Management of Recurrent IVF failures, pregnancy failures, and miscarriages
Recurrent Miscarriage/ Recurrent Pregnancy Failures
Recurrent miscarriage is also known as recurrent pregnancy loss. It is an extremely distressing condition that can affect some couples who are trying to conceive. There are many reasons for miscarriage. Sometimes the couples get so disheartened that they lose hope, but there are solutions to every problem and hence, a miscarriage should not stop any woman or couple from trying for a child again.
In cases where a woman goes through more than one miscarriage can be disheartening. It should be kept in mind that miscarriages are often a natural process. As much as two-thirds of women who go through recurrent pregnancy loss can eventually have a healthy baby with the right help.
Recurrent IVF Failures
Recurrent Implantation Failures stands for the inability to achieve a clinical pregnancy despite transfers of four or more good quality embryos in at least three fresh/frozen cycles for women under 40 years of age. The reasons for failure to the implant can be due to the embryo or uterine factors. The reason for failure to the implant can also be due to contributory factors such as poor egg quality, poor sperm quality, or increased sperm DNA fragmentation. Recurrent implantation failure can lead to repeated IVF failure.
What factors influence recurrent pregnancy loss and miscarriages?
- Age: The risk of miscarriage is higher as women get older beyond 40.
- Genetic factors: Many women or their partners may have a chromosomal abnormality that can cause a problem if passed on to the newborn.
- Structure of the womb: Women with serious anatomical abnormalities of the womb such as the uterine septum, bicornuate uterus, unicornuate uterus are more likely to have a miscarriage or give an early birth. Minor structural variations do not cause miscarriages.
- Autoimmune factors: About 15% of women who have had a recurrent miscarriage are those with antibodies called antiphospholipid (aPL) in their blood. For a woman with a history of recurrent pregnancy loss and the presence of aPL antibodies, the chances of a successful outcome are bleak without treatment.
- Abnormalities in the embryo: Abnormalities in the embryo due to chromosome are high in women age more than 37 years and are a common reason for a miscarriage.
- Blood conditions: Inherited conditions such as thrombophilia can play a part in miscarriage. Thrombophilia is a condition where blood is more likely to clot than usual.
- Infections: Infections such as bacterial vaginosis early in pregnancy can increase the risk of miscarriage or premature birth.
- Weak cervix: In several women, the cervix or the entrance of the womb opens too early during pregnancy causing a miscarriage in the third or fourth month.
How can you prevent recurrent miscarriages?
- Screening for genetic problems: Either of the partners can have a chromosomal abnormality. A blood test called karyotyping can be done to check for any abnormalities and risks associated with it.
- Screening for abnormalities of the womb: An ultrasound scan of the pelvic region should be done to check for any abnormalities in the structure of the womb and if found should be corrected by hysteroscopy and laparoscopy.
- Screening for infection: Women who have had miscarriages in their fourth to sixth month or premature labour should be screened for bacterial vaginosis. Antibiotics treatment can reduce the risk of miscarriage considerably.
- Treatment for hormone imbalance: Women with hormonal imbalance should take progesterone or human chorionic gonadotropin hormones early in their pregnancy after a suggestion from their doctor. This can help to prevent miscarriage.
- Treatment for weak cervix: With a weak cervix, miscarriage is likely. An ultrasound scan can help to indicate that. A stitch in the cervix can be put to ensure it stays closed.
- Treatment for aPL antibodies: Treatment for women with aPL antibodies can be done with low dose aspirin and heparin injections after a suggestion from your doctor. This can improve changes for birthing women with a history of recurrent miscarriages.
- Treatment for thrombophilia: Even though Thrombophilia increases the risk of miscarriage, treatments can help to reduce the risk of a blood clot.
Dr. Richa Singh is a well known IVF specialist from Max Hospital, Delhi who has been awarded for her exemplary work in the field of infertility, and now she is available in Lucknow. She has a proven track record of high success rates and has been helping numerous families to conceive through various procedures of ART. She has expertise in treating complicated cases of infertility with a history of recurrent pregnancy loss and implantation failures. Patients all across the nation and abroad have been seeking her help for conception in such cases. She has managed to give pregnancies to previous 6-7 cycle IVF failure patients and thus gained their trust. Her patients can vouch for her exceptional services.
Happy Patients Review
We want to thank Dr. Richa for your intense knowledge, care, and support, as well as the compassionate services you gave us each and every time we saw you. We will always be grateful to you for helping us complete our family. We would like to thank both the doctor and her team for their kindness and generosity. We are so fortunate for your services.
