I’ve had a miscarriage
why did it happen to me
What is a miscarriage
A miscarriage is the spontaneous loss of a baby at any time up until the 24th week of pregnancy. After 24 weeks the loss is referred to as a stillbirth. The signs of a miscarriage are vaginal bleeding and periodlike cramps. As not all miscarriages follow the same pattern, there are various terms to describe what occurs:
✱ A threatened miscarriage occurs when there is bleeding and possibly pain, but the fetus survives.
✱ An inevitable miscarriage occurs when there is bleeding and pain due to contractions in the uterus, the cervix opens, and the fetus is expelled.
✱ A missed miscarriage occurs when the fetus dies but remains in the womb and either is expelled naturally later or removed by surgery
The risk of miscarriage
What can increase the likelihood of a miscarriage
There are several factors that can increase your risk of miscarriage Older women have an increased risk of having a miscarriage. It is thought that this is largely due to the fact that older women are more likely to have babies with chromosomal abnormalities, which may have problems developing and miscarry. Some underlying medical conditions can also increase your chances of miscarriage, such as polycystic ovary syndrome or fibroids. Other factors that can increase your risk are if you are
particularly underweight or overweight, smoke, drink heavily, or take recreational drugs. Miscarriages are also more likely the more pregnancies you have had
What can increase the likelihood of a miscarriage
There are several factors that can increase your risk of miscarriage Older women have an increased risk of having a miscarriage. It is thought that this is largely due to the fact that older women are more likely to have babies with chromosomal abnormalities, which may have problems developing and miscarry. Some underlying medical conditions can also increase your chances of miscarriage, such as polycystic ovary syndrome or fibroids. Other factors that can increase your risk are if you are
particularly underweight or overweight, smoke, drink heavily, or take recreational drugs. Miscarriages are also more likely the more pregnancies you have had
I’ve recently miscarried—why did this happen
Miscarriage occurs in 10–20 percent of pregnancies.In the vast majority of these the cause is never identified, but it’s unlikely to be related to anything you did or didn’t do. There are thought to be several reasons why miscarriages occur There may be a genetic problem, in which the baby or placenta doesn’t develop normally; levels of the pregnancy hormone progesterone may be low; there may be an immune disorder in which the mother’s immune system reacts against the pregnancy; an infection may be present; or there may be problems with the uterus or cervix. Miscarriages tend to be
more common in older women
Miscarriage occurs in 10–20 percent of pregnancies.In the vast majority of these the cause is never identified, but it’s unlikely to be related to anything you did or didn’t do. There are thought to be several reasons why miscarriages occur There may be a genetic problem, in which the baby or placenta doesn’t develop normally; levels of the pregnancy hormone progesterone may be low; there may be an immune disorder in which the mother’s immune system reacts against the pregnancy; an infection may be present; or there may be problems with the uterus or cervix. Miscarriages tend to be
more common in older women
My period was late and now I’m bleeding really heavily—could I be having a miscarriage
In the absence of a positive pregnancy test or a pregnancy confirmed by an ultrasound scan, it is difficult to know whether or not you were pregnant. If you have had unprotected intercourse in the time since your last period, it is possible that you could have been pregnant and this is a miscarriage. The lateness of your period may be a clue, but won’t confirm one way or another. If you have any other
symptoms of pregnancy it might be worth doing a pregnancy test since sometimes, even when there has been bleeding, a viable pregnancy is discovered. However, it could also be a late period for no other reason than that this happens on occasion to
everyone. A delayed period can be caused by weight loss or gain, stress, or if you have been taking an oral contraceptive pill but missed a dose. Talk to your midwife or doctor if the bleeding continues; you feel faint or experience palpitations;
your period lasts for longer than seven days; you have more than six well-soaked pads a day; or if you have any severe abdominal pain. Your doctor can do a blood test to check your iron levels and possibly determine if you have been pregnant, in which case an incomplete miscarriage or ectopic pregnancy will need to be ruled out
In the absence of a positive pregnancy test or a pregnancy confirmed by an ultrasound scan, it is difficult to know whether or not you were pregnant. If you have had unprotected intercourse in the time since your last period, it is possible that you could have been pregnant and this is a miscarriage. The lateness of your period may be a clue, but won’t confirm one way or another. If you have any other
symptoms of pregnancy it might be worth doing a pregnancy test since sometimes, even when there has been bleeding, a viable pregnancy is discovered. However, it could also be a late period for no other reason than that this happens on occasion to
everyone. A delayed period can be caused by weight loss or gain, stress, or if you have been taking an oral contraceptive pill but missed a dose. Talk to your midwife or doctor if the bleeding continues; you feel faint or experience palpitations;
your period lasts for longer than seven days; you have more than six well-soaked pads a day; or if you have any severe abdominal pain. Your doctor can do a blood test to check your iron levels and possibly determine if you have been pregnant, in which case an incomplete miscarriage or ectopic pregnancy will need to be ruled out
I’m 10 weeks pregnant and getting cramping pains. Do I need to rest to avoid a miscarriage
Cramping pains on their own without vaginal bleeding or spotting can occur at this stage of pregnancy. Sometimes pain can be felt as the ligaments stretch when the baby and your uterus grows. There are also other possible causes for the pain aside from miscarriage, such as constipation or a urinary tract infection. Many doctors advise rest to avoid a “threatened” miscarriage, but there is no strong evidence that
