For some women, the biggest challenge to building a family isn't getting
pregnant - it's staying pregnant. If recurrent pregnancy loss is keeping you
from achieving your reproductive goals, we can help. The fertility specialists
at Penn Fertility Care - Lancaster General Health offer the guidance and
treatments you need for a healthy, full-term pregnancy.
What Are Recurrent Miscarriages?
Recurrent pregnancy loss (RPL) occurs when a woman has two or more
miscarriages that occur before the 20th week of pregnancy reaches 20 weeks. A
single miscarriage occurs in about 10% of pregnancies; RPL occurs in about 2%
of pregnancies.
What Causes Recurrent Pregnancy Loss?
In about half of cases, miscarriage is the result of abnormal chromosomes in
the embryo or fetus. Chromosomes may be missing, duplicated or in the wrong
location. The risk of chromosomal abnormalities increases as a woman gets
older. But since the majority of these chromosomal anomalies occur randomly
during fertilization (meaning they usually aren't inherited), you can't
control or prevent them. In rare cases, we recommend genetic testing to find
out if you have an inherited disorder.
There are other medical conditions that can increase your risk of recurrent
miscarriages, including:
But in about 50% to 75% of cases of recurrent pregnancy loss, the cause isn't
known.
How Do We Evaluate Recurrent Pregnancy Loss?
Our fertility specialists do a comprehensive assessment to find out what could
be causing repeated miscarriages. We review your reproductive history to learn
about any past pregnancies or births you've had. We also assess your personal
and family medical history to find out if miscarriages run in your family, or
if there are any health conditions or lifestyle factors that increase your
risk of miscarriages.
During the diagnostic process, you can also expect:
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Physical exam: We check your weight, blood pressure and assess your overall
health. Your provider may ask you about your eating and exercise habits,
stress levels and mental health. It's also important to tell us if you
smoke, drink alcohol or use drugs.
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Blood tests: We use blood tests to check your hormone levels, thyroid
function and blood glucose. We also test for sexually transmitted infections
or autoimmune disorders.
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Imaging exams: We may do a pelvic ultrasound, transvaginal ultrasound or a
saline sonohysterogram to evaluate your uterus and its lining. These exams
show us if your uterus is an abnormal size or shape, or if it contains
growths such as fibroids.
Can I Have a Successful Pregnancy After Recurrent Pregnancy Loss?
The good news is that the majority of women who have had multiple
miscarriages - about 65% - go on to have a successful pregnancy. At Penn Fertility
Care, our unique blend of expertise, personalized care and advanced fertility
treatments can increase these odds.
When Should You See a Fertility Specialist for RPL?
Recurrent pregnancy loss is still considered a form of infertility since you
have been unable to achieve a live birth, even though you've gotten pregnant.
Many of the same treatments we recommend for other causes of infertility can
also help women with RPL. If you've had two or more consecutive miscarriages,
we recommend scheduling an appointment with our fertility care team.
Our Treatments for Recurrent Miscarriages
We start by addressing any underlying causes of miscarriages, such as treating
thyroid or autoimmune disorders or getting diabetes under control. We also
offer a variety of advanced treatments that can increase your chances of
having a successful pregnancy, including:
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Hormone management: We may recommend progesterone supplementation to reduce
the risk of a miscarriage, especially if you've had bleeding early in
previous pregnancies. Progesterone helps prepare your uterus for pregnancy
and may reduce bleeding.
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In vitro fertilization: In vitro fertilization is the process of fertilizing
an egg with sperm in a lab. We develop the embryo until it's ready to
transfer to your uterus.
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Preimplantation genetic testing: We test embryos for genetic or chromosomal
conditions before transferring or freezing them. Preimplantation genetic
testing allows us to select the healthiest embryo, which increases your
chances of a healthy pregnancy.
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Reproductive surgery: If we discover that miscarriages are related to a
uterine condition such as fibroids, surgery may be a treatment option. Your
fertility doctor can tell you more about the risks and benefits of different
surgeries.
Make an Appointment
Call 717-544-0107 or request an appointment to schedule your fertility
consultation.