Miscarriage
Recurrent miscarriages can cause a significant amount of heartache and distress for many couples. Medically this condition is defined when a couple have had three or more consecutive miscarriages. There are multiple factors that may cause miscarriage but unfortunately the underlying problem often remains unexplained. FertilityCare and NaProTechnology have the ability to identify couples who are at risk of miscarriage even before the first miscarriage occurs. Pre-menstrual Syndrome (PMS) which last for more than four days each cycle may indicate that the couple have an increased risk of miscarriage.
The Miscarriage Association of Ireland Newsletter Winter 2006/2007 published the stories of two couples who each had 6 recurrent miscarriages prior to achieving successful pregnancies with NaProTechnology treatment. Article 1. Article 2.
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The FertilityCare System can identify:
- · Unusual bleeding patterns,
- · A short luteal phase in the menstrual cycle
- · Limited cervical mucus flow
all of which are associated with Progesterone deficiency and increased likelihood of miscarriage.
Identifying and treating abnormal looking cycles increases the chances of success with treatment.
Our initial evaluation usually focuses on the woman's FertilityCare chart together with timed hormone evaluation to assess for subtle deficiencies of Progesterone or Oestradiol 17 beta in the luteal phase of the menstrual cycle. If these hormone levels are found to be below the normal range treatment is given to correct the underlying abnormality. In cases where hormonal evaluation is completely normal we would recommend further surgical evaluation of the woman's uterus (womb). We recommend investigations such as a hysterosalpingogram or hysteroscopy to evaluate the uterine cavity. In addition an endometrial biopsy is taken to evaluate for a possible low-grade endometrial infection which can sometimes contribute to the cause of miscarriage.
We send additional blood tests to evaluate for chromosomal or blood clotting abnormalities and we evaluate for other physical illnesses, which the woman may have and are recognised to contribute to recurrent miscarriage.
Environmental and lifestyle factors are often very significant contributors to miscarriage. In particular excessive alcohol and cigarette smoking together with a busy stressful working environment or other lifestyle stress may be the primary reasons why the couple are having miscarriages.
The FertilityCare and NaProTechnology approach to managing recurrent miscarriage is one of searching for the underlying problem and treating whatever we find. Interestingly, Endometriosis can be a significant cause of recurrent miscarriage for some couples. In addition once the couple does conceive we recommend ongoing hormone support during pregnancy with intramuscular Progesterone injections and HCG support. This is gradually reduced and discontinued depending on the results of Progesterone blood tests taken every two weeks during the early stages of pregnancy.
If a couple miscarry with their first attempt at treatment we often recommend having at least one further attempt with this approach before giving up. We often modify treatment for subsequent attempts that may improve the chances of success.
Nearly 80% of couples will eventually have successful treatment using this approach. Couples with a history of eight to nine previous miscarriages have now had successful pregnancies using this system, but unfortunately it does not work for everybody. In most instances it is certainly worth a try. Treatment is safe and minimally invasive and significantly increases your chances of having a successful pregnancy.