this will make any difference to the outcome of a pregnancy. If you feel like resting because you are in discomfort from the cramping pains then do rest, but if you feel happy to continue as you normally would then that may be the best option for you. Soaking in a warm bath and practicing relaxation techniques may ease the intensity of the pain. If the pain increases or you get any bleeding or spotting,
contact your doctor
Cramping pains on their own without vaginal bleeding or spotting can occur at this stage of pregnancy. Sometimes pain can be felt as the ligaments stretch when the baby and your uterus grows. There are also other possible causes for the pain aside from miscarriage, such as constipation or a urinary tract infection. Many doctors advise rest to avoid a “threatened” miscarriage, but there is no strong evidence that
this will make any difference to the outcome of a pregnancy. If you feel like resting because you are in discomfort from the cramping pains then do rest, but if you feel happy to continue as you normally would then that may be the best option for you. Soaking in a warm bath and practicing relaxation techniques may ease the intensity of the pain. If the pain increases or you get any bleeding or spotting,
contact your doctor
Does bleeding in pregnancy mean that miscarriage is inevitable
No, many women experience bleeding in early pregnancy and then proceed to have a healthy pregnancy and baby. Indeed, some women have intermittent bleeding throughout pregnancy. Despite this, any bleeding should be investigated. This is usually done with an ultrasound to determine if the pregnancy is viable and to identify if there is any indication of where the bleeding is coming from. In very early pregnancy, it can be hard to see the pregnancy on an ultrasound and a blood test to measure levels of the pregnancy hormone human chorionic gonadotrophin (hCG ) may be done,mainly to rule out the possibility of an ectopic pregnancy Unfortunately for you, this is a time of waiting; the timing of any further scans is usually determined by the findings of the initial scan and the blood tests and the symptoms you are experiencing
No, many women experience bleeding in early pregnancy and then proceed to have a healthy pregnancy and baby. Indeed, some women have intermittent bleeding throughout pregnancy. Despite this, any bleeding should be investigated. This is usually done with an ultrasound to determine if the pregnancy is viable and to identify if there is any indication of where the bleeding is coming from. In very early pregnancy, it can be hard to see the pregnancy on an ultrasound and a blood test to measure levels of the pregnancy hormone human chorionic gonadotrophin (hCG ) may be done,mainly to rule out the possibility of an ectopic pregnancy Unfortunately for you, this is a time of waiting; the timing of any further scans is usually determined by the findings of the initial scan and the blood tests and the symptoms you are experiencing
I’ve had three miscarriages before and I’m scared of trying again—is there anything I can do
It is understandable given your experiences that trying to get pregnant again is a scary proposition. Following a third miscarriage, it is usual for your doctor to offer you a number of investigative tests to see if a reason for the miscarriages can be found. In some cases, a cause is identified and treatment can be offered to help improve the outcome for subsequent pregnancies. You are likely to be given a number of blood tests. These are to look for antibodies (proteins in the blood that fight any substance they recognize as foreign to your body), chromosomal abnormalities, and infection. You may also have a vaginal examination and swab and an ultrasound scan to check your womb and tubes. If a chromosomal abnormality is found, genetic counseling should be offered to discuss the implications for future pregnancies. The levels of the hormones progesterone and prolactin may also be checked since these can play a role in miscarriage. Sometimes, the cervix is found to be weakened and likely to open early. If this is the case, you may be offered a cervical stitch that acts like a drawstring on the cervix and hopefully prevents future miscarriage or premature delivery.If you haven’t already been offered these tests, talk to your doctor about them before trying to get pregnant again so that you can begin any recommended treatment as soon as possible
It is understandable given your experiences that trying to get pregnant again is a scary proposition. Following a third miscarriage, it is usual for your doctor to offer you a number of investigative tests to see if a reason for the miscarriages can be found. In some cases, a cause is identified and treatment can be offered to help improve the outcome for subsequent pregnancies. You are likely to be given a number of blood tests. These are to look for antibodies (proteins in the blood that fight any substance they recognize as foreign to your body), chromosomal abnormalities, and infection. You may also have a vaginal examination and swab and an ultrasound scan to check your womb and tubes. If a chromosomal abnormality is found, genetic counseling should be offered to discuss the implications for future pregnancies. The levels of the hormones progesterone and prolactin may also be checked since these can play a role in miscarriage. Sometimes, the cervix is found to be weakened and likely to open early. If this is the case, you may be offered a cervical stitch that acts like a drawstring on the cervix and hopefully prevents future miscarriage or premature delivery.If you haven’t already been offered these tests, talk to your doctor about them before trying to get pregnant again so that you can begin any recommended treatment as soon as possible
My mom had two miscarriages—does that mean I am more likely to miscarry
