Miscarriages - blessing or curse ??
***Being an Infertility specialist and gynecologist for more than a decade, I have been lucky to witness the joy of a mother when she hold her baby for the first time, but I also had to shed tears with heartbroken women when they lost their baby prematurely due to miscarriage.
The excitement and joy experienced by a couple , when they see a second line on UPT kit is no less than winning a marathon .But sometimes this joy is short lived and all their hopes are shattered by miscarriage or a scan report which indicates lack of growth of the baby.As doctors, one of the toughest part of our job is to explain it to the patients , especially when it happens repeatedly .The sad and devastating look on the faces of the aspiring mother and the aggressive attitude of their spouses are both difficult to deal with .
It is shocking that miscarriage occurs in one out of every three pregnancy and many a times it happens before the detection of pregnancy and goes unnoticed.It is more common in sub fertile couple and women with PCOS , so infertility specialists have to deal with it frequently.
Let me share some facts about the cause for miscarriages.Most of the time, the baby stops growing, because the foetus is not normal enough to continue to grow.( none of us are perfect, but most of us are viable) .
The mother nature is actually blessing us by stopping such pregnancy to grow, as it may have ended up in either physically or mentally abnormal child who might die later in an advanced pregnancy stage or early childhood .Our body is selective and often recognise that the embryo is genetically abnormal, so the uterus does not allow it to grow ( uterus is apparently a huge lab where genetics is recognised ) .
Thus 60 % or more miscarriages happens due to genetic problems with the embryo, which can result from abnormal eggs or sperms or both .
In some cases, there can be problems in blood circulation , like clot formation , which can cause blocks in the normal circulation to the tiny embryo resulting in cessation of foetal heart beat.This condition can be screened by labs by doing certain blood tests in non pregnant stage and are called APLA screening ( anti phospholipid screening) .Women who are found positive are treated with blood thinning agents like aspirin and heparin injections ( low molecular weight heparin ) which gives successful results.
Autoimmune disorders like thyroiditis and many undiagnosed disorders , can result in repeated miscarriages , and medical treatment with steroid may have benefit in confirmed cases.Steroids should not be given without proper indication as they have lot of side effects.
Some acute viral infections can trigger a miscarriage, but not a very common cause.This again helps to avoid an abnormal child which might result because of foetal infection.
Hormonal problems, as in PCOS charecterised by high circulating estrogen or lack of luteal support because of low progesterone is also a reason for miscarriages in a very small percentage of women .Pumping all women with hormones is not needed to treat this.Best treatment for PCOS is diet and exercise and change in life style .
There are abnormalities of reproductive organs, like uterus or cervix , which causes miscarriages in some women, which is again only a negligible percentage and screening in the form of scanning is sufficient to diagnose it in most of the cases.Surrogacy can be a good option for in-correctable cases.
It can be inferred that, the common determinant for the mishap is invariably genetic abnormality.Currently no treatment is available in science to correct the genetic abnormality, so if we look at it positively, these miscarriages are a blessing rather than a curse.Proper tests must be done , by checking chromosomal analysis of husband and wife and the dead foetus to diagnose the cause correctly.If genetic abnormalities are there in one parent or both the parents, it is better to opt for Donor egg or sperm or both and you will be blessed with a healthy baby.
***Dr.Anita Mani
Infertility& Surrogacy Specialist at Gift IVF Centre
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