Causes
Unravelling the cause of RPL is crucial for choosing the most effective treatment approach. Here’s an overview of some common reasons for recurrent losses:
- Chromosomal abnormalities: Abnormal chromosome number in the embryo can lead to pregnancy loss. This could be due to problems with either partner’s chromosomes or an error during cell division.
- Anatomical abnormalities: Uterine abnormalities like fibroids, polyps, or a septum (wall dividing the cavity) can hinder implantation or fetal development.
- Hormonal imbalances: Issues with thyroid function or insufficient progesterone levels can affect the uterine lining and support for a growing pregnancy.
- Immunological factors: In some cases, the immune system might attack the developing embryo due to unrecognized factors.
- Infectious diseases: Certain infections like cytomegalovirus (CMV) or Chlamydia can contribute to miscarriage.
- Other medical conditions: Underlying health conditions like uncontrolled diabetes or blood clotting disorders could play a role.
Working with Your Healthcare Provider to Identify the Cause:
A thorough evaluation by a healthcare provider specialising in reproductive health is recommended. This may include:
- Medical history review: Discussing past pregnancies, medical conditions, and family history can offer clues.
- Physical examination: This assesses potential uterine abnormalities.
- Blood tests: Hormones, thyroid function, and clotting factors can be evaluated.
- Genetic testing: This may be recommended for both partners to assess chromosomal abnormalities.
- Imaging tests: Ultrasounds or hysterosalpingography (X-ray with dye) can identify uterine concerns.
Treatment Options
Depending on the identified cause of RPL, various treatment approaches may be considered:
- Chromosomal abnormalities: If identified through genetic testing, options like preimplantation genetic testing for aneuploidy (PGT-A) during IVF can be considered to select embryos with the correct number of chromosomes.
- Anatomical abnormalities: Surgery might be recommended to correct uterine fibroids, polyps, or a septate uterus.
- Hormonal imbalances: Medications like progesterone supplements can help support a healthy pregnancy lining.
- Immunological factors: Intravenous immunoglobulin (IVIG) therapy might be offered in certain cases.
- Infectious diseases: Treatment of identified infections can improve pregnancy outcomes.
- Other medical conditions: Addressing underlying health problems like diabetes or blood clotting is essential.
Considerations When Choosing a Treatment Option:
- Underlying cause: The treatment option chosen should address the identified cause of your RPL.
- Success rates: Discuss the potential benefits and limitations of each treatment with your doctor, understanding that success rates can vary based on individual circumstances.
- Potential side effects and risks: Consider potential side effects and risks associated with each treatment option.
- Emotional impact: Acknowledge the emotional impact of RPL and treatment decisions. Seek support from healthcare professionals, support groups, or therapists.
Seeking support
Recurrent pregnancy loss can be emotionally challenging. Building support from your partner, family, friends, or a therapist can be invaluable. Connecting with others facing similar experiences through support groups can offer invaluable comfort and understanding. Additionally, remember, you are not alone. Many couples face RPL and find ways to build their families. Having had RPL does not necessarily mean you cannot have a successful pregnancy in the future. Advancements in diagnosis and treatment offer increasing hope. Embrace self-care, prioritize your well-being, and work collaboratively with your healthcare team to navigate this journey.
