Female Infertility

 

Treating Recurrent Miscarriage at Midwest Reproductive Center


Two or more failed pregnancies will escalate your case at Midwest Reproductive Center, and Dr. Dan Gehlbach will begin to treat the disease of infertility in conjunction with the disease of recurrent miscarriage.

Making the decision to seek treatment is difficult, but warranted. The American Society for Reproductive Medicine recommends a thorough fertility workup in these circumstances:

1. You have had two consecutive miscarriages
2. The miscarriages occurred in the first 20 weeks of pregnancy
3. The cause of miscarriage is unknown

ASRM Guide on Recurrent Pregnancy Loss

Resolving Your Pain: Finding the Causes of Recurrent Miscarriage


It’s common to have an early miscarriage, but less than 5 percent of women will experience two consecutive miscarriages, and only 1 percent will have three miscarriages, one after the other.

The most common cause of early miscarriage involves how chromosomes ‘match up’ when the sperm fertilizes the egg.

Dr. Gehlbach explains what can go wrong in early pregnancy:

• The mother and the father each provide a unique genetic blueprint of 23 chromosomes, one of which is the sex chromosome.


• These pairs connect to form a new person.


• When one too many or one too few chromosomes exist, miscarriage can result. Maternal age greatly increases the risk of chromosomal abnormalities.

Random occurrences aside, 5 percent of couples will have a genetic problem with their DNA (one they can pass on to their baby) that leads to miscarriage. With translocation, a large part of a chromosome breaks off and attaches to another chromosome, resulting in early miscarriage. Problems with the proteins and gene code can lead to inherited disease such as Fragile X.

Other causes of recurrent miscarriage include:

• Luteal phase defects
• Polyps
• Fibroids
• Endometriosis
• Autoimmune disorders (Antiphospholipid syndrome)
• Septums
• Uterine defects
• PCOS
• Immune system irregularities
• Hormonal disruptions
• Thrombosis
• Diabetes

 

Treating Recurrent Miscarriage


Blood work, genetic testing, and a physical exam provide Dr. Gehlbach with diagnostic clues. Your fertility specialist will then determine a preventative course of action.

Some commonly prescribed treatments for recurrent miscarriage that Dr. Gehlbach employs:

Preimplantation Genetic Diagnosis with In Vitro Fertilization IVF The Midwest Reproductive Center IVF lab can remove one non-essential cell from an early embryo to diagnose chromosomal abnormalities. Rather than leaving conception to chance, PGD enables us to transfer embryos that are genetically sound and have the best chance at progressing along in pregnancy.

Progesterone Support Women with short cycles or apparent luteal phase defects may benefit from progesterone to support a pregnancy. We routinely include progesterone in an IVF fertility treatment cycle.

Aspirin and Heparin Therapy If we identify antiphospholipid syndrome in a patient, Dr. Gehlbach will prescribe a combination of aspirin and heparin.

Insulin Sensitizing Agents Polycystic Ovarian Syndrome (PCOS) and diabetes, when controlled with medication, do not have to impede your ability to get pregnant. Dr. Gehlbach combines nutritional support with fertility treatment to improve the chances for conception.

Minimally Invasive Fertility Surgery Polyps, fibroids or endometriosis can affect an embryo’s potential to attach to the uterus and thrive. Dr. Gehlbach can diagnose and treat many reproductive conditions, including anatomical issues with the uterus, with minimally invasive surgery. Some conditions can be treated with in-office procedures.

Painful as it is, recurrent miscarriage can provide clues as to the cause of infertility. Dr. Gehlbach reassures patients that targeted treatment can make a world of difference in subsequent attempts to get pregnant. In fact, nearly 70 percent of women with recurrent miscarriage will go on to have successful pregnancies.

Contact a caring and compassionate staff member at Midwest Reproductive Center to arrange for help with recurrent miscarriage.