Ask your mom if she was given any particular reason for her miscarriages. If, for example, she knows that they were due to a chromosomal abnormality, such as sickle-cell disease, or if she had a medical condition, such as heart disease, then there is a possibility that the condition is hereditary and the risk of miscarriage may be the same for you too. However, it’s most likely that your mother’s miscarriages were unfortunate chance occurrences for which no reason was found. If this is the case,
then you are at no more risk of experiencing a miscarriage than any other woman your age. However, if you do become pregnant, it would be worth mentioning your mother’s pregnancy history at your initial prenatal appointment, since your family medical history is an important part of your medical record during pregnancy
Ask your mom if she was given any particular reason for her miscarriages. If, for example, she knows that they were due to a chromosomal abnormality, such as sickle-cell disease, or if she had a medical condition, such as heart disease, then there is a possibility that the condition is hereditary and the risk of miscarriage may be the same for you too. However, it’s most likely that your mother’s miscarriages were unfortunate chance occurrences for which no reason was found. If this is the case,
then you are at no more risk of experiencing a miscarriage than any other woman your age. However, if you do become pregnant, it would be worth mentioning your mother’s pregnancy history at your initial prenatal appointment, since your family medical history is an important part of your medical record during pregnancy
QI’ve had several miscarriages and my doctor has referred me to a genetic counselor—why
A genetic counselor is a highly trained professional who supports families before and after conception. Often a miscarriage is caused by a genetic abnormality in the fertilized egg or embryo. This is usually a one-time occurence and can affect anyone.
However, if a woman has recurrent miscarriages, it may be that she is carrying a genetic condition. Women and their partners are referred to a genetic counselor if either partner has a condition that can affect future children or the chances of
becoming pregnant or continuing with a pregnancy since they may be more likely to miscarry or be offered a termination. For example, if there is a history of sickle-cell disease, a blood disorder that causes chronic anemia and increases the risk of a
preterm birth and health problems in the baby, it may be that either or both parents are carrying a gene that can affect a baby. A genetic counselor helps you understand how your genes could affect conception and pregnancy and about the tests available to determine if a fetus is affected. The counselor will discuss a range of issues,
including the moral and ethical issues related to genetic testing, since it is common for couples to feel stress, guilt, and confusion in this type of situation
A genetic counselor is a highly trained professional who supports families before and after conception. Often a miscarriage is caused by a genetic abnormality in the fertilized egg or embryo. This is usually a one-time occurence and can affect anyone.
However, if a woman has recurrent miscarriages, it may be that she is carrying a genetic condition. Women and their partners are referred to a genetic counselor if either partner has a condition that can affect future children or the chances of
becoming pregnant or continuing with a pregnancy since they may be more likely to miscarry or be offered a termination. For example, if there is a history of sickle-cell disease, a blood disorder that causes chronic anemia and increases the risk of a
preterm birth and health problems in the baby, it may be that either or both parents are carrying a gene that can affect a baby. A genetic counselor helps you understand how your genes could affect conception and pregnancy and about the tests available to determine if a fetus is affected. The counselor will discuss a range of issues,
including the moral and ethical issues related to genetic testing, since it is common for couples to feel stress, guilt, and confusion in this type of situation
I lost my baby, but I want to get on and try again—is this OK
Although there are no hard rules about when to try for another baby, it is important that you allow yourself time to grieve and your body to recover before trying to conceive again. Some women feel able to try again within a month, while others may
not feel ready for at least a year. Whatever you feel, it’s wise to let your hormones and body settle down after a miscarriage before considering another
pregnancy. The usual advice is to wait for at least three months before trying to conceive again so that you feel both emotionally and physically prepared for another pregnancy. Your partner also needs to feel that the time is right for you both to try again
Although there are no hard rules about when to try for another baby, it is important that you allow yourself time to grieve and your body to recover before trying to conceive again. Some women feel able to try again within a month, while others may
not feel ready for at least a year. Whatever you feel, it’s wise to let your hormones and body settle down after a miscarriage before considering another
pregnancy. The usual advice is to wait for at least three months before trying to conceive again so that you feel both emotionally and physically prepared for another pregnancy. Your partner also needs to feel that the time is right for you both to try again
Possible causes of miscarriage
Losing a baby in pregnancy
About 1 in 4 first pregnancies ends in miscarriage, generally within the first 12 weeks. Often no cause is identified and may not be investigated unless a woman has had three or more miscarriages in a row, known as “recurrent miscarriages.” Why has it happened? Some miscarriages occur because of a one-time genetic problem (caused by a faulty chromosome) when the baby does not develop properly. Genetic problems account for 60 percent of early miscarriages. If you think this may have been the cause, you can request tissue tests from the baby. Based on these results, you may be able to receive specialized counseling to discuss the risk of it happening
again. After 12 weeks, the chances of you losing your baby because of a chromosomal
