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Recurrent Pregnancy Loss
The tragic event of three or more consecutive miscarriages is traditionally defined as recurrent pregnancy loss (RPL). This occurs in approximately one percent of women of reproductive age.
The causes of RPL are very complex and difficult to diagnose. The following causes should be sought for and well-targeted treatment should be given:
- Genetic abnormalities occur in 3 –5% of couples presenting with RPL. Genetic testing of both partners is imperative and testing of the miscarriage itself also offers additional information. Abnormal findings should be accompanied by thorough genetic counselling.
- Abnormalities of the womb can cause RPL in more advanced pregnancies. These conditions should be identified and treated.
- Deficient adaptation of the maternal system to the developing pregnancy can occasionally cause RPL. If tests confirm this problem, support of the immune system can be given to help with the adaptation to the developing pregnancy.
- Some women might suffer from a condition where her body attacks the cell membranes of the developing pregnancy (Antiphospholipid Syndrome). This condition can be identified by specific blood tests and appropriate treatment from early pregnancy decreases the chances of another miscarriage.
- Patients suffering from Polycystic Ovarian Syndrome sometimes have raised levels of a pituitary hormone that increases the risk of a miscarriage. Before falling pregnant, this hormone should therefore be lowered.
- Infections can sometimes cause RPL and should be identified and treated in early Pregnancy.
Investigation after one or two miscarriages rarely identifies a cause, and should only be performed in women of 35 years or older or in those suffering from infertility. In only 60% of patients with RPL an underlying cause can be found. Even if no cause is identified, repeated assessment and support in early pregnancy has been shown to improve the outcome of these pregnancies.
Support Program
Do you feel:
- Lonely and isolated at times?
- That no-one understands how difficult infertility can be?
- That everyone else is having babies?
- That infertility is affecting your work and your personal relationships?
- Out of control of your body and/or your life?
- Unreasonably angry or impatient with others?
- That holidays and coping with family and friends are becoming increasingly difficult?
Vitalab offers in-house counselling and ongoing support for our patients. If further in-depth counselling is required we have experienced therapists to whom we can refer you.
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