• 30 March 2017
    Recurrent Miscarriage clinic

    Recurrent Miscarriage clinic

    Recurrent Miscarriage clinic

    Miscarriage is the spontaneous loss of pregnancy products from conception until 20 or 24th week of pregnancy.

    Recurrent miscarriage is referred to at least two consecutive miscarriages or at least three non-consecutive miscarriages. Based on the reputable guidelines of the world besides European and American Associations, evaluation and treatment of the individuals with miscarriage should be carried out in clinics that are exclusively designed for this purpose. Based on the recent studies, the success rates of patients referred to miscarriage clinics is more than the ones referred to female clinics. Therefore, women who experience the spontaneous loss of pregnancy products, and the problem is clinically confirmed through ultrasound or pathology, should be referred to miscarriage clinics in order to diagnose the main cause and hinder the consecutive occurrence of the problem.

    The workflow:

    Patients with the initial criteria for miscarriage are first visited in the clinic. After examination and ultrasound if needed, the gynecologist request the necessary tests to diagnose the cause of miscarriage. Also, the necessary consultations with genetics clinic, endocrinology and nutrition clinic are done. When the initial results of the test are ready, patients are referred to the miscarriage clinic, so their profile and history can be completed. Different factors may result in recurrent miscarriage and multifactorial causes may include genetics, anatomical, uterine, autoimmune, hormonal, thrombophilia and environmental factors. Nearly, 50% of causes for recurrent miscarriage are known and all patients with explained and treatable causes should start the consultation and treatment. About the other 50% of the causes are still unexplained despite the hard attempt to understand their origin. Although in the latter group the origin of the recurrent miscarriage is not recognized, the chance for getting pregnant exists. Two important factors affecting the miscarriage are the age of women and the number of previous miscarriages. In women over 35 years of age with multiple previous miscarriages, the risk of having miscarriages increases.   

    The advantages of the clinic:

    Due to interference of multiple factors in recurrent miscarriage, the cooperation of a team of specialists including the ones in genetics, andrology, gynecology, immunology, endocrinology, nutrition and psychology has a pivotal role in a successful treatment. Although gynecologist first examines these patients, but in case of additional consultation or more evaluation, the profile of the patient is sent to the special cases commission containing a group of specialists of the center. Also, in a number of patients with recurrent miscarriage, especially the ones with PCO, recurrent miscarriage occurs with primary or secondary infertility. Therefore, proximity to infertility treatment is one of the merits of Avicenna Fertility Center. Moreover, establishing many seminars in recurrent miscarriage and repeated failure in infertility treatment besides the research projects are the main activities of this clinic. Also, this clinic performs continuous follow-ups to check the condition of the patient before pregnancy and after it.  

    Several suggestions for preventing the recurrent miscarriage incidence:

    Several observational studies confirm the relationship between obesity, PCO and recurrent miscarriage. Therefore, based on this relation and the effect of obesity on the general health of the individuals and especially pregnant women, nutrition consultation and correcting the nutritional habits and life style pattern is highly recommended. Also, smoking or exposure to the smoke and fumes increases the risk of recurrent miscarriage.

    Folic acid supplementary with sufficient dosage before pregnancy also reduces the chromosomal disorders and the risk of recurrent miscarriage.

    Moreover, progesterone consumption early in pregnancy with a doctor's prescription, is one of the treatments recommended to patients with recurrent miscarriage.

    In patients with recurrent miscarriage, the risk of problems like recurrent miscarriage, preterm delivery, intrauterine fetal growth retardation and pregnancy poisoning are increased. Therefore, meticulous and continuous care before planning to get pregnant and during pregnancy is essential.
    It should be remembered that recurrent miscarriage is an unpleasant and stressful experience for the couples that in half of the cases the origin is unexplained and subsequently the effect of using several drugs is useless .Therefore, increasing the knowledge, peace, trust and hope for a successful pregnancy are ancillary means to help having a successful conception.