disorder reduce to about 10 percent; however, if you are over 35, this risk is higher. Other less common causes of miscarriage include fibroids (noncancerous growths), infection, problems with the uterus, hormonal imbalances, and immune system disorders. An ectopic pregnancy, below, occurs when the embryo implants in a fallopian tube and needs to be removed. What can cause late pregnancy loss? A late
pregnancy loss (referred to as a stillbirth after 24 weeks) can be due to the cervix being weak (or “incompetent”), causing the cervix to dilate too early. This accounts for 15 percent of repeated miscarriages. In future pregnancies, a stitch around the cervix can strengthen this muscle and prevent it from opening early. Another cause of a late miscarriage can be if the placenta does not function properly and affects the baby’s growth
Losing a baby in pregnancy
About 1 in 4 first pregnancies ends in miscarriage, generally within the first 12 weeks. Often no cause is identified and may not be investigated unless a woman has had three or more miscarriages in a row, known as “recurrent miscarriages.” Why has it happened? Some miscarriages occur because of a one-time genetic problem (caused by a faulty chromosome) when the baby does not develop properly. Genetic problems account for 60 percent of early miscarriages. If you think this may have been the cause, you can request tissue tests from the baby. Based on these results, you may be able to receive specialized counseling to discuss the risk of it happening
again. After 12 weeks, the chances of you losing your baby because of a chromosomal
disorder reduce to about 10 percent; however, if you are over 35, this risk is higher. Other less common causes of miscarriage include fibroids (noncancerous growths), infection, problems with the uterus, hormonal imbalances, and immune system disorders. An ectopic pregnancy, below, occurs when the embryo implants in a fallopian tube and needs to be removed. What can cause late pregnancy loss? A late
pregnancy loss (referred to as a stillbirth after 24 weeks) can be due to the cervix being weak (or “incompetent”), causing the cervix to dilate too early. This accounts for 15 percent of repeated miscarriages. In future pregnancies, a stitch around the cervix can strengthen this muscle and prevent it from opening early. Another cause of a late miscarriage can be if the placenta does not function properly and affects the baby’s growth
We had a miscarriage at 20 weeks. Will the doctors find the cause so that we can move on
Coping with the loss of a baby well into pregnancy is difficult and upsetting. Many women ask themselves why a miscarriage happened and feel unable to move on until that important question is answered. Unfortunately, unless this was a recurrent
miscarriage of three or more, there may not be an investigation, although it may be suggested that you have a cervical stitch in future pregnancies to stop the cervix from dilating too early It may be worth talking to a counselor who is trained to support women and families through such difficult times; your doctor or midwife may be able to refer you. You may find that discussing your miscarriage directly with a health professional helps to answer any concerns you or your partner have, and by communicating in this way you will have started to move forward and may begin to feel
able to consider planning another pregnancy
Coping with the loss of a baby well into pregnancy is difficult and upsetting. Many women ask themselves why a miscarriage happened and feel unable to move on until that important question is answered. Unfortunately, unless this was a recurrent
miscarriage of three or more, there may not be an investigation, although it may be suggested that you have a cervical stitch in future pregnancies to stop the cervix from dilating too early It may be worth talking to a counselor who is trained to support women and families through such difficult times; your doctor or midwife may be able to refer you. You may find that discussing your miscarriage directly with a health professional helps to answer any concerns you or your partner have, and by communicating in this way you will have started to move forward and may begin to feel
able to consider planning another pregnancy
My partner had a miscarriage. I’m being supportive but I’m devastated too. What should I do
Dealing with a miscarriage is very difficult for both women and men, but often far more attention is given to a woman, and a man’s feelings are simply ignored. However, it’s important that you don’t internalize your loss and do acknowledge your feelings, which may range from feeling scared, disappointed, and out of control, to blaming yourself for not being supportive enough and mourning your loss of identity as a father. Although you want to support your partner, you also need to recognize your own need to grieve, as working through your emotions can help you to come to terms with your loss more quickly. A good support network is also important for both of you and it can help to find a sympathetic listener outside of your relationship. Initially, you may find discussing your feelings with another male easier than talking to your partner. You could also talk to your doctor or to a trained counselor
for additional support
Dealing with a miscarriage is very difficult for both women and men, but often far more attention is given to a woman, and a man’s feelings are simply ignored. However, it’s important that you don’t internalize your loss and do acknowledge your feelings, which may range from feeling scared, disappointed, and out of control, to blaming yourself for not being supportive enough and mourning your loss of identity as a father. Although you want to support your partner, you also need to recognize your own need to grieve, as working through your emotions can help you to come to terms with your loss more quickly. A good support network is also important for both of you and it can help to find a sympathetic listener outside of your relationship. Initially, you may find discussing your feelings with another male easier than talking to your partner. You could also talk to your doctor or to a trained counselor
for additional support
Talking to others
coming to terms with your loss
Losing a baby during pregnancy can be devastating, leading to feelings of grief such as anger, depression, guilt, and anxiety. Talking to others can help you to work through your feelings.
