system.
Although recurrent pregnancy loss is very emotionally debilitating for a woman and her partner, there are several means and measures to overcome this tragedy. One should not be disheartened by such an occurrence and get the required help needed.


Recurrent Pregnancy Loss - Possible Reasons Behind It!

Female infertility is considered as the inability of conceiving. As per WHO it is described as the inability to be pregnant, maintain and carry forward a pregnancy to its full term. It is often of two types:

    Primary Infertility: This is the inability to give birth to a baby either due to the inability to become pregnant or maintain a pregnancy, which includes stillborn and miscarriage.
    Secondary Infertility: This refers to the inability to give birth when there is already a live birth or the woman was pregnant.

The causes of infertility can vary from being acquired or genetic. However, following factors are largely responsible for infertility:

    Genetic: Some genes can lead to mutation leading to infertility like, in case of BMP15 gene there is a hypergonadotrophic ovarian failure which causes infertility.
    Acquired: This is caused by factors like age, smoking, sexually transmitted diseases, obesity, body weight, eating disorders, diseases like diabetes, thrombophilia and also radiation and chemotherapy.

The treatment for infertility usually depends on the cause, age, duration of time for which a person has been infertile and preference of the patient. Infertility is believed to be a complex disorder and the treatment involves a huge amount of physical, financial and psychological commitments. All this also requires a lot of time. Some women might need just a minimum of two therapies to attain fertility while others might require different treatment before they can conceive.

Treatment is largely aimed to restore the fertility either by means of medication and surgery or help in reproduction with the help of some procedures.

Fertility Restoration through medication

This is the main treatment for women who are infertile because of ovulation disorders. These drugs include:

    Gonadotropins: These are injected to stimulate the ovaries. Drugs like Menopur, Repronex, Follistim AQ, Gonal-F, Bravelle restore the production of eggs, while Ovidrel and Pregnyl are used for maturing the eggs and for their release.
    Clomiphene citrate: This is taken orally and stimulates ovulation by releasing more Follicle Stimulating Hormone and Luteinizing Hormone from the pituitary gland.
    Metformin: This is used in females who have PCOS and also when insulin resistance plays a major role in infertility.
    Bromocriptine: Used when the infertility is caused due to excess prolactin production.
    Letrozole: This also induces ovulation

Fertility Restoration through surgery

Surgical procedures can amend the problem of infertility. However, these treatments are very rare these days owing to the success of other fertility treatments. These include:

    Tubal ligation reversal surgery: In case a tubal ligation has been performed it can be reversed by reconnecting the tubes again through surgery.
    Hysteroscopic surgery: This corrects or removes the abnormalities that cause infertility. This surgery can correct the shape of the uterus, remove endometrial polyps and improve chance of getting pregnant.
    Tubal surgeries: In case of blocked fallopian tubes laproscopic surgery can be performed to dilate the tubes, removed blockages or create a new opening.

Assistance in Reproduction through techniques

The most common used techniques for reproduction assistance are:

    Intrauterine insemination or IUI: In this about million healthy sperms are put in the uterus at the time of ovulation.
    Assisted reproductive technology: In this mature eggs are retrieved from a woman and this is then fertilized with sperms in a dish in the lab. Once the fertilization is done the embryo is placed in the uterus for further development. IVF is the most common and effective assisted reproductive technology. This procedure takes place over weeks with several blood tests and hormone injections.

Dealing with infertility is not easy and can be emotionally and physically draining. To cope with the various tests and treatments of infertility one should be fully prepared, eat a healthy diet, exercise reach out for help and support of family and friends and look for other options like a donor egg, adoption or no children.

Treatments of Infertility

Menstrual disorders are caused by a variety of factors and affect every woman in a different manner. In most cases, it manifests itself in the form of fluctuations in menstrual flow and irregularity in the monthly cycle. Certain disorders are not too severe and can be easily alleviated. Others are more complicated and require the immediate attention of a gynecologist.

As mentioned, there are different specific causes of different kinds of disorders resulting from a range of factors such as hormone levels, functioning of the central nervous system, health of the uterus, etc. 

Some of the most common causes of menstrual disorders are as follows:

Hormonal imbalance
Fluctuating hormone levels in the body have a direct impact on the menstrual cycle. These fluctuations can be caused by dysfunction in the pituitary gland, thyroid gland or adrenal gland. It can also be a result of malfunction in either or both ovaries and the secretion of hormones originating there.