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After losing a lot of money on 3 IVF cycle failures, my husband and I had accepted the fact that we wouldn’t be able to conceive but when our friend forced us to visit Dr. Richa, we visited her for the sake of our friend but from there everything changed. Dr. Richa counseled us and told us not to lose hope. It is because of her that I am now a mother to a beautiful baby girl.
Dr. Richa came as a blessing in our life. Having heard so many stories of failed infertility treatment, we were scared to give it a try. When we met with Dr. Richa, we knew we were in the right hands. Her treatment was well planned and she guided us very well. It is because of her that we became parents after 10 years of trying.
Dr. Richa is one of the best doctors I’ve known so far. We had been trying to get pregnant for so long, but nothing happened then someone recommended me to Dr. Richa. We visited Dr. Richa, she did some tests and studied our case. She concluded that my wife was having some issues in getting pregnant. She suggested some procedures to overcome the issues. We followed what she said and believed her. Now my wife is 4 months pregnant. We are so glad that we visited Dr. Richa. She has brought happiness to our life. We are so thankful to her.
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What is infertility?
Infertility is the inability of a couple to conceive even after a year of trying to get pregnant through unprotected and well-timed sexual intercourse in which the woman is under the age of 35. If the woman is above 35, it is diagnosed after six months of trying to get pregnant. Infertility can be due to male or female factors or even both. It can also be due to unexplained reasons.
Does age affect a woman’s ability to have children?
Yes, age does affect a woman’s ability to have children. More and more women now prefer to wait until their 30s and 40s to conceive. A woman’s fertility starts to reduce from her 30s and more after the age of 35. As much as one-third of couples who face fertility problems are those in which the woman is above the age of 35.
How does age affect a woman’s ability to have children?
Here are a few ways of how a woman’s ability conceive reduces due to her age:
- The ability of ovaries to release eggs ready for fertilization reduces with age
- The quality of eggs released reduces with an increase in the age of women
- An increase in age can lead to more health problems which may interfere with a woman’s fertility
- The risk of miscarriages increases as a woman ages
- Children born to older women tend to have more abnormalities
How long should women try to get pregnant before visiting a doctor?
Women who are healthy and below the age of 30 need not worry about infertility unless they have been trying to get pregnant for a year or so. If such is the case, they should talk to their doctor for a fertility evaluation. They should also ask their partners to do the same.
Women in their 30s trying to get pregnant should talk to their doctor after trying for 6 months as a woman’s chances of having a baby decline rapidly after the age of 30.
Is infertility only a woman’s problem?
No, infertility can affect both men and women. About one-third of cases of infertility are due to female factors and another one third are due to male factors. The remaining cases are either due to a mixture of both male and female factors or due to unknown reasons.
Can male infertility be treated?
In most cases, male infertility can be treated. Your doctor may suggest you use assisted reproductive technologies (ART) such as In Vitro Fertilisation (IVF). Although ART cannot cure or treat the causes of infertility, it can help couples achieve pregnancy even with the male’s low sperm count.
What are the risk factors for infertility?
There are several external factors, lifestyle choices, and environmental causes that can lead to infertility. Although some risk factors can be gender-specific, some common risk factors are:
- Alcohol Consumption
- Substance Abuse
- Obesity and Underweight
- Sexually Transmitted Diseases
- Tubal Disease
- Genetic Causes
What are the ways to treat infertility?
There are many ways to treat infertility for both men and women. With advancing medical technologies, you and your partner along with your doctor can decide depending on the options available.
What causes infertility in women?
The most common reason for infertility in women is problems with ovulation. No ovulation or improper ovulation can prevent eggs from fertilizing or there may be no eggs at all. Irregular periods or no periods are a sign of no or improper ovulation. Some other causes of infertility include:
- Uterine Fibroids
- Blocked Fallopian Tubes
- Physical problems with the uterus
- Pelvic Inflammatory Disease
- Several Miscarriages
- Unexplained Reasons
What causes infertility in men?
Infertility in men can be due to the following:
- Low or no sperm production
- Low motility of sperms- sperms inability to move fast or reach the egg to fertilize it
- Abnormal shape/structure of sperms that prevent it from fertilizing the egg
- Erectile Dysfunction or Retrograde Ejaculation
Sometimes, men may be born with these problems, and the other times, they may develop these problems due to an illness or injury.