✱ Ask your midwife or doctor to put you in touch with a counselor who specializes in
pregnancy loss.
✱ Let close friends and family members know how you are feeling.
✱ Share Pregnancy and Infant Loss Support is a great source of support.
✱ Talk to your doctor or midwife about why the miscarriage may have happened
coming to terms with your loss
Losing a baby during pregnancy can be devastating, leading to feelings of grief such as anger, depression, guilt, and anxiety. Talking to others can help you to work through your feelings.
✱ Ask your midwife or doctor to put you in touch with a counselor who specializes in
pregnancy loss.
✱ Let close friends and family members know how you are feeling.
✱ Share Pregnancy and Infant Loss Support is a great source of support.
✱ Talk to your doctor or midwife about why the miscarriage may have happened
What is a “D and C”
D and C stands for dilation and curettage, a surgical procedure in which the opening to the uterus, called the cervix, is stretched (dilatation)and the tissue that lines the uterus is scraped or removed (curettage). This procedure is sometimes carried out after a miscarriage to ensure that any of the remaining products of the conception and pregnancy have been removed. There are advantages and disadvantages to
consider before having a D and C. The procedure is usually completed within two hours and most women resume their usual activities within a week. However,the need for routine surgical evacuation, or a D and C, following a miscarriage has been questioned because of potential complications, such as bleeding and infection. Ask your doctor for advice. There are less invasive options than a D and C for dealing with a miscarriage. One method is simply to watch and wait to see if the uterus will spontaneously expel any remaining products of conception. Another option is a drug treatment that works by stimulating the uterus to contract and naturally expel pregnancy tissues
D and C stands for dilation and curettage, a surgical procedure in which the opening to the uterus, called the cervix, is stretched (dilatation)and the tissue that lines the uterus is scraped or removed (curettage). This procedure is sometimes carried out after a miscarriage to ensure that any of the remaining products of the conception and pregnancy have been removed. There are advantages and disadvantages to
consider before having a D and C. The procedure is usually completed within two hours and most women resume their usual activities within a week. However,the need for routine surgical evacuation, or a D and C, following a miscarriage has been questioned because of potential complications, such as bleeding and infection. Ask your doctor for advice. There are less invasive options than a D and C for dealing with a miscarriage. One method is simply to watch and wait to see if the uterus will spontaneously expel any remaining products of conception. Another option is a drug treatment that works by stimulating the uterus to contract and naturally expel pregnancy tissues
We’re not getting pregnant
what do we do now
We’ve been trying to conceive for 12 months—can the doctor identify the problem
There are many factors that can increase or decrease your chances of becoming pregnant, but if you have been trying for a year, it would be sensible to contact your doctor. After an initial assessment of your general health and lifestyle, your doctor will offer your partner a sperm test (see below) and you will be offered tests to see if you are producing eggs and check whether or not your fallopian tubes are blocked. Blood tests will be carried out to check your iron levels, your red and white blood cell count,and to check how organs such as your liver and kidneys are functioning. In addition, couples are asked to agree to a sexual health screening to check for previous or current STIs, such as HIV and syphilis
what do we do now
We’ve been trying to conceive for 12 months—can the doctor identify the problem
There are many factors that can increase or decrease your chances of becoming pregnant, but if you have been trying for a year, it would be sensible to contact your doctor. After an initial assessment of your general health and lifestyle, your doctor will offer your partner a sperm test (see below) and you will be offered tests to see if you are producing eggs and check whether or not your fallopian tubes are blocked. Blood tests will be carried out to check your iron levels, your red and white blood cell count,and to check how organs such as your liver and kidneys are functioning. In addition, couples are asked to agree to a sexual health screening to check for previous or current STIs, such as HIV and syphilis
My wife has been tested and has the all clear—how can I tell if I’m causing our fertility problem