Anatomic problems
One fourth menstrual disorders are caused by problems of the anatomy. These include various gynecological issues like the presence of uterine fibroids and polyps, reduced uterine contractile strength, adenomyosis (intrusion of uterine tissue into the muscular wall of the uterus), a uterus with an excessively large surface area, and endometrial cancer.

Clotting irregularities
Abnormality in clotting is a cause of heavy menstrual bleeding in women. It leads to exceeding blood loss from minor cuts and gashes and makes one easily prone to bruising. This may also include medical conditions such as thrombocytopenia (platelet dysfunction) and Von Willebrand disease.

Medications and supplements
There is a wide range of medications and nutritional or hormonal supplements which often cause menstrual disorders in women and lead to fluctuations in the menstrual cycle. These include medicines such as aspirin, ibuprofen, estrogen pills, Vitamin E supplements etc.

Miscellaneous factors
These are comparatively rare and require a greater degree of medical attention. It includes conditions such as cervical cancer, ovarian tumors, liver and kidney diseases, uterine infections, extreme psychological stress, obesity, etc. Incidents such as miscarriages and unsuspected pregnancies are also known to cause abnormal menstrual bleeding.

5 Causes of Menstrual Disorders

Many people across the world spend a considerable amount of time contemplating on which type of delivery is the most preferable. In earlier times, normal delivery was the only option but these days, there is an increase in the number of caesarean or C-sections. Today, 30% of children of children around the world have been born through the C-section. Since it is up to the woman to select which type of delivery she would prefer, it is imperative to comprehend the advantages as well as risks of both the options.

Advantages of vaginal delivery to the mother
From a psychological point of view, women who opt for normal delivery are believed to have a relatively positive birthing experience. Women who go through normal delivery often feel that it is empowering to be actively involved in the procedure of giving birth to their babies. Such mothers have a much shorter span of recovery time compared with those opting for C-sections. This procedure also lets the mother as well as the baby to come in contact with each other, which in turn speeds up the process of bonding.

Pros of normal delivery for the baby
It has been found that babies who are born via vaginal delivery are less prone to developing any kind of complications related to health. They can be fed, sooner and develop fewer allergies and respiratory issues. However, very few babies born through vaginal delivery can experience any injury while being born, though this is an extremely rare condition.

Benefits of Caesarean section for the mother
There are numerous women who opt for the C-section so that there is no need to go through extended hours of labour. Today, with the advancement in medical science, mothers are able to plan the birth of their child, and it allows more control over the birthing process along with more predictability. Women who go for a C-section do not suffer from any damage to the pelvic floor, which often leads to incontinence in the course of time.

Advantages of a C-section delivery for the child
In most cases, when there are twin babies, or a single baby is too large, opting for a C- section can prove to be the most viable option. Plus, if the mother is a carrier of certain diseases like HIV, then a C-section reduces the chances of passing it to the baby.

Thus, both the options have their own set of pros and cons, and it is best to speak with a qualified gynaecologist before deciding on anything.

C-Section Vs Normal Delivery - Which Is Better For You?

Miscarriage is the early loss of foetus within 20 weeks of pregnancy. It is also known as  spontaneous abortion . According to research, about 8-20% of the pregnancies end in miscarriage. Out of the total number of miscarriages, 80% of them end within 12 weeks of pregnancy.

Types of Miscarriages and their Symptoms 

Threatened Miscarriage   As the term suggests, in this condition the process of miscarriage might have begun. This is the initial stage of the process. In threatened miscarriage, there is slight bleeding accompanied by cramps and pain in the lower back, which is usually mild. The cervix (the lower part of the uterus) remains closed. 
Inevitable and Incomplete Miscarriage   In these conditions, there is bleeding along with an open cervix. When there is dilatation and thinning of the cervix, miscarriage is inevitable. In incomplete miscarriage, part of the tissue comes out and a part remains inside the uterus. In inevitable and incomplete abortions, the bleeding and cramps are more severe. 
Complete Miscarriage   Complete miscarriage is when the embryo has completely emptied from the uterus. The pain and bleeding reduce once the foetus is expelled. This can be confirmed through ultrasound. 
Missed Miscarriage   In Missed miscarriage, there is no sign of the life of the embryo and there is no expulsion of the embryo. It can be detected from the absence of heartbeat of the embryo found on ultrasound. 
Recurrent Miscarriage   It happens when there are two or three miscarriages one after the other. It affects about 1% of the pregnancies. 
Risk Factors 

Increased maternal age i.e., women above 35 years. 
Excess or insufficient chromosome in embryo. 
Placenta is the organ which links mother and the baby for blood supply. Problem in the development of placenta can cause miscarriage. 
Excessive smoking and drinking during pregnancy. 
Obese women have higher risk of miscarriage. 
Long-term health conditions like high blood sugar, high blood pressure, liver disease etc.
Infections like rubella, malaria etc. 
Weakened cervix, which is the result of previous injury or surgery, can also result in miscarriage. 
What are the symptoms of a miscarriage? 

