Evaluation of Recurrent Pregnancy Loss
At the Reproductive Medicine Institute, we strive to offer exceptional individualized care. As such, after your initial consultation and diagnostic testing, your fertility specialist will determine the next best step for you in regards to treatment. In general, treatment is determined by the underlying etiology for loss.
Advanced Maternal Age, Genetic
In couples with advanced maternal age of a genetic etiology for loss, the best option is to consider in vitro fertilization along with preconception genetic screenin g of the embryos or donor egg in vitro fertilization. In the former, the couple undergoes in vitro fertilization, and the resultant embryos are tested to see whether a normal complement of chromosomes exists; subsequently, only screen normal embryos are placed back into the uterus during embryo transfer. Donor egg in vitro fertilization involves the use of donor oocytes along with partner or donor sperm; the resultant embryo is placed back into the intended parent’s uterus.
Women with anatomic abnormalities require surgical correction. Surgical correction can be accomplished hysteroscopically , laparoscopically , or through an incision on the abdomen. The route of surgery depends on the underlying abnormality.
If an underlying medical condition is identified, attention should first be made to controlling the underlying disease. This may involve the initiation of medical therapy (insulin sensitizing agents in the setting of diabetes, thyroid medication in the setting of thyroid abnormalities).
Women who are diagnosed with APAS will require blood thinners during pregnancy. The specific regimen and duration of treatment will be determined by your fertility specialist and a hematologist.
Your specialist will be able to provide resources and strategies to make the critical lifestyle changes necessary for a healthier pregnancy and a healthier baby.
As the majority of unexplained losses are likely genetic, your doctor may recommend in vitro fertilization along with genetic screening of the embryos.