Infertility after a miscarriage, what are your options?

By Jennifer “Jay” Palumbo

A miscarriage is defined as the loss of a pregnancy within the first 20 weeks. According to the March of Dimes, between 10 and 15 percent of known pregnancies end in miscarriage. Knowing these statistics and that pregnancy loss is something that is common however doesn’t make it any easier. Especially if you’ve if you find you may have difficulty getting pregnant again after experiencing a pregnancy loss.

If you suspect you have infertility after a miscarriage (even if your fertility has never been a concern previously), this blog is going to offer advice on when you seek the help of a reproductive endocrinologist, what issues may impact your chances of conceiving or carrying a pregnancy and the options you can discuss with your fertility doctor.

When should you see a doctor?

If you’re having difficulty conceiving after a miscarriage, there are certain parameters that you may fall into to offer some guidance on when to make an appointment with a reproductive endocrinologist (RE), which is a specialist who has received a board certification by the American Board of Obstetrics and Gynecology in both Obstetrics and Gynaecology, and Reproductive Endocrinology and Infertility. If any of the following describes you, you may want to see a RE sooner rather than later:

  • Women under 35 years old who have been regularly trying to conceive for more than a year.
  • Women over 35 years old who have been regularly trying to conceive for more than six months.
  • Couples in which either the male or female has a known medical issue such as a polycystic ovarian syndrome (PCOS), endometriosis, blocked fallopian tubes, diminished ovarian reserve or in the men’s case, a concern with their sperm (low sperm count, etc.)
  • Women 40 years old or older. Both egg quantity and quality diminish as a woman gets older, so it can be helpful to seek the help of a reproductive endocrinologist if you’re in your late 30’s – early 40’s to get the proper testing to best determine fertility protocol for you to expand your family.
  • Women who have missed periods or experience irregular periods
  • Women who are concerned that they may not be ovulating
  • Women who have had treatment or suspect you have endometriosis
  • Have been diagnosed with Polycystic Ovarian Syndrome
  • Women who have had a history of pelvic infection, such as pelvic inflammatory disease (PID) pelvic pain
  • Have had two or more miscarriages (also known as Recurrent Pregnancy Loss)

If this was your second or even your third miscarriage, that is known as Recurrent Pregnancy Loss. Recurrent Pregnancy Loss (RPL) is defined as two or more pregnancy losses by the American Society of Reproductive Medicine (ASRM). It can be caused by autoimmune issues, endocrine issues, uterine anomalies and chromosomal abnormalities of the embryo. The risk of miscarriage can increase with the number of previous pregnancy losses. Therefore, if you’re concerned about infertility after a miscarriage, even if you haven’t necessarily been trying for the recommended amount of time, you may want to see a specialist soon, so they can help reduce your risk of any additional losses.

Getting answers

Having one miscarriage is very unfortunately common. If you’ve had more than one, there can be different reasons for it such as uterine anomalies, endocrine issues or a chromosomal abnormality in the embryo. Especially if you’re finding infertility after miscarriage, getting a fertility work-up (health history, blood work, ultrasound, etc.) can provide insight and options in how to best proceed in having a healthy pregnancy and child.

For example, chromosomal abnormalities are responsible for roughly 70 percent of miscarriages, one way to reduce the risk of miscarriage would be to undergo In Vitro Fertilization (IVF) with Preimplantation Genetic Testing for Aneuploidy (PGT-A). PGT-A can test for chromosomal abnormalities in embryos prior to implantation. PGT-A can potentially improve the chance of a healthy pregnancy by selecting embryos that appear to be chromosomally normal to transfer into your uterus.

There’s so many resources, genetic tests, options and reproductive tools that can support you

Whether you do have an infertility diagnosis or a perhaps an issue that can be easily addressed by a change in lifestyle, medication or minor surgery, we are here for you.

If you have any questions at all, just email us at askanexpert@ivfbabble.com and your queries will be responded by leading fertility experts.

 

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