One of the saddest and most frustrating events that a patient or couple can experience is a miscarriage. This is especially true when they have undergone some type of fertility therapy, since it often makes them feel as if the patient now has a problem of holding onto a pregnancy, despite having gone through such aggressive means to achieve it.
Depending upon when a miscarriage occurs, i.e. early in the first trimester or later in the pregnancy, various underlying causes may be responsible. These include uterine abnormalities, hormonal imbalances and other factors. Often, such abnormalities can be corrected through surgery, different medical treatments or supplements depending upon the identified cause. However frequently, an obvious cause is not found, and this compounds the frustration and fear that the patient may then experience. Recently, two studies addressed this very issue, and happily, the results are quite reassuring.
To begin with, Dr. Harvey Kliman from Yale University reported on a decade’s worth of microscopic analyses of the placental tissue obtained after pregnancy losses. His group found that over 80% of these miscarriages were caused by genetic abnormalities, rather than the commonly thought contributors of thrombophilias or antiphospholipid syndromes (both are blood clotting disorders), immunologic problems, or other maternal factors. In addition, a second study by Dr. Ruth Lathi’s group from Stanford demonstrated that chromosomal abnormalities of the embryo accounted for a significant portion of the miscarriages, and happily, two-thirds of women with prior loss of such a genetically abnormal embryo went on to have a live birth in a future pregnancy! Dr. Lathi pointed out that “Each new pregnancy is a new set of genetics… a new egg,… a new sperm, and what went wrong in the last pregnancy may not carry over to the next pregnancy”. In addition, she was quoted as saying “Luckily, these genetic abnormalities are for the most part random, and women can have a combination of abnormal pregnancies and normal pregnancies.”
The results of these two recent studies are truly exciting for patients who have suffered through the tragedy of miscarriages. In essence, they provide hope, and to some degree, comfort for those patients in knowing that they are not to blame for their losses. As Dr. Kliman so accurately stated, “If women know that recurrent miscarriages are unlikely to be related to something they have done, such as having a cocktail… when they weren’t even aware that they were pregnant, they will be better able to cope emotionally and resume trying”.