You will be offered a semen analysis to determine your sperm quantity and quality—how sperm move(motility) and whether they are a normal form. A healthy sperm count should have a concentration of 20 million spermatozoa per milliliter of semen, with 75 percent of these alive and 50 percent of these “motile,” or moving as well as possible. Differences can occur over time in both the quality and quantity of sperm, so if your first sample is poor, you will probably be tested again a couple of months later.You are also likely to be advised to give up smoking, reduce alcohol intake, and to wear loosefitting underwear to avoid overheating the testes. If a problem is found, you will be referred to a specialist.Try to avoid becoming stressed since this can also affect fertility. Learning relaxation techniques with
your partner and practicing these regularly will help
You will be offered a semen analysis to determine your sperm quantity and quality—how sperm move(motility) and whether they are a normal form. A healthy sperm count should have a concentration of 20 million spermatozoa per milliliter of semen, with 75 percent of these alive and 50 percent of these “motile,” or moving as well as possible. Differences can occur over time in both the quality and quantity of sperm, so if your first sample is poor, you will probably be tested again a couple of months later.You are also likely to be advised to give up smoking, reduce alcohol intake, and to wear loosefitting underwear to avoid overheating the testes. If a problem is found, you will be referred to a specialist.Try to avoid becoming stressed since this can also affect fertility. Learning relaxation techniques with
your partner and practicing these regularly will help
We can’t conceive naturally—what do we do now
Assisted conception, or assisted reproduction, is the term used when women are helped to conceive without having intercourse. There are five main procedures available, listed below. Your doctor will go through each one with you, and together you can make a decision about which is most appropriate depending on your problem. You can also contact the Center for Disease Control and Prevention(CDC)
✱ Ovarian Stimulation (OS), or Super Ovulation(SO), involves injections of fertility hormones to boost egg production. This is followed by intrauterine insemination (IUI) of sperm, whereby sperm are collected and sorted so that only the strongest remain and these are then artifically placed inside the uterus via a catheter. This is ideal for couples when the man’s sperm is “slow” or the woman has problems ovulating, or there is a combination of both.
✱ Gamete Intrafallopian Transfer (GIFT). This is for couples for whom no cause for infertility has been found. It involves stimulating the ovaries to produce eggs, which are removed, mixed with sperm and replaced directly into the fallopian tubes,
allowing conception to occur inside the body
✱ In Vitro Fertilization (IVF). This is the most widely used treatment and involves a seven-step process This is ideal for most problems,
including blocked tubes
✱ IntraCytoplasmic Sperm Injection (ICSI). This is used if the man’s sperm count is low, the motility of the sperm is very poor, or the woman is allergic to her partner’s sperm. The treatment involves injecting just one viable sperm into an egg
✱ Artificial Insemination by Donor (AID). This is simply the injection of donated sperm into the cervix.This is used when a man is unable to maintain an erection or is sterile. Similarly, women may require an egg donation if they are unable to produce their own eggs, although this is more complicated.Whatever treatment is provided, it is important that you and your partner are treated as a couple rather than separate patients. It is also essential that you are kept informed throughout the process and given information on any risks and benefits
Assisted conception, or assisted reproduction, is the term used when women are helped to conceive without having intercourse. There are five main procedures available, listed below. Your doctor will go through each one with you, and together you can make a decision about which is most appropriate depending on your problem. You can also contact the Center for Disease Control and Prevention(CDC)
✱ Ovarian Stimulation (OS), or Super Ovulation(SO), involves injections of fertility hormones to boost egg production. This is followed by intrauterine insemination (IUI) of sperm, whereby sperm are collected and sorted so that only the strongest remain and these are then artifically placed inside the uterus via a catheter. This is ideal for couples when the man’s sperm is “slow” or the woman has problems ovulating, or there is a combination of both.
