Repeated Miscarriage And Conception Possibilities With Advanced Fertility Treatments

Repeated miscarriages do not preclude you from having your own child. There are several advanced fertility treatments that can help couples overcome repeated miscarriages and achieve parenthood.

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For some couples, the journey to parenthood takes a little more time than the others. Miscarriage can shatter hope and cause physical and emotional pain. But even couples who had faced repeated miscarriages can conceive with the help of advanced fertility treatments. 

Miscarriage can happen due to a lot of reasons and hence the diagnosis of the cause becomes critical. The vital aspect is to consult a fertility specialist if the couple has had repeated miscarriages which can help in finding out the cause and also enabling in a successful pregnancy. 

Dr Meghana Nyapathi, Clinical Head and Fertility Specialist, Oasis Fertility, HSR, Bengaluru, spoke with ABP Live about some common causes of repeated miscarriages and briefly discussed advanced fertility treatments.

Causes of Repeated Miscarriages:

• Genetic conditions/chromosomal abnormalities in the embryo
• Uterine Anomalies
• Uncontrolled Diabetes 
• Advanced Maternal Age
• Hypertension
• Thyroid Disorders
• Obesity
• Smoking and Alcohol intake
• High DNA Fragmentation Index

Advanced Fertility Treatments/Investigations: 

Karyotyping

Hysterolaparoscopy

Thrombophilia Profile 

DNA Fragmentation Index Testing

PGT (Pre-implantation Genetic Testing)

Lifestyle Modifications

Karyotyping: Many are not aware that genetic disorders in the male or female partner can lead to miscarriage. If a couple has faced miscarriages, they should consult a fertility specialist who may carry out the initial evaluation and ask the couple to take up Karyotyping through which the presence of any genetic disorder can be detected. Karyotyping and chromosomal analysis of the abortus if present, can further aid in the diagnosis and management of this couple.

Kallmann Syndrome, Y Chromosome Microdeletion, and Klinefelter Syndrome are some of the genetic disorders that can result in a miscarriage. 

Hysterlaparoscopy: Septate uterus and bicornuate uterus are some of the abnormalities in the uterus that can cause miscarriage in 1st or 2nd trimester and also may lead to preterm birth. 

Procedures like metroplasty, hysteroscopic septal resection, etc. can be done to help these women to have a successful conception. 

Thrombophilia Profile: Autoimmune conditions like the presence of antiphospholipid antibodies (APLA), anticardiolipin antibodies (ACA), and antinuclear antibodies (ANA), are some of the autoimmune conditions that may result in miscarriage. These can be detected by blood tests and can be treated using steroids, iv immunoglobulins, etc. 

DNA Fragmentation Index Testing – The semen sample of the male partner can be tested for DFI. Raised DFI could be due to the presence of varicocele, chronic smoking, etc. The methods to reduce DFI include newer semen preparation techniques like microfluidics, MACS, surgical procedures like varicocele repair, TESA, etc.

Lifestyle Modifications: Weight reduction, regular physical activity, quitting smoking and alcohol, and adopting a healthy lifestyle can help in improving the chances of a successful pregnancy. 

How can we reduce the risk of miscarriage?

PGT (Pre-implantation Genetic Testing) can be the solution as it is an advanced technology that helps in picking up the right embryos devoid of chromosomal abnormalities for implantation that can reduce miscarriage. PGT also prevents the child from inheriting any genetic disorder from the parents. 

PGT Types: 

1. PGT – A (Aneuploidy) – PGT-A checks for extra or missing chromosomes. Aneuploidy is the condition when there are either more or a lesser number of chromosomes. Down Syndrome in which case there is an extra copy of chromosome 21 can be detected by PGT-A.
2. PGT-M (Monogenic) – Single-gene disorders like Cystic Fibrosis, and Huntington’s disease can be detected by PGT-M.
3. PGT-SR (Structural Rearrangements) – This is used to find out any structural rearrangements. 

Repeated miscarriages don’t mean that you cannot have a child of your own. Never give up hope. Awareness is the key as there are several advanced fertility treatments that can help couples overcome repeated miscarriages and attain parenthood.