Causes of Infertility

Recurrent Pregnancy Loss

Miscarriage is both traumatic and relatively common.  Many pregnancies are lost even before a woman knows she is pregnant. It is estimated that 30 percent of pregnancies miscarry. Most pregnancy losses occur prior to eight weeks gestational age. Only three percent of pregnancies will miscarry after eight weeks.

Having two to three consecutive miscarriages has been termed recurrent pregnancy loss. It is important to recognize the likelihood of having a successful pregnancy remains high in couples who have experienced multiple miscarriages. Among women who have had three consecutive, unexplained miscarriages, there is a 70 percent chance that the subsequent pregnancy will be entirely normal. That is because the majority of all miscarriages are due to random chromosomal abnormalities of the fetus that typically do not recur.

For women experiencing several miscarriages, we routinely perform a hysteroscopy to look inside the uterine cavity for the presence of fibroids, polyps, congenital malformations or scar tissue. Both female and male partners are also tested for chromosomal abnormalities called balanced translocations. Extensive blood testing on the female partner is also performed, evaluating for immunologic disorders, abnormalities of blood clotting and hormonal imbalances. Even with a very thorough evaluation, a cause for recurrent pregnancy loss can be found in less than half of the couples evaluated.

Therapies for treatment of recurrent pregnancy loss are determined by the underlying disorder found through diagnostic testing. For example, women who are found to have a disorder of blood clotting will be treated with a blood thinner. Many women with unexplained recurrent pregnancy loss are treated with ovulation induction medication or luteal phase progesterone support. In vitro fertilization (IVF) with PGD (preimplantation genetic diagnosis), which tests the embryos for chromosomal abnormalities, is also an effective treatment options for many.

Other Causes of Infertility:

• Ovulation Disorders
• Tubal Disease
• Endometriosis
• Diminished Ovarian Reserve
• Fibroids
• Uterine Receptivity
• Male Factor

 

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