How does one avoid a miscarriage?
Almost one in six pregnancies that are conceived naturally are destined to miscarry. The incidence of miscarriages with conceptions following a fertility treatment is higher and is between ten to thirty-five percent. This depends on a range of variables that can lead to a miscarriage.
The reassuring aspects are that one miscarriage does not increase the risk of a subsequent miscarriage. It is taken as a random chance event. Even if you have had two miscarriages most of the time (almost 80 to 85 percent), the woman should still be able to conceive, have an ongoing pregnancy and have a take home baby.
Even more reassuringly, if you have three or more miscarriages still in that situations without any interventions, fifty to sixty percent of patients can achieve a pregnancy and a take home baby.
Various factors can lead to a miscarriage such as lifestyle factors including smoking, excessive alcohol consumption, excessive caffeine consumption, stress – though it has not been directly linked – can also sometimes be playing a part towards a miscarriage. Other simple measures such as vitamin D deficiency are associated with infertility and failure of the implantation of the embryo.
There is a simple blood test that can be undertaken and be taking vitamin D supplements can correct some of the problems. On the same note, simple conditions again like thyroid gland dysfunction, an under-active or overactive thyroid can also contribute towards miscarriage. This can be easily treated by taking thyroid supplements for a couple of months, and that may help you have a successful pregnancy.
See your GP
However, if you have experienced three or more miscarriages, then it may be worthwhile to speak to your GP and seek further advice or visit a gynaecologist to explore potential reasons. If certain reasons are identified taking some extra medicine such as aspirin or blood thinning injections might help you to have an ongoing pregnancy and a live birth. Especially if you’ve been diagnosed with antiphospholipid antibody syndrome.
See your Gynaecologist
If you have had a miscarriage which was beyond 12 weeks, in that case, seeing a gynaecologist is important because it might be related to anatomical disorders of the womb such as cervical incompetence or the presence of septum. With cervical incompetence inserting a cervical suture (cervical stitch) can help most of the time to take the pregnancy to birth. So there are simple measures, but equally, it’s important that you seek the help at the right time rather than being anxious about going through a similar experience again.
There is another important point to remember that if you have been experiencing multiple miscarriages going to see a gynaecologist may help you by undertaking some of the investigations such as thrombophilia screen and taking genetic test both for yourself and your partner.
There are conditions such as translocation and inversion of the chromosome which are minor genetic errors in the genome. These are not significant enough to affect your health but sometimes it can affect fertility or can lead to recurrent miscarriages. We also know that sixty percent of the miscarriages that happen at less than 12 weeks are of genetic nature.
Therefore, it may be worthwhile to consider doing pre-implantation genetic screening (PGS) also known as comprehensive chromosome screening CCS).
By doing PGS you will be advised to go through a procedure very similar to an IVF procedure, you will have to take fertility drugs, undergo follicle development monitoring and egg collection. Before we replace the embryos at the day 5 stage (blastocyst stage), we will take few cells from the embryo and the embryos will then be frozen.
These cells will then be analysed for the normality of the chromosome complement. In a couple of months time, you would start the treatment again. We will then take the embryos that have been proven to be genetical normal and replace these embryos back into the womb with the aim to correct a genetic cause behind the repeated miscarriages.
That is one of the important measure interventions one can consider when managing or looking after patients with repeated miscarriages.