Miscarriage — also known as spontaneous abortion — is a pregnancy that ends by itself before the 20-week mark. Although only 10% of known pregnancies end in miscarriage, researchers estimate that about 26% of all pregnancies miscarry. In these cases, though, the miscarriage occurs so early that most women didn’t even know they were pregnant.
About half of all miscarriages are due to chromosomal abnormalities in the fetus. These abnormalities are beyond the control of either parent or any kind of lifestyle intervention. The only way to prevent them is to test both partners for chromosomal abnormalities or to undergo in vitro fertilization (IVF) and test the embryos before implantation.
Another common cause of miscarriage is a faulty immune system, which attacks the fetus as a foreign object and therefore causes a spontaneous abortion. If you’ve had more than one miscarriage, you may have an immune system disorder that makes it difficult for you to carry a baby to term.
At Columbia Fertility Associates, our fertility specialists help you understand the reasons for your miscarriage with reproductive immunology assessments. If we diagnose an immune system problem, we devise a treatment plan to help you become — and stay — pregnant.
Control your known immune disorder
Any immune disorder increases your risk for miscarriage. Your hyper-alert immune system attacks your own healthy tissues and therefore perceive a fetus as a risk, too.
You’re more at risk for miscarriage if you have:
- Systemic lupus erythematosus
- Antiphospholipid syndrome
- Rheumatoid arthritis
- Sjogren’s Syndrome
Autoimmune diseases can also cause complications for the mother during pregnancy and may even cause birth defects. If you have an autoimmune disease, we work with your health care team to ensure that your disease is controlled and that you receive frequent monitoring throughout your pregnancy.
Undergo a reproductive immunology assessment
Even if you’re not aware of having an immune system problem, if you’ve had multiple miscarriages, we recommend a reproductive immunology assessment. The assessment consists of a series of blood tests that analyze your antibodies and a type of cytotoxic lymphocyte (white blood cell) called natural killer (NK) cells.
If your immune system is abnormally high in antibodies and NK cells, you may be more likely to miscarry. Research has demonstrated that NK cells are elevated after a miscarriage of a fetus that was chromosomally abnormal. However, the high NK cells may lead your body to expel a subsequent, chromosomally normal fetus, too.
Support your immune system to reduce the risk
If we analyze your immune response and find that it may contribute to recurrent miscarriage, we then custom-design a treatment protocol to help your body allow the pregnancy to continue to term.
Depending on your needs, we may recommend:
- Intravenous immunoglobulin (IVIg)
- Tumor necrosis factor (TNF) blocking agents
We also help you make lifestyle changes that may strengthen your immune system. A healthy diet, exercise, and avoiding toxins and stressors is good for your body and good for your baby.
Once you do become pregnant again, we label your pregnancy as high risk to ensure that you and your baby get the care you deserve. We monitor your pregnancy more frequently with exams and ultrasounds and may continue to make modifications to your treatment plan.