Good afternoon, I am Dr. Puneet Kocchar. I am a consultant gynecologist and a fertility specialist at Elixir Fertility Center, New Delhi. Today I will be talking about Recurrent miscarriages and abortions.
A positive pregnancy test is a very exciting news not only for the couple but for the entire family. However, sometimes there is a miscarriage and the chances of miscarriage in the normal pregnancy are about 10-15%. If you have had only one miscarriage, then the chances that you will carry on till term without requiring any medical extensive treatment in your next pregnancy are nearly 80% or more. For women who have had only one miscarriage, we will not recommend going for extensive testing or treatment.
What is recurrent abortion or recurrent miscarriage?
If a lady has had 3 or more repeated abortion, it is called recurrent abortions. Even these days we start doing test and treatment if a lady has had 2 abortions and we do not wait for third one to occur.
So, why does an abortion occur?
In simple terms, either it is a fetus, that is, an embryo is not normal or the womb which is going to carry the pregnancy has some problems in it. What happens to a fetus if you are carrying a genetically abnormal baby, that can lead to miscarriage. It is nature's way to take care of the pregnancy and not letting the abnormal baby come into life. So, we do tests called genetic tests to check the chromosomic make up of a baby. They can be done on the products of conception. We also recommend that we have complete parental care, that is the blood test of both mom and dad to check the both of the chromosomal content.
Sometimes, in2-5%of the cases, there is balanced chromosomal translocation. Now this translocation will not cause any problem to the person who is guiding translocation. But when you produce an egg or the sperm, the embryo can be abnormal and this will lead to a miscarriage.
What happens to a person carrying a translocation?
If you are carrying a translocation which is leading to repeated miscarriages, it is better to plan IVF cycle along with PGD or PGS rather than normal conception.
IVF is where we create an embryo using the eggs from the lady and sperm from the husband. When the embryo is ready, we take a small biopsy and we subject it to test and a complete chromosomal analysis. And once the results are back, the normal embryo is transferred back into the lady's womb resulting in healthy pregnancy. This is one factor that we just addressed.
The second factor that we talked about is abnormalities in the womb. Now, simple test to analyze hormonal balance from the blood taken from the lady will tell us about thyroid status, diabetes, abnormal prolactin. These are all hormones which if are elevated or below the range can lead to abortions. THis can all be treated by giving oral tablets. So, these are important to be tested for any women having recurrent abortions.
So, these are the various causes due to which a lady can have an abortion. An important thing here is do not loose hope and do not give up treatment. If you have had 2-3 abortions, you need to get complete panel of tests done and with the help of a treatment, you have 60% of the chance to deliver a baby normally.
If you wish to consult me, please contact me through Lybrate or you can visit my clinic directly.