Sometimes getting pregnant is not the issue. Many couples have no problems conceiving but are unable to sustain a pregnany. Other times, couples who initially come to us with infertility will suffer through repetitive pregnancy losses following infertility treatments.
Three consecutive miscarriages is considered “recurrent pregnancy loss”, but at the MFC, we offer testing after 2 losses. Fortunately, a cause can often be found and corrected in many patients. Roughly 1/3 of couples will have more than 1 cause for their inability to sustain a pregnancy.
The work-up for recurrent pregnancy loss is similar to the infertility work-up but includes some extra testing, including:
- Chromosome/karyotype testing for both partners
- Evaluation of the woman’s uterine cavity (HSG, sono-HSG, or hysteroscopy)
- Mycoplasma testing
- Sperm chromatin structure assay test (DNA fragmentation)
- Immune screening
Depending on the cause of the pregnancy losses, treatment can range from surgical removal of a uterine septum, to progesterone support after ovulation, to complex immune therapy. Occasionally, couples resort to egg or sperm donation if a genetic abnormality is identified in one of the parents. Rarely, for women with unexplained recurrent pregnancy loss, a surrogate is recommended.