✱ Gamete Intrafallopian Transfer (GIFT). This is for couples for whom no cause for infertility has been found. It involves stimulating the ovaries to produce eggs, which are removed, mixed with sperm and replaced directly into the fallopian tubes,
allowing conception to occur inside the body
✱ In Vitro Fertilization (IVF). This is the most widely used treatment and involves a seven-step process This is ideal for most problems,
including blocked tubes
✱ IntraCytoplasmic Sperm Injection (ICSI). This is used if the man’s sperm count is low, the motility of the sperm is very poor, or the woman is allergic to her partner’s sperm. The treatment involves injecting just one viable sperm into an egg
✱ Artificial Insemination by Donor (AID). This is simply the injection of donated sperm into the cervix.This is used when a man is unable to maintain an erection or is sterile. Similarly, women may require an egg donation if they are unable to produce their own eggs, although this is more complicated.Whatever treatment is provided, it is important that you and your partner are treated as a couple rather than separate patients. It is also essential that you are kept informed throughout the process and given information on any risks and benefits
What can affect a man’s fertility
A semen analysis may reveal various reasons why sperm have difficulty in fertilizing an egg. The sperm count may be low (less than 20 million sperm per ml); the motility of the sperm (how they move)may be poor; and there may be a high percentage of abnormally formed sperm. Some men experience a failure to ejaculate at orgasm. There
may also be damage to the tubes that connect the testicles to the seminal vesicles where sperm are produced, and this may have been present from birth or caused by a later infection
A semen analysis may reveal various reasons why sperm have difficulty in fertilizing an egg. The sperm count may be low (less than 20 million sperm per ml); the motility of the sperm (how they move)may be poor; and there may be a high percentage of abnormally formed sperm. Some men experience a failure to ejaculate at orgasm. There
may also be damage to the tubes that connect the testicles to the seminal vesicles where sperm are produced, and this may have been present from birth or caused by a later infection
What can affect a woman’s fertility
Conditions such as polycystic ovary syndrome(a hormonal imbalance that causes ovarian cysts)and endometriosis can disrupt fertility.Other hormonal imbalances, such as low levels of FSH and LH, can affect ovulation; or levels of progesterone may be too low to sustain a fertilized egg. Damaged fallopian tubes, caused by an ectopic pregnancy, surgery,endometriosis, or pelvic inflammatory disease,which may be caused by an infection such as chlamydia, can prevent conception. Damage to the ovaries can occur from scarring as a result of surgery or infection, or the supply of eggs may be low. Some women have an abnormally shaped uterus, or have uterine scarring, that can prevent the successful implantation of an egg
Conditions such as polycystic ovary syndrome(a hormonal imbalance that causes ovarian cysts)and endometriosis can disrupt fertility.Other hormonal imbalances, such as low levels of FSH and LH, can affect ovulation; or levels of progesterone may be too low to sustain a fertilized egg. Damaged fallopian tubes, caused by an ectopic pregnancy, surgery,endometriosis, or pelvic inflammatory disease,which may be caused by an infection such as chlamydia, can prevent conception. Damage to the ovaries can occur from scarring as a result of surgery or infection, or the supply of eggs may be low. Some women have an abnormally shaped uterus, or have uterine scarring, that can prevent the successful implantation of an egg
top left
Endometriosis causes cells from the lining of the uterus to travel to other areas such as the ovaries and tubes, which can affect fertility.
top right
Here, a special dye injected through the cervix reveals a blockage in the left
fallopian tube since the dye has been unable to enter the tube.
bottom left
If the head,or cap, of the sperm is
abnormally shaped it will be
unable to fertilize an egg.
bottom right
In polycystic
ovary syndrome, cysts in the
ovaries mean that the follicles
are unable to mature and
produce ripened eggs
What does IVF involve
IVF, or In Vitro Fertilization, involves the surgical removal of an egg, which is then mixed with sperm in a laboratory dish to fertilize and produce an embryo outside of the womb.IVF treatment occurs in cycles, since there are various stages that must be completed for it to be successful. Initially, a drug is used in the form of a nasal spray or injection to switch off the woman’s natural cycle of egg production in the ovaries, known as “down-regulation.” Fertility drugs are then given
to stimulate the ovaries to produce more than one egg (ovulation induction). Mature eggs are collected from the ovaries using a fine needle guided by ultrasound. The procedure is usually uncomfortable rather than painful. On the same day, the partner’s sperm is collected and then the eggs and sperm are mixed in a dish. Within a few days, multiple embryos are transferred into the womb. If an embryo successfully attaches to the inside of the womb and continues to grow, a pregnancy results
IVF, or In Vitro Fertilization, involves the surgical removal of an egg, which is then mixed with sperm in a laboratory dish to fertilize and produce an embryo outside of the womb.IVF treatment occurs in cycles, since there are various stages that must be completed for it to be successful. Initially, a drug is used in the form of a nasal spray or injection to switch off the woman’s natural cycle of egg production in the ovaries, known as “down-regulation.” Fertility drugs are then given
