The way forward
It is a surprise for many women to discover how common miscarriage actually is. More than one in five pregnancies ends in a miscarriage. When you conceive and a baby is created, it takes half of its genes from the sperm and half from the egg that ovulated that month. At the exact time of conception, the cross-over of these genes takes place. But for many different reasons this complex process sometimes goes wrong and sadly the pregnancy miscarries.
A miscarriage of pregnancy can shatter dreams. While individual reactions to pregnancy loss vary, most women find the experience deeply distressing. For too many women and their partners, their distress is made worse by a lack of understanding amongst those around them.
It is also natural that they want an explanation from their doctors of what has gone wrong. The investigation and diagnosis for miscarriage however is not always straightforward and this can add to the parent’s anxiety.
We know that half of these miscarriages can be explained by either chromosomal or genetic abnormalities which occur naturally as part of the random nature of the eggs and sperm joining, and it is a matter of ‘luck’ that some of these pregnancies do not survive.
Sometimes there are other causes that usually only begin to become apparent when the mother has a further miscarriage. ‘Recurrent miscarriage’ is diagnosed when a woman miscarries consecutively 3 times, before 9 weeks gestation. Some of these will also be due to bad luck, although the probability of there being some other explanation increases the more miscarriages she has. The incidence of miscarrying 3 times is about 1 in 100. As further miscarriages occur, the rarer is the incidence and the more likely that there would be an underlying cause.
A proportion of these women can be diagnosed with a variety of conditions, and the outcome for them after treatment is very good. For other women, however, there is no apparent cause of their recurrent miscarriage and the reason for their pregnancy loss remains a ‘supposed mystery’ to medical science. Frustratingly, there is nothing obviously wrong with the mother’s eggs, uterus or hormones, and her partner’s sperm is in good health. They can conceive, sometimes with the help of IVF, and yet time and again the pregnancy miscarries. The lack of explanation adds to the suffering and grief they are enduring. Up until now, doctors have been able to offer them little hope other than to keep ‘trying’.
However the good news is that in our clinic, we have taken long awaited steps forward in the diagnosis and treatment of women who suffer recurrent miscarriage.
Using radical scientific advances, we now understand that in some instances a mother’s immune system can actually turn on itself and damage her own pregnancies. Using our knowledge of ‘reproductive immunology’ alongside other established therapies we are now able to diagnose and treat a much greater proportion of women who have previously been offered little hope.
Even women in their late thirties and early forties who have suffered several miscarriages consecutively without any apparent reason and may have been told that their pregnancy loss is age related, are finally able to carry their pregnancies full term and take their babies home with them.