RECURRENT MISCARRIAGE
Recurrent miscarriage is the term used to define the condition where a woman has suffered 3 or more consecutive losses of pregnancy. It affects approximately 1% of women and although it does not seem likely that recurrent miscarriage is just due to bad luck or the result of a random event, quite frequently no cause is found with conventional testing.
How can Fertility Advanced help you?
Dr Diamantopoulos recognizes that a miscarriage carries a tremendous emotional burden on the couples involved. He has successfully treated many couples, which had experienced recurrent miscarriage and in occasions had even given up hope.
The causes of recurrent miscarriage are complex and often more than one contributing factors may coexist. All the women that have experienced miscarriages either as a result of natural conception or through IVF treatment are carefully reviewed, to ensure that there are no potentially treatable causes that may have not been acknowledged in the past.
Depending on your history details we choose among a full range of highly sensitive and innovative diagnostic tests the most appropriate ones, to determine the possible causes of a miscarriage, thus increasing your chances of a successful outcome. Attention to detail and delivery of individualized plan for each of our patients, are both playing a key-role to help you successfully complete your journey to parenthood.
Our recommendation for thorough screening is not limited to women with 3 or more miscarriages but depending on your medical and reproductive history it could be considered earlier, after your second or sometimes, even after your first miscarriage.
Which are the screening options we offer?
We offer a full range of highly sensitive diagnostic tests and specialized treatments, including immune therapies. The suggested tests/ investigations and the subsequent treatment plan are completely personalized, in line with your medical and reproductive history.
The tests/ treatments we offer are divided into three categories:
- Tests/ treatments for the woman
- Tests/ treatments for the man
- Tests for the embryo
- Check your Karyotype. This is a blood test to assess the number and structure of your chromosomes.
- 3-D Pelvic Ultrasound Scan. It consists a valuable tool for the assessment of women who are experiencing infertility. A 3-D scan of the uterus is particularly valuable for the diagnosis and management of uterine conditions such as polyps, fibroids or uterine septum, which if they remain undetected may increase the risk of miscarriage.
- In some women the immune system may be overactive, reject the embryo or interfere with the hormones that are essential in pregnancy. This hostile response of the immune system may lead to infertility, miscarriage or even cause complications later in pregnancy. To identify any immunological issues potentially associated with your infertility, IVF implantation failure or recurrent miscarriage the following blood tests could be suggested to you:
- Natural Killer (NK) Cell Cytotoxicity Assay
- TH1: TH2 Cytokine ratio
- Testing For Inherited and Acquired Thrombophilia
- Testing For Autoimmune Factors: (Antinuclear antibodies (ANA), Thyroid antibodies (anti – TPO) & (anti – TG), Anti- DNA antibodies, Anti-histone antibodies, Anti –cardiolipin antibodies)
Read more information on our Reproductive Immunology page.
4.Hysteroscopy is a minor surgical procedure that involves examining the inside of the uterus by passing a thin telescope-like device (hysteroscope) through the cervix. A high definition camera attached to the hysteroscope will project the image of the uterine cavity on a screen, to allow the doctor diagnose and treat conditions such as polyps, fibroids, adhesions and septum. Those may interfere with the embryo implantation and cause infertility or recurrent pregnancy losses.
Various research studies suggest that, in some women, causing a minor “controlled” injury to the inside of the uterus can provoke an inflammatory healing response. As a result increased vascularization and regeneration of the endometrial tissue occurs, increasing the chances of an embryo to implant. During the hysteroscopy, an overall assessment of the uterine cavity is performed and at the same time small incisions (implantation cuts) are made at the fundus of the uterus where implantation normally occurs. This procedure appears to be particularly beneficial for women with a history of multiple implantation failures following IVF treatment or repeated pregnancy losses.
Read more information on our Hysteroscopy with implantation cuts page.
5.Endometrial Receptivity test (ERA). The ERA test is a pioneering test that evaluates the endometrial receptivity and gives the opportunity to perform the embryo transfer in a personalized way by defining the optimal time for embryo transfer that is specific for each woman.
The ERA test aims to prevent implantation failure by establishing the ideal day for embryo transfer, thus increasing the chances of a successful outcome. ERA test may be particularly beneficial if you have experienced recurrent implantation failures, including recurrent miscarriages or repeated unsuccessful IVF treatments including the transfer of embryos, which through genetic testing were found to be normal.
Read more information on our Endometrial Receptivity test page.
6.Endometriome test. It is a diagnostic tool for the evaluation of the endometrial flora. If an imbalance is detected, it recommends the best probiotic or antibiotic treatment, in order to balance the endometrial flora. Endometriome test may be particularly beneficial if you have experienced recurrent implantation failures, including recurrent miscarriages or repeated unsuccessful IVF treatments including the transfer of embryos, which through genetic testing were found to be normal.
Read more information on our advanced female genital infection test page.
7.Advanced chlamydia test. Chronic infections of the genital tract have been associated with infertility and pregnancy losses. This is test, a highly sensitive test for the diagnosis of infectious microorganisms such as Chlamydia, Ureoplasma or Mycoplasma. The test involves the examination of period’s blood, containing shed endometrial cells.
Read more information on our advanced female genital infection test page.
8.Check your vitamin D level, as suboptimal levels maybe associated with reduced fertility and an increased risk of miscarriage.
9.If you have a known medical condition, such as diabetes or thyroid disease, ensure that are well controlled. Suboptimal levels of TSH have been associated with an increased risk of miscarriage.
10.Stop smoking or/ and recreational drugs. Smoking including e-cigarettes can reduce your fertility and is also associated with a higher miscarriage rate. Furthermore smoking during pregnancy can adversely affect the growth and the development of your baby. The same applies for the use of recreational drugs.
- Check your Karyotype. This is a blood test to assess the number and structure of your chromosomes.
- DNA sperm fragmentation test. Various studies have shown that increased levels of sperm DNA damage are associated with unexplained infertility, unsuccessful IUI or IVF treatments and recurrent miscarriages. Read more information on our Advanced Male Fertility testing page.
- Sperm Aneuploidy Test (SAT). This is a diagnostic test that assesses for chromosomal abnormalities in the sperm, which are associated with spontaneous miscarriages (chromosomes 13, 18, 21, X and Y).
Read more information on our Advanced Male Fertility testing page.
- Consider doing an advanced Infection screen test in your sperm.
The presence of bacteria, such as chlamydia, or other pathogenic microorganisms in the sperm may remain undetected, as it is often asymptomatic. Sometimes these pathogenic microorganisms may be located inside the spermatozoa (intracellular) and subsequently transferred inside the embryo, leading to a miscarriage.
Read more information on our Advanced Male Fertility testing page.
- Genetic testing of embryos: PGT-A (PGS)
PGT-A is a type of embryo testing which can determine the number of chromosomes and detect any structural chromosomal abnormalities.
Healthy embryos carry 46 chromosomes in their cells with half of the chromosomes derived from the sperm and the rest from the egg. However some embryos may have too few or too many chromosomes. Those embryos are associated with risks, as they often fail to implant, can cause miscarriage or result in the birth of a child with a genetic syndrome such as Down’s.
Read more information on our Genetic testing of embryos page.