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Recurrent miscarriage

After becoming pregnant naturally or after IVF treatments, some women suffer miscarriage after miscarriage. Repeated miscarriage is the spontaneous loss of two or more pregnancies before week 20 of gestation.

The real rate of repeated miscarriage is not certain, but is estimated to affect between 2% and 5% of women of reproductive age. This percentage is even higher among couples who undergo in vitro fertilisation treatments.

The most important causes of repeated miscarriage are: anatomical, genetic, endocrinal, autoimmune, infectious, alloimmune and thrombophilia. Additionally, there are environmental and toxic factors (coffee, alcohol, tobacco, heavy metals, etc.) which may have an additional impact.

Diagnostic tests

Diagnostic imaging (Hysterosalpingography, Ultrasound, hysteroscopy)

This allows us to rule out the presence of a uterine malformation, uterine fibroid and uteri with low receptivity (uteri with mullerian malformations or lack of endometrial thickness, reduced uterine cavity).

Karyotype for both

Occasionally, the cause is due to one of the parents having a structural alteration in one of the chromosomes, causing a predisposition to miscarriage or failure of IVF treatments.

Hormonal determination (FSH, estradiol, TSH, PRL and optional diabetes study)

It is important to carry out an evaluation of the thyroid hormones to rule out subclinical hypothyroidism which is often associated with reproductive failure.

Study of thrombophilias and autoimmune disorders

- Antiphospholipid syndrome (Lupus Anticoagulant and Anticardiolipin antibodies IgG and IgM)

- Antithyroid antibodies and anti-β2-glycoprotein IgG and IgM

- Antitransglutaminase antibodies IgA (family history of celiac disease)

- Study of thrombophilias:

Protein C and S deficit

Antithrombin III

Factor VIII

Mutation of the Prothrombine Gene

Mutation of the Factor V Leiden

Resistance to activated Protein C

Homocysteine (mutation MTHFR)

Study of the alloimmune cause

Determination of the Natural Killer cells in peripheral blood. An increase in Natural Killer cells may be the cause of these miscarriages and the failure of IVF because they prevent the normal implantation of the embryo.

Specific Treatment

Genetic cause (5-40%)

Includes genetic counselling and preimplantation genetic diagnosis (PGD). This technique allows the selection of embryos which have a normal genetic load and which are suitable for transfer, and which lead to a healthy newborn. Currently, array comparative genomic hybridisation (aCGH) allows the study of whether there is an excess or lack of chromosomes or genes in the total number of chromosomes of the embryo, which has far exceeded the FISH (fluorescent in situ hybridisation) technique which only studied 7 chromosomes.

 

Endocrinal cause (12%)

The treatment is based on correction of hormonal alterations (Thyroxine, metformin, ovarian stimulation and dopamine agonists).

 

Anatomical cause (15%)

The hysteroscopy with resection of the uterine septum or a submucosal fibroid and the enlargement of the uterine cavity are the solutions when the cause is in the uterus.

 

Thrombophilia cause (10%)

Si usano le eparine di basso peso molecolare (HBPM) e l’acido acetil salicílico (AAS 100mg/giorno) e in caso di iperomocisteinemia acquisita si usano folati e vitamine.

 

Autoimmune Cause

- Antiphospholipid syndrome based on the joint administration of LMWH and AAS.

- In the case of autoimmune hypothyroidism, the administration of levothyroxine has been shown to improve results.

- The gluten-free diet has reduced rates of miscarriage and IVF failure in patients with celiac disease.

 

Alloimmune Cause

- Administration of intravenous non-specific immunoglobulins in cases of expansion of natural killer cells.

In all cases we offer personalised psychological support

We are aware that takin this step involves a series reflection and a brave, crucial decision. We will not only accompany and support you, but will also help you search for associations, support groups, portals, etc. which may help you as a single mother.

Why FIV-Valencia?

 

FIV VALENCIA PERSONALIZES THE TREATMENT DOWN TO THE FINEST DETAILS

You choose the transfer date, and we will organize your trip and the treatment cycle, adapting everything to your personal needs.

We have many years of experience with patients from abroad and in particular from Italy, so we know just what you need to make you feel at home. With our help, you can undergo the treatment in two simple steps:

Make a first visit to FIV Valencia, during which you can also vitrify a sperm sample. That way you can come the second time just for the IVF transfer!

Choose the day that best suits your needs to make the transfer! We will take care of the rest.

 

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C/ Santa Rosa, 12; 46021

VALENCIA (España)

+34 96 110 41 41

info@fiv-valencia.es

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