Recurrent pregnancy loss is one of the toughest spots for women that require extensive support and counseling. We start by asking the couple not to attempt pregnancy and use a birth control method till the workup is completed. We run both partners’ chromosomes, antiphospholipid antibodies and tests for excessive clotting (thrombophilia). We also investigate the shape of the uterus and exclude any abnormalities in its cavity. We refrain from ordering tests or recommending treatment of anecdotal or no proven relation to recurrent miscarriage.
After testing is completed with convene with the couple to discuss 1. Test results and how to address any abnormality and 2. The odds for a delivery of a healthy newborn.
Women with specific abnormality e.g. clotting problems are treated with aspirin and heparin. Women with abnormalities in the uterus require surgical correction, mostly through hysteroscopy not major surgery. Women or men carrying a chromosomal abnormality as translocation are offered IVF with embryo biopsy followed by chromosomal analysis of the embryos and transfer of normal ones.
For women with no abnormalities, there is a 70% chance of delivering a viable baby if they continue to try using intercourse, IUI or IVF cycle.