Miscarriage
Evaluation of NaProTechnology (NPT) treatment
for couples with 6 or more recurrent miscarriages
Objective: We evaluated outcomes in all couples with 6 or more recurrent miscarriages treated with natural procreative technology (NPT), a systematic medical approach for optimising physiologic conditions for conception in vivo.
Methods: All couples receiving treatment with NPT in the Galway Clinic, Ireland between January 2004 and April 2008 were studied. Couples were advised to avoid attempting conception until optimum conditions were restored according to our criteria. Progesterone support was recommended for every couple as soon as they had a positive pregnancy test. The main outcome was live birth or successful ongoing pregnancy beyond 24 weeks at the time of study. Crude percentage and adjusted percentage for compliant and non-compliant couples were calculated.
Results: A total of 18 couples with 6 recurrent miscarriages were evaluated. 11 couples conceived 15 times, with 7 still pre-conception at the time of study. The average female age was 34.3 years, 75% of the couples had a previous live birth and were an average of 3.5 years trying to achieve a successful pregnancy. All 11 couples previously had unexplained recurrent miscarriage with normal clotting studies and chromosomal analysis. Following NPT evaluation 90.9% were found to have progesterone deficiency. A total of 32 different diagnoses were identified as contributory factors for recurrent miscarriage and nobody had a diagnosis of unexplained miscarriage. The crude percentage achieving a successful pregnancy was 53.3%, rising to 77.7% for compliant couples and falling to 16.7% for non-compliant couples. There was one ectopic pregnancy and no multiple births.
Discussion: Couples with unexplained recurrent miscarriage have few treatment options available to them other than reassurance and early ultrasound monitoring of subsequent pregnancy. The expected incidence of future miscarriage in those with 6 or more previous miscarriages is about 50% and was only 22.3% for compliant couples in this retrospective analysis. Interestingly 83.7% of conceptions were unsuccessful for non-compliant couples, suggesting significant benefit from NPT intervention. Further studies with larger numbers are required to investigate this new approach further.
Main Author: Dr. Phil C. Boyle, Suite 11, The Galway Clinic, Doughiska, Co. Galway
E mail: info@fertilitycare.ie ph 091 720055
Aim for optimum cycle pre-conception
Results
