Treatments Overview

Miscarriage Care

Overview

About 1 in 4 pregnancies miscarry, making this a common though distressing occurrence. A miscarriage is broadly defined as pregnancy loss before 20 weeks.

Some women will experience more than one consecutive miscarriage. When a woman experiences three or more consecutive early pregnancy losses, it is called recurrent miscarriage. About 1 in 200 women experience this.

Women undergoing fertility treatment are no more likely to have a miscarriage than those who conceive naturally.

Causes of miscarriage

Some of the causes of miscarriage include:

Random chromosome
Genetic abnormalities
Parental chromosome
Uterine abnormalities
Immune causes
Blood clotting disorders
Other medical conditions
Hormone imbalances
Age

IVFAustralia's Miscarriage Care Program tests:

IVFAustralia undertakes a range of routine tests as part of the investigations into the causes of miscarriage.

CATEGORY:	TESTS PERFORMED:	DESCRIPTION:
Genetic Conditions	Parental Karyotype	Some people can unknowingly be carriers of abnormal chromosomes. This may only become apparent when they try to conceive, as the number of chromosomes in the egg and sperm that form the embryo are unbalanced, which causes a miscarriage.
Antiphospholipid Syndrome	ACA (Anti Cardiolipin Antibody) Lupus Inhibitor	These are tests for a particular syndrome called Antiphospholipid Syndrome. This is where a woman has immune factors in her blood called antibodies, which can either attack the developing embryo or increase the risk of blood clotting.
Thrombophilia	Full blood count Activated Protein C Resistance Factor V Leiden Protein C, Protein S Antithrombin III Prothrombin gene mutation MTHFR gene mutation Fasting homocysteine	Thrombophilia is the predisposition to develop thrombosis (the formation of blood clots inside the blood vessel), which can occur in small blood vessels of the uterus and lead to miscarriage. Women may be unsuspecting carriers of a thrombophilia, which may cause problems such as miscarriage, thrombosis in pregnancy, high blood pressure in pregnancy and stillbirth.
Polycystic Ovary Syndrome (PCOS)	Pelvic Ultrasound LH (Luteinizing Hormone): FSH (Follicle Stimulating Hormone) ratio Free Androgen Index Fasting insulin Fasting glucose HBA1c – hemoglobin A 1 – sugar	Women with PCOS may have difficulty conceiving, but they also have an increased risk of miscarriage.
Decreased Ovarian Reserve	FSH – Follicle Stimulating Hormone	Women start to lose their fertility potential (egg numbers) 10 years before their menopause. As this happens, there are fewer eggs to choose from, and the chance of an abnormal egg increases. This leads to an increase in miscarriage risk.
Other Hormone Problems	TSH (Thyroid Stimulating Hormone) Prolactin	Sometimes the first sign of abnormal hormone levels is miscarriage. These can be easily treated.
Anatomical Problems	Pelvic ultrasound scan HyCoSy or HSG Laparoscopy and hysteroscopy	Some uterine abnormalities are congenital (uterine septum, bicornuate uterus) and some acquired (fibroids, adhesions). Detailed assessment is necessary to decide whether surgery would be beneficial.
Sperm Problem	Sperm DNA fragmentation	This test is done on a semen sample. It is a measure of damage to the genetic material in sperm while it is stored in tubules. This damage may be due to male problems such as varicocele, previous groin surgery, diabetes, smoking and other occupational factors. Abnormal sperm lead to abnormal embryos and miscarriage.
Immune Problems	Natural killer cell blood test Natural killer cell womb biopsy Thyroid antibodies Antinuclear antibodies	Natural Killer cells are the main immune cells found in the womb, and play a key role in implantation. Immune testing is still considered experimental as there is not yet enough evidence that treatment is beneficial.