When most women think of fertility specialists, they about difficulty conceiving a pregnancy, but fertility specialists (also known as Reproductive Endocrinology and Infertility Specialists) also see women who can get pregnant but have difficulty staying pregnant because of miscarriage or recurrent pregnancy loss.
As women age, the number of eggs in their ovaries decreases and the quality of those remaining eggs can also decline. Eggs that are less healthy have a higher chance of fertilizing incorrectly, leading to an embryo that has either too many or too few chromosomes to produce a viable pregnancy. This change in the eggs over time is why miscarriage risk goes up with the age of the woman. The risk for miscarriage is approximately 25% of pregnancies in women age 35-39, 50% in women age 40-44, and as high as 90% in women 45 or older.
Diagnosing Recurrent Pregnancy Loss
Because having one miscarriage is so common, the diagnosis of recurrent pregnancy loss (RPL) is made after a woman experiences two or more miscarriages that are far enough along to either see the pregnancy with an ultrasound or confirm the pregnancy by looking at the tissue under a microscope. This means that very early, or biochemical, pregnancies that stop developing before this stage don’t technically count toward making the diagnosis of RPL.
If a woman is diagnosed with recurrent pregnancy loss, it’s important to have a thorough evaluation done to check for preventable reasons for the miscarriages and improve the chance that the next pregnancy will be healthy. Some of the tests that may be done include blood tests for genetic, autoimmune, or hormonal issues as well as a 3D ultrasound of the uterus to check for any anatomic problems like a uterine septum or scar tissue in the uterus. If an infection of the uterus is suspected, testing for that will be recommended as well. It is also important to screen the male partner for certain genetic or sperm quality concerns that may be contributing to the pregnancy losses.
October is Infant and Pregnancy Loss Awareness Month and a good opportunity to discuss miscarriage openly. It is not something to be ashamed of or kept secret. In fact, once the miscarriage conversation is started, you realize how many women have been affected. Having a miscarriage can be incredibly difficult emotionally and having multiple miscarriages can feel devastating. It is important to know that help is out there and many reasons for miscarriage are treatable. Most women will go on to have a successful pregnancy! The first step toward success is seeking help.
There is Hope and Help
If you have questions about recurrent pregnancy loss and miscarriage and would like to learn more about the many options in the fertility process, contact us today to schedule an appointment. Our experienced, caring physicians at Vios are here to help.