to stimulate the ovaries to produce more than one egg (ovulation induction). Mature eggs are collected from the ovaries using a fine needle guided by ultrasound. The procedure is usually uncomfortable rather than painful. On the same day, the partner’s sperm is collected and then the eggs and sperm are mixed in a dish. Within a few days, multiple embryos are transferred into the womb. If an embryo successfully attaches to the inside of the womb and continues to grow, a pregnancy results
ICSI(IntraCytoplasmic Sperm Injection)
This procedure may be used when it is thought that the quality of the partner’s sperm
may be responsible for fertility problems.If the sperm count is low or movement is poor,sperm may be “assisted” in fertilizing the egg.An individual sperm is injected directly into the egg and, if fertilization takes place, the resulting embryo is placed in the uterus
What are the success rates of fertility treatments
Success rates for treatments vary, depending on the treatments used and the health of the couple.If you want to know the success rates of individual clinics, you can ask for their ratio of “live-birthsper-cycle-started.” This information is available
from each clinic.Overall, couples have a better success rate if the woman is age 23–39 years, has been pregnant or had a baby, and has a normal body weight (a BMI between 19 and 24). The older a woman is, the less likely she is to conceive and maintain the pregnancy.Figures show that for every 100 women who are 23 to 35 years, more than 20 will get pregnant after one IVF cycle; from 36 to 38 years, around 15 will get pregnant; at 39, around 10 will get pregnant; and in women over 40, around 6 will get pregnant.
Success rates for treatments vary, depending on the treatments used and the health of the couple.If you want to know the success rates of individual clinics, you can ask for their ratio of “live-birthsper-cycle-started.” This information is available
from each clinic.Overall, couples have a better success rate if the woman is age 23–39 years, has been pregnant or had a baby, and has a normal body weight (a BMI between 19 and 24). The older a woman is, the less likely she is to conceive and maintain the pregnancy.Figures show that for every 100 women who are 23 to 35 years, more than 20 will get pregnant after one IVF cycle; from 36 to 38 years, around 15 will get pregnant; at 39, around 10 will get pregnant; and in women over 40, around 6 will get pregnant.
IVF treatment The process of IVF
In vitro fertilization, or IVF, is a complex procedure with several stages, from the stimulation and harvesting of your eggs to the successful fertilization of the eggs, development of embryos,and transfer of the embryos into the womb for implantation. Undergoing IVF can be a stressful and time-consuming undertaking, but knowing in
advance how the procedure works and what you can expect at each stage can reduce anxiety and help you and your partner cope.What happens first? To optimize the chances of success with IVF, more than one egg at a time is removed for fertilization. Normally, your body produces one egg each month. In IVF, drugs, such
as clomiphene and hMG (human menopausal gonadotrophin) may be used to stimulate your
ovaries to produce several eggs. While you are undergoing this treatment, you will need to visit your clinic frequently in order to monitor the development of the eggs. Once it is thought that the eggs are mature, you will be given a blood test to measure your levels of estrogen, which is released around ovulation. What happens next? Once your follicles are ready for ovulation, your eggs will be collected at
the clinic using ultrasound or laparoscopy to guide a probe. Once the eggs have been collected, they will be mixed with your partner’s sperm in a petri dish in a laboratory ready for fertilization.Your partner will need to produce some sperm on the same day as the egg collection.For sperm collection, ask the staff members at
your clinic for instructions regarding timing and specimen collection
In vitro fertilization, or IVF, is a complex procedure with several stages, from the stimulation and harvesting of your eggs to the successful fertilization of the eggs, development of embryos,and transfer of the embryos into the womb for implantation. Undergoing IVF can be a stressful and time-consuming undertaking, but knowing in
advance how the procedure works and what you can expect at each stage can reduce anxiety and help you and your partner cope.What happens first? To optimize the chances of success with IVF, more than one egg at a time is removed for fertilization. Normally, your body produces one egg each month. In IVF, drugs, such
as clomiphene and hMG (human menopausal gonadotrophin) may be used to stimulate your
ovaries to produce several eggs. While you are undergoing this treatment, you will need to visit your clinic frequently in order to monitor the development of the eggs. Once it is thought that the eggs are mature, you will be given a blood test to measure your levels of estrogen, which is released around ovulation. What happens next? Once your follicles are ready for ovulation, your eggs will be collected at
the clinic using ultrasound or laparoscopy to guide a probe. Once the eggs have been collected, they will be mixed with your partner’s sperm in a petri dish in a laboratory ready for fertilization.Your partner will need to produce some sperm on the same day as the egg collection.For sperm collection, ask the staff members at
your clinic for instructions regarding timing and specimen collection
Subscribe to:
Posts (Atom)
