Miscarriage

Miscarriage is a very distressing occurrence for any couple and there are numerous factors that may cause this condition, but the underlying problem often remains undetected. Moreover, to add to the couples frustration, investigation is generally not undertaken until after a woman has experienced her third miscarriage.

FertilityCare and NaProTechnology can often identify couples who are at risk of miscarriage, even before any miscarriage occurs. Treatment can be directed towards correcting abnormalities prior to conception and in this way the risk is reduced. Some couples unfortunately suffer with both subfertility and recurrent miscarriage; NaProTechnology can also provide invaluable help to these couples.

Investigation

Using the NaProTechnology approach to address this problem, a detailed study of the woman's FertilityCare chart is performed, followed by a targeted (i.e. accurately timed) hormonal analysis of her cycle to look for deficiencies of both Progesterone and Oestrogen in the phase of the cycle after ovulation.

Treatment

If it is discovered that these hormone levels are below the normal range, then the woman is given treatment to restore the levels to normal; the effect of this is that, not only is her fertility enhanced, but the risk of miscarriage is reduced if she conceives in the cycle in which this correction was made. Hormonal monitoring is then continued, on a cycle by cycle basis, along with correction of any abnormality found, also on a cycle by cycle basis, until a pregnancy is achieved.

Hormone Support in Pregnancy

Once a conception occurs and has been confirmed, the woman is advised to continue with hormone support during the pregnancy using natural Progesterone treatment, and in the case of women with a history of recurrent miscarriage, HCG injections are often given in addition to Progesterone.

Depending on the results of blood tests, which are usually performed every two weeks, treatment is usually gradually reduced and eventually discontinued, when it is considered safe to do so. The aim is to give treatment to maintain Progesterone in the woman's blood at levels which have been found, through prolonged and detailed research in the United States, to reduce the risk, and hopefully prevent the occurrence, of miscarriage and other pregnancy events.

Surgical Investigation and Treatment

If the initial hormonal evaluation prior to conception confirms a completely normal hormone profile, then surgical investigation, in the form of hysteroscopy or hysterosalpingogram, to evaluate the uterine cavity (inside of the womb) is recommended; in addition, if a hysteroscopy is performed, an endometrial biopsy ( a sample of tissue from the lining of the womb) is taken for examination, to exclude a possible low grade endometritis (infection of the lining of the womb), which sometimes contributes to the occurrence of miscarriage.

Further Investigation

Further evaluation of miscarriage consists of other investigations, including blood tests for chromosomal analysis and blood clotting abnormalities, as well as a general health assessment of the woman to identify any other factor, e.g. thyroid deficiency, which might contribute to miscarriage.

The key principle in the NaProTechnology approach to managing women with a history of one or more miscarriages is to search for the underlying cause, (which of course may not always be found), rather than leave the condition unexplained, and then to treat only what is found. In a large percentage of cases, some hormonal deficiency is actually identified and the problem then becomes treatable.

Couples who unfortunately miscarry after their first NaProTechnology intervention are encouraged to try using this approach at least one more time; the chances of success in subsequent attempts may be increased by the knowledge gained from their previous evaluation and treatment, which may lead to some, often minor, treatment adjustments.

This methodical and persevering approach to addressing the problem of miscarriage often leads to very rewarding and satisfying outcomes, but sadly and inevitably, there are also on occasions some great disappointments. Many physicians who have used this approach have experience of having helped couples who have suffered multiple miscarriages (sometimes eight or more), to achieve pregnancies with successful outcomes.

Over 70% of couples can eventually have success with this treatment. Treatment, as well as being safe and minimally invasive, significantly increases the chances of a successful pregnancy outcome.