Bleeding or spotting can be one of the symptoms of miscarriage. It should be kept in mind that not all pregnant women who suffer from spotting or bleeding, end in miscarriage. 
Lower backache starts before or right after bleeding, which can be persistent or you could have cramps which may be mild or sharp and can feel like more of pelvic pressure. 
Missed miscarriages are detected through ultrasound when the doctor finds that there is no heartbeat of the embryo or when the uterus is not growing. 
What are the treatment options in miscarriage? 

Medical   In most of the cases, there are no specific drugs to stop a miscarriage from occurring. In some cases, certain hormonal preparations help. There is no point in prescribing medicines for prevention of miscarriage if there is heavy bleeding. 
Surgery   Dilatation and evacuation (D&E) is a simple operation which is done under general/local anaesthesia. In this operation, the cervical canal is dilated and contents present in the uterus are evacuated. There is no cutting involved as it happens through the vagina. The process needs only five to ten minutes, but the patient has to stay in the hospital for about 3-4 hours. 
This process is opted when: 

There is heavy bleeding. 
The patient suffers from missed miscarriage. 
What can you do to prevent miscarriage? 

Nothing much can be done to prevent miscarriage in most of the cases. However, following supportive measures may help: 

There should not be overexertion during pregnancy. Moderate amount of physical activity is permissible. 
One should have a well-balanced diet. Studies have shown that a diet loaded with fruits and veggies helps in overall well-being during pregnancy. One should limit the consumption of caffeine. 
Avoid smoking, alcohol and certain drugs to prevent miscarriage. 
Avoid stress and anxiety. 
Report to Doctor (preferably Obstetrician) as soon as any symptom related to miscarriage appears.

Miscarriage - Symptoms, Treatment and Prevention

Post pregnancy, you may experience pain due to multiple reasons. However, such pain might subside within a few weeks, but still it is advisable that one should be prepared prepared for all kinds of discomfort post pregnancy, such as the pain you endure while breastfeeding or the epidural pain. If you have undergone surgery, then there may be pain due to surgical incisions as well. One should keep herself hydrated all throughout and be patient while trying to deal with such post pregnancy pain.

Managing pain depends on the type of pain you are experiencing. Below is a summarized account of the different types of pain one might go through and how to come out of it.

    Incisions: In case the delivery occurs by the caesarian procedure, you might have to endure pain from the incisions. The pain generally lasts till all the incisions heal, so you will require pain medications to get relief from the pain.
    Uterine contractions: The uterus needs to return to its normal size after the delivery. The pain from these contractions tends to increase with subsequent pregnancies. Like incisions, pain medications will be administered to help you get relief from the pain.
    Vaginal dryness: A woman s vagina tends to be dry while she is breastfeeding. This can cause pain if you want to indulge in sexual intercourse. In this regard, lubricants (preferably water based) are a good way to treat vaginal dryness.
    Engorgement of the breast: When a woman starts lactating, her breasts tend to become fuller and thus, cause minor but persisting pain. A breast pump (used to extract milk from a woman s breasts), in this case, can relieve you of such pain.
    Back pain: Pregnancy related stress and strain can often lead to back pain. This back pain usually stems from holding the baby and breastfeeding it. If it so happens, you can consider changing your posture while breastfeeding and taking warm baths twice a day to get rid of the backaches.
    Joint pain: There may be pain in your joints such as the one in your wrists, hands and feet. This usually occurs due to all the chemical changes that your body undergoes during pregnancy. Pain medications and stretches can help ease this sort of a pain.
    Pain in the legs: Post pregnancy leg pain is caused because of all the fluids that are administered intravenously. Once the content of fluids in the body reduces, the pain tends to subside. However, any sign or symptom of blood clots or visible redness in the legs might warrant medical attention at the earliest.
    Headaches: This is the most common type of pain that can result from a pregnancy. Headaches are caused due to hormonal imbalances, insomnia and stress that you may experience. It is advisable to not take any pain medication in this regard as painkillers can interfere with your bodily hormones even more, given that headaches are usually not something to worry about. Drink plenty of water and try to get ample rest; this should take care of the pain automatically.

Post Pregnancy Pain - How best to Manage it?

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