Miscarriage Treatment in Long Island
A miscarriage is the loss of pregnancy before 20 weeks of gestation with most occurring in the first 12 weeks of gestation. At NYU Langone Reproductive Specialists of New York, we treat women suffering from recurrent miscarriages to help them conceive.
Recurrent Miscarriage Causes
A variety of factors can cause recurrent pregnancy loss, including the following conditions.
The most common cause of pregnancy loss is due to an embryo possessing an abnormal number of chromosomes – either one too many or one too few. During the formation of eggs and sperm, the number of chromosomes each cell possesses is normally halved (from 46 to 23), so that when the egg and sperm join at fertilization, the normal number 46 is restored. Unfortunately, that halving process (termed meiosis) can go wrong. This problem increases with a woman’s age, but not a man’s age, although men with very low sperm counts at any age can have increased numbers of chromosomally abnormal sperm. The majority of embryos possessing an abnormal number of chromosomes are lost in the first trimester of pregnancy, although some babies may be born with an extra chromosome 21 (Down’s syndrome) or missing X chromosome (Turner’s syndrome).
After an egg is released during ovulation, the ovary produces progesterone, which helps to create the “fertile bed” in which the embryo grows to establish a normal pregnancy. The level of progesterone is measured during pregnancy to confirm that there is enough of this hormone to support a pregnancy. Another hormone, HCG (human chorionic gonadotropin), is measured at the same time. This hormone is produced by the embryo and stimulates the ovary to produce large amounts of progesterone. In early pregnancy, HCG levels approximately double every two days, and this increase provides a measure of the health of the embryo. If HCG levels do not rise normally when measured over several days, the embryo itself is not healthy. Measuring the levels of both hormones, HCG and progesterone, helps to distinguish cause and effect and determine whether to prescribe additional progesterone, to support the pregnancy.
Abnormal Uterus Shape
An abnormally shaped uterus may predispose you to a miscarriage. The uterus is formed during a woman’s embryonic development from two primitive tubes (the Mullerian ducts) that join together. Sometimes this joining is incomplete so that the uterus has an abnormal shape. This can be corrected by surgery in some cases (as when there is a uterine septum). MRI, 3D ultrasound, and a saline sonogram of the uterus can aid in the diagnosis. These congenital abnormalities of the uterus may predispose to miscarriage in the second trimester, but also are associated with a weakening of the entrance of the uterus, (the cervix), which may open prematurely and lead to pregnancy loss. Monitoring by repeated ultrasound examinations during pregnancy is done to look for this and take action.
Recurrent Pregnancy Loss
Sometimes, a miscarriage itself may lead to future miscarriages. When the uterus does not empty its contents completely after a miscarriage, this may possibly lead to infection and the need for a subsequent dilation and curettage. These circumstances predispose to scarring within the uterus, leading to a subsequent miscarriage. This scarring needs to be removed before a woman attempts to become pregnant again. Saline sonograms, during which sterile saltwater is injected within the uterus while it is studied by ultrasound, can be performed to diagnose the presence of these scars. Blood tests must also be performed to look for hidden diabetes and abnormal thyroid function, as well as for antibodies to phospholipids that damage the placenta.
Most of the time, having had a miscarriage does not indicate that there will be difficulties in the future. In fact, the likelihood of a second pregnancy loss following a first loss is approximately 20 percent, and even following a subsequent second loss, the odds of a miscarriage in the next pregnancy are about 25 percent. This means that the majority of couples in whom no other cause of miscarriage is found to have a good chance of a successful pregnancy in the future.
Recurrent Miscarriage and Fertility Treatment Options in NY
Having treated patients since 1991, our reproductive specialists know what a stressful time this can be for you. Whether you’re looking for more information about fertility treatments, evaluations, or an egg check test, give yourself some peace of mind with physicians who will always put you first. Contact us now to make an appointment for personalized care that you will not find anywhere else!