Miscarriage - When to Seek Treatment
Can a Fertility Specialist Help Prevent Pregnancy Loss?
May 25, 2008
Based on the definition of recurrent miscarriage, which is three or more consecutive miscarriages, there is only one way to diagnose repeated pregnancy loss: a woman has to have suffered multiple losses in a row. Usually, she will not be offered testing and treatment until she has met this criteria.
Scientific Perspective on the Treatment of Miscarriage
Though treatment options are available to any patient who has miscarried, many obstetricians will not refer a patient for testing and treatment unless she has met the criteria of three or more consecutive miscarriages. From the doctor’s perspective, the chances are in favor that a patient will not miscarry again, since:
- According to the American Pregnancy Association, most women have an 80-85% chance of having a successful pregnancy. Though, some studies show this statistic slightly lower in a woman who has suffered several successive losses.
- Up to 60% of miscarriages are caused by random chromosomal errors, which are unavoidable.
- The University of Chicago Medical Center states that only 1-2% of women will suffer recurrent miscarriage.
- Approximately 50% of those women who do suffer recurrent loss will not find a cause.
- Studies that show the benefits of treatment are considered controversial, since most of them are difficult to reproduce.
Recurrent Miscarriage Testing
A woman does not have to wait for diagnosis and referral to seek treatment on her own. There are tests to determine if a woman who has had one miscarriage is more susceptible to repeated miscarriage. A woman with an underlying condition may have a slightly higher risk of experiencing recurrent miscarriage. Fertility specialists, reproductive endocrinologists, doctors of reproductive medicine and specialists in infertility (and some obstetricians) may provide testing for these underlying conditions. The doctor will:
- Analyze blood samples to determine certain clotting disorders or antibodies
- Look for internal structural abnormalities of the uterus and fallopian tubes
- Determine the health of the endometrium (the lining of the uterus)
- Analyze the patient for infections and chronic conditions which may cause miscarriages
Treatment for Miscarriage
If a patient does have an underlying condition, she will be treated accordingly. Though, a patient who has no proven underlying condition may also choose certain treaments for prevention. Current miscarriage treatments available include:
- Surgeries which can correct certain structural abnormalities
- Progesterone supplements, which may help support a healthy endometrium
- "Baby” aspirin alone or with a steroid or heparin (these may help reduce complications with blood clotting or antibodies)
- Treatment for infection or chronic conditions
Personal Perspective of Seeking Treatment for Recurrent Miscarriage
Seeking testing and treatment does not guarantee that a woman will have a healthy baby, but it does give the woman with an underlying condition the best chance of avoiding future miscarriage. Recurrent miscarriage affects about 1-2% of women. Of these, about 50% who seek testing will find a cause. A patient will not know if she has an underlying condition until she seeks treatment.
Many specialists and patients offer personal testimony to the success of miscarriage treatments. It is definitely advisable for a woman to seek testing before she suffers multiple losses to determine or rule out any condition that would cause a future miscarriage.To most women, it is worth the effort to avoid the tragedy of losing multiple children through miscarriage.
Additional Resources on Miscarriage
- Avoiding Miscarriage by Susan Rousselot (Sea Change Press, 2007)
- How to Prevent Miscarriage and Other Crises of Pregnancy by Stefan Semchyshyn, M.D. (MacMillan, 1989)
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