The Devastating Effect Of Recurrent Miscarriage
Even for the healthiest and most fertile individuals, conceiving and carrying a child to full term is not guaranteed. Some women can experience a miscarriage, which is a sudden pregnancy loss before the 20th week of gestation. What is less typical is recurrent miscarriage, which is the loss of at least 2 consecutive pregnancies before week 20. While 10% of pregnancies can end in miscarriage, this condition is rare, impacting about 1-2% of couples. In many cases, there is an underlying cause, such as an ectopic or chemical pregnancy, that a doctor can help couples uncover and potentially resolve with treatment.
The different types of early pregnancy loss
Many health factors must line up to conceive and carry a child to full term. Hormones, sperm and egg quality, ovarian health, and uterine lining must all be healthy enough for a successful pregnancy. Early pregnancy loss can stem from an underlying condition or challenge that leads to multiple, recurrent miscarriages. An underlying cause is an ectopic pregnancy. The fertilized egg implants outside the uterus, usually in the fallopian tube. This is not a viable space for the embryo, leading to pregnancy loss. A chemical pregnancy is perhaps the most common cause of recurrent miscarriages. The embryo implants but fails to develop, leading to an early miscarriage. A blighted ovum and molar pregnancy are other less common causes. Early detection is vital to treatment and minimizing complications.
Understanding ectopic pregnancies
An ectopic pregnancy can form when the embryo begins to develop outside of the uterus. The fertilized egg could not move down the fallopian tubes to the uterus in time. Most cases of ectopic pregnancy develop in the fallopian tubes and are referred to as tubal pregnancies. The fallopian tubes can be blocked or damaged by a previous surgical procedure. An ectopic pregnancy can cause abdominal pain, shoulder pain, and vaginal bleeding. The issue can be life-threatening if left untreated. Damage to the fallopian tubes can lead to recurrent miscarriages.
Have you had a chemical pregnancy?
Chemical pregnancies can happen on occasion and might go unnoticed. Some cases can develop repeatedly and are the cause of recurrent miscarriage. The resulting miscarriage from a chemical pregnancy happens shortly after implantation. A chemical pregnancy can occur so early that some women are not aware of the pregnancy or miscarriage. The embryo moves to the uterus but suddenly stops forming and growing. The only early sign is a positive pregnancy test followed by menstrual-like bleeding a few days later. Mild cramping and the passing of blood clots may occur, mistaking a chemical pregnancy for a heavier, late period. The root cause is often linked to the genetic health of the embryo, leading to chromosomal abnormalities or implantation issues.
Diagnosing and treating each condition
Ectopic pregnancies have early signs of pelvic pain, consistent vaginal bleeding, and shoulder pain. The patient may already be aware of pregnancy via a pregnancy test. An ultrasound, along with a blood test that checks human chorionic gonadotropin (hCG) levels, can confirm ectopic pregnancy. Medication or surgical intervention may be necessary to remove the ectopic pregnancy. Chemical pregnancy is normally identified by women who are diligently tracking fertility, actively trying to conceive, or undergoing fertility treatment. An hCG test also helps with chemical pregnancy. High amounts of the hormone are a sign of pregnancy. Sometimes, chemical pregnancy requires no intervention. However, recurrent miscarriages may need fertility treatment or support.
When ART is life
Recurrent miscarriage may open the door for assisted reproductive technology (ART) to increase the chances of pregnancy. If a patient is at risk of developing another ectopic pregnancy, in vitro fertilization (IVF) can help. IVF creates the embryo outside of the body in a fertility clinic using harvested eggs and a sperm sample. The best embryo is then surgically placed into the uterus, bypassing the fallopian tubes. IVF is a safer option for women with damaged or impaired fallopian tubes. Intrauterine insemination (IUI) or IVF is also helpful for chemical pregnancy. Recurrent chemical pregnancies can be traced to a genetic issue with sperm or eggs. IUI can provide washed, concentrated sperm while bypassing the cervix. IVF opens the door for preimplantation genetic testing (PGT), which identifies embryos with chromosomal abnormalities. Using the best embryo can limit recurrent pregnancy loss.
There is hope for recurrent miscarriage troubles
Recurrent miscarriages are devastating for couples. In the case of ectopic pregnancy, there is a health risk to the potential mother. Chemical pregnancy, while physically harmless, can impact family planning goals. Finding the root cause is essential for effective treatment. In both cases, IVF and other forms of ART can provide a safer way to get and stay pregnant. There are many moving parts involved with ART. Treatments like IVF are complex, time-consuming, and expensive. After treatment for recurrent miscarriages, speak with a fertility specialist to craft a plan to get pregnant in the near future.
