By – Dr Meghana Nyapathi, Clinical Head & Fertility Specialist, Oasis Fertility, HSR, Bengaluru
Miscarriage is a devastating experience both physically and mentally as it shatters one’s hope of becoming a parent. Many couples tend to remain worried and hopeless in this condition. But it is very important to know that through fertility evaluation, the reason/cause of miscarriage can be known, and the relevant fertility treatment can be devised by the fertility specialist that can enable the couples to achieve their long-cherished dream. If a couple undergoes repeated miscarriage, it is vital to consult a fertility specialist.
Causes of Repeated Miscarriages:
Advanced maternal age
Smoking & Alcohol consumption
Uncontrolled sugar levels
High DNA Fragmentation Index
Advanced Fertility Treatments/Investigations:
DNA Fragmentation Index Testing
PGT (Pre-implantation Genetic Testing)
Hysterolaparoscopy: Some women may have a septate uterus or bicornuate uterus. These abnormalities can lead to miscarriage or preterm birth. Hysteroscopic septal resection or metroplasty can correct the abnormality and help in the conception of women.
DNA Fragmentation Index Testing: If the male semen sample has high DNA fragmentation, miscarriage can happen. Varicocele and chronic smoking may be the cause of high DNA fragmentation. Advanced techniques like varicocele repair and semen preparation methods like MACS (Magnetic Activated Cell Sorting), Microfluidics, and TESA (Testicular Sperm Aspiration) can reduce DNA Fragmentation Index.
Karyotyping: Genetic factors in the male or female partner can be a reason for miscarriage. Karyotyping can help to check if there is any genetic disorder like Kallmann Syndrome, Klinefelter Syndrome, etc. that’s causing miscarriage.
Thrombophilia Profile: Autoimmune conditions can also lead to miscarriage which can be detected by blood tests. These conditions can be treated using iv immunoglobulins, steroids, etc.
PGT: Chromosomal abnormalities in embryos can result in miscarriage. This can be prevented using PGT. Couples with repeated miscarriages can undergo PGT (advanced genetic testing) which allows the selection of embryos without any chromosomal abnormality for implantation during an IVF process. PGT-A (Aneuploidy) helps to find out extra or missing chromosomes in the embryo. PGT-M (Monogenic) can detect single gene disorders like Huntington’s disease, Cystic Fibrosis, etc. PGT-SR (Structural Rearrangements) is used to find out any structural rearrangements.
Lifestyle modifications like reducing weight, indulging in regular physical activity, and adopting a healthy way of living can reduce the risk of miscarriage.
Don’t lose hope. It is possible to conceive even after repeated miscarriages. Advanced fertility treatments can help in achieving your parenthood dream.