Most early miscarriages (as many as 60% of first trimester ones) will remain unexplained. It is usually assumed these losses are genetic, where the chromosomes simply did not replicate correctly. Many people will assume that something that happened recently, such as an illness, fall, or exposure to something will have caused the miscarriage. This is rarely true, since by the time a miscarriage is diagnosed or begins, the baby has been lost for quite some time When we talk about a hormone problem, you have likely miscarried in less than 10 weeks. After that, the placenta has taken over hormone production and any normal deficiency you have is not a factor. Low progesterone, the most common problem, is not as easy to treat as you might hope. Progesterone suppositories, while frequently prescribed, are not proven to be helpful and often actually cause a nonviable pregnancy to last longer than it should. The only situation where progesterone is a sure solution is with a luteal phase defect, where the corpus luteum, which is formed along with egg at ovulation, does not produce the hormones needed to sustain a pregnancy. For most women, however, this is usually not an every-month problem. Usually the situation rights itself with the next egg and the next corpus luteum. This problem, if it is a permanent one, can be diagnosed through two separate endometrial biopsies. Progesterone must be started 48 hours after ovulation to work. By the time you have missed a period, it is too late to save a pregnancy with a luteal phase defect.5 Low progesterone, however, is usually a symptom of an nonviable pregnancy, and not the cause. Doctors often prescribe progesterone suppositories out of patient pressure when the hormone levels are low, but their use is controversial and usually completely ineffective. A common treatment for a suspected progesterone problem is Clomid, a pill taken for five days early in your cycle to rev up your hormone production. Not everyone is a candidate for Clomid, and 25% of women will have decreased cervical mucus, which can actually make you less fertile. Other hormone problems may be created when you have an untreated thyroid disorder. Your thyroid function can easily be tested, and this problem is very treatable. Miscarriages differ according to 2 main factors: how far the pregnancy has progressed and how much of the fetus and other elements of pregnancy, such as the placenta, have been expelled from the body. To prevent infection, it's important to ensure that all material related to pregnancy has been either expelled naturally or removed from the uterus. Inevitable Miscarriage When bleeding and pain are accompanied by the breaking of membranes (the amniotic sac surrounding the fetus) and the widening of the cervix, the pregnancy is viewed as lost (inevitable miscarriage). Uterine contractions to expel the fetus usually begin soon after these symptoms develop. Incomplete and Missed Miscarriages In some miscarriages, the body does not expel all the elements of pregnancy. This is called an incomplete miscarriage. At other times—in about 1 percent of pregnancies—the body does not discharge the fetus, the placenta, or any other elements of the pregnancy for several weeks, even though the fetus has died. This is known as a missed miscarriage. Early pregnancy symptoms may suddenly diminish or disappear (although after the 12th week this typically occurs in healthy pregnancies). Not all missed miscarriages are preceded by warning signs. An incomplete or missed miscarriage that takes place early in pregnancy is usually removed with either suction or dilation and curettage (D&C). In this procedure, the cervix is dilated to access the uterus and its contents scraped out through the vagina, with an instrument called a curette. These procedures not only clear the uterus but also prevent infection. When incomplete miscarriage occurs later in pregnancy, the doctor may have to induce labor to remove the fetus. Recurrent Miscarriage "Recurrent miscarriage,” is typically classified as having had 3 consecutive miscarriages. At this time your doctor will usually recommend a complete diagnostic workup. The investigation will probably start with a detailed interview. Which tests are performed will depend on your own personal and medical history, the father's history, and how many miscarriages you have had. You will be tested for infections of various kinds, possibly including sexually transmitted diseases. Blood tests may be done for hormonal problems or a malfunction in the immune system. You and your partner may be tested for chromosomal abnormalities and genetic diseases as well. The lining of your uterus may be analyzed from a small sample. The doctor may order x-rays of your uterus and fallopian tubes to look for a blockage, fibroid, or scar tissue. Knowing as much as possible about why the miscarriages are happening can increase the chances of having a normal pregnancy in the future. It's best to postpone trying to conceive again until your medical evaluation is complete. More than likely, you can carry a baby to term. Unless the problem involves autoimmune antibodies, chromosomal abnormalities, or a weak cervix, there's a 70 to 85 percent chance of success, even after 3 miscarriages. If you would like to share your story please email Me Add Me Site Map |
