Diagnostics Intervention in Detecting causes of Recurrent Pregnancy loss
Oct 24, 2023
When couples recognize their pregnancy, they plan for their little one's arrival. While the transformative phase brings a wave of chemical and physical changes, it also affects the mental state. Pregnancy complications might cause stress in mental/ physical well-being, which might lead to depression in couples. One such complication is Recurrent pregnancy loss (RPL), which poses a devastating experience for most women.
RPL is more complicated as the strategies or treatments are unavailable to diagnose the condition properly. However, certain tests help the couple face the condition, assess their health, and create a suitable treatment plan to conceive successfully and experience a secure pregnancy.
What is RPL?
RPL, or recurrent pregnancy loss, is characterized as two or more consecutive miscarriages. As it is considered a sporadic incidence, around 10-20% of women experience miscarriage in their first pregnancy. The chances for recurrent miscarriages tend to increase as the gestation age at the time of pregnancy loss increases. Miscarriage in the context of gestational age is defined as the loss of a pregnancy before the period of viability.
How can Diagnostic Intervention Help in Recurrent Pregnancy Loss?
Most couples prefer to know the cause behind their recurrent pregnancy loss experience, even if it cannot prevent future complications. Diagnostic intervention in detecting causes of recurrent pregnancy loss often helps patients and healthcare professionals find the answers. It will enable them to identify the causes of pregnancy loss that will likely recur and reveal the medical issues that must be addressed. The tests can assist in:
- Detecting whether the pregnancy loss is due to abnormal chromosome number (referred to as aneuploidy)
- Provide information to patients and physicians to better understand the cause of miscarriage.
- Develop a plan to support healthy pregnancy in the future.
What are the Causes of Recurrent Pregnancy Loss?
After a complete fertility evaluation, experts can easily identify the causes of recurrent pregnancy loss in women. Let’s take a look at them.
- Chromosome abnormalities – In 2-8% of couples with recurrent pregnancy loss, either men or women have been diagnosed with abnormality in their chromosomal structure.
- Anatomical abnormalities – In 15% of RPL cases, women have abnormalities in their uterine cavity. The abnormality also includes urine septum (when the cavity is in unusual shape) and scar tissue within the uterus, fibroids, or polyps.
- Immunological problems – People with recurrent pregnancy loss experience circulating antibodies that adversely affect the proper functioning of the placenta. The placenta, an important tissue, supports the overall pregnancy. The interference might lead to miscarriages.
- Blood clotting disorders – Some women suffering from recurrent pregnancy loss have been diagnosed with inherited disorders that make them susceptible to generating clots in their blood vessels. The link between blood clotting disorders (thrombophilias) and miscarriage is more likely to be diagnosed in the late first or early second trimester.
- Hormonal abnormalities – Women diagnosed with pre-existing hormonal disorders, including uncontrolled diabetes mellitus or unregulated thyroid gland dysfunction, are highly prone to develop recurrent pregnancy loss.
- Fetal chromosomal anomalies - Experts have found that around 70% of miscarriages happen due to the anomalies diagnosed in the number of chromosomes in the fetus. The cause is more common in women with higher maternal age, and the condition is often called random miscarriage.
- Unexplained RPL– While there are above specific causes for RPL, there are certain cases with no identified cause. Unexplained or undiagnosed RPL can be a frustrating and challenging experience for couples. However, studies have found that with consistent attempts at conception and no excess interventions, the chances for future birth remain quite high for couples, even with unexplained recurrent pregnancy loss. Depending on their age and individualized health status, they have a 50-80% chance of experiencing natural pregnancy in the future.
What are the Types of Diagnostic Tests for Recurrent Pregnancy Loss?
To diagnose recurrent pregnancy loss, fertility specialists follow a series of diagnostic procedures that includes:
- Blood tests
The healthcare professions will draw the blood from couples to test the levels of progesterone, a hormone that thickens the uterus lining and nurtures embryo development. It also produces certain proteins that affect maintaining a safe pregnancy. Women will also be tested for pelvic inflammatory disease, a sexually transmitted disease that might increase the risk of miscarriage.
Ultrasound uses sound waves to create images of organs and inner structures of the fetus, enabling doctors to predict fibroids or polyps that cause miscarriage or infertility problems. During the procedure, the doctor uses a transvaginal ultrasound, where a transducer will get detailed images of the reproductive organs.
- Genetic Screening
Most recurrent pregnancy loss happens due to aneuploidy. It means the embryo has an irregular number of chromosomes. The genetic variations due to translocation (chromosomal rearrangement) in men or women might cause chromosomally unbalanced eggs or sperm. Hence, the embryo cannot fully develop after conception, resulting in miscarriage.
- Hormone test
The risk for recurrent pregnancy loss increases with age, especially in women who are 35 or older and will be diagnosed for blood tests to determine the follicle-stimulating hormone (FSH) level. The level of FSH might decrease as women age, contributing to age-related pregnancy loss problems.
When Should You See A Doctor for Recurrent Pregnancy Loss?
If you have had three or more miscarriages, you should be referred to the fertility unit dedicated to managing recurrent pregnancy loss. The specialized doctor will perform certain tests and investigations to find a possible reason. People with pregnancy loss with fetal abnormalities and repeated miscarriages while opting for IVF treatment should also visit a fertility specialist for early diagnosis.
Despite advancements in the medical field, most parents fail to discover the reason for their miscarriage. However, we believe that every parent deserves to know the reason. The profound diagnostic intervention will end the cycle of self-blame and guilt and drive them toward finding ways to prevent the incidence.
At Apollo Diagnostics, we have a team of professionals who specialize in helping women and couples struggling with recurrent pregnancy loss (RPL). We specialize in advanced fertility diagnostic services and conduct a series of fertility evaluations to unveil the exact cause behind RPL, aiding in designing a proven approach to prevent future incidents. Schedule an appointment at the nearest Apollo Diagnostic Center today!
Frequently Asked Questions (FAQs)
1. What is the diagnosis of RPL?
Recurrent pregnancy loss (RPL) is defined as two or more consecutive failed pregnancies documented by histopathology or ultrasound examination. A complete physical exam, including pelvic exam, blood tests, and imaging tests, is usually carried out to detect the causes of repeated miscarriages.
2. Can the hCG test detect pregnancy loss?
Human chorionic gonadotropin (HCG) is a hormone secreted by the female body during pregnancy. The hormone plays a vital role in supporting fetal growth. Usually, the level of HCG in urine or blood is tested to confirm the pregnancy. Nonetheless, the hormone level in the blood is also used to determine if the woman is experiencing an ectopic pregnancy or miscarriage.
3. How can healthcare professionals treat recurrent pregnancy loss in women/ couples?
Your healthcare professional might recommend specific treatment approaches for recurrent pregnancy loss, including correction or hormonal problems and surgical treatment for uterine abnormalities and fibroids. The treatment will be decided based on the cause, which is not applicable in every case.
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