Being an Infertility specialist and gynecologist
for more than a decade, I have been lucky to witness the joy of a mother when
she held her baby for the first time, but I also had to shed tears with heartbroken
women when they lost their baby prematurely due to miscarriage.
The excitement and joy experienced by a couple, when they see a
second line on UPT kit is no less than winning a marathon. But
sometimes this joy is short lived and all their hopes are shattered by miscarriage or a scan report which indicates lack of
growth of the baby. As doctors, one of
the toughest part of our job is to explain this to the patients, especially when it happens repeatedly. The sad and devastating look on
the face of the aspiring mother and the
aggressive attitude of the spouse are both difficult to deal with.
It is shocking that miscarriage occurs in one
out of every three pregnancies and many a times it happens before the detection
of pregnancy and goes unnoticed. It is more common in sub fertile couple and women
with PCOS, so infertility specialists have to deal with it frequently. I am sharing some facts regarding the common causes for
miscarriages.
In most cases, the baby stops growing because the
foetus is not normal enough to continue
to grow. (none of the foetus are perfect, but most of them are viable).The mother nature is actually blessing us by
stopping such pregnancy to grow, as it may have ended up in either
physically or mentally abnormal child who might have later died in an advanced pregnancy
stage or in early childhood. Our body is selective and often recognise that
the embryo is genetically abnormal, so the uterus does not allow it to
grow. (uterus is apparently a huge lab where genetics is recognised ). Thus 60 % or more miscarriages happens due to
genetic problems with the embryo, due to the abnormal eggs/ sperms or both.
In some cases, there can be problems in
blood circulation, like clot formation, which can cause blocks in
the normal circulation of the tiny embryo resulting in cessation of foetal heart beat. This
condition can be screened in labs by doing certain blood tests during non pregnant
stage and are called APLA screening (anti phospholipid screening) . Women who
are found positive are treated with blood thinning agents like aspirin
and heparin injections ( low molecular weight heparin ) which gives successful results.
Autoimmune disorders like thyroiditis and many
undiagnosed disorders can result in repeated miscarriages and
medical treatment with steroid may have benefit in confirmed cases. Steroids
should not be given without proper indication as they have lot of side effects.
Some acute viral infections can trigger a miscarriage, but not a very common cause. The child might become abnormal because of foetal infection.
Hormonal problems, as in PCOS charecterised by high circulating estrogen or
lack of luteal support because of low progesterone is also a reason for miscarriages in a very small percentage of
women . Pumping women with hormones is not needed to treat this. Best
treatment for PCOS is diet and exercise and change in life style.http://bangaloreivf.blogspot.ae/2014/09/low-glycemic-food-chart-for-pcos.html http://bangaloreivf.blogspot.ae/2014/08/dr.html
There are abnormalities of reproductive organs, like
uterus or cervix, which causes miscarriages in some women, which is again
only a negligible percentage and screening in the form of scanning is
sufficient to diagnose in most of the cases.
It can be inferred that, the common determinant for the mishap is invariably genetic abnormality. So if we look
at it positively, these miscarriages are a blessing rather than a curse. Proper tests
must be done by checking chromosomal analysis of husband and wife and
the dead foetus to diagnose the cause correctly. If genetic abnormalities are
there in one parent or both the parents, it is better to opt for Donor egg or
sperm or both and you will be blessed with a healthy baby.
Dr. Anita Mani
Infertility Specialist at Gift IVF Centre
Infertility Specialist at Gift IVF Centre
anitadane@gmail.com
Dr. Anita Mani is a renowned infertility specialist in south India with 15 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore, along with her spouse Dr. S Mani. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist London, DFFP from ART Warwick university and worked in UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and Bangalore. Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI , donor egg / sperm. Her proficiency is in genetic abnormalities and high risk pregnancies.
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