Most general OB-GYN doctors and Reproductive/Infertility specialists agree that a woman should have a specialized evaluation for ‘recurrent miscarriages’ if she has had more than two miscarriages, or in any case where there is some obvious issue which may cause repetitive pregnancy loss.
An evaluation of a recurrent pregnancy loss case will require very close examination of all the circumstances around each and every pregnancy loss. This is quite a bit of time-consuming work and so the better access we have to medical records dealing with each miscarriage, the better. Often after review of the history, further testing may be recommended for the couple experiencing recurrent miscarriages.
Even after a thorough review of all the pertinent history, and after analysis of additional testing, sometimes a complete resolution of the problem(s) causing the miscarriages may remain elusive. In such cases, the recommendation is usually made to start a very close observation, and sometimes early testing, of the next pregnancy that ensues. Sometimes a couple may be encouraged to undergo in vitro fertilization to start the next pregnancy so that we can have informational access to the embryos formed in our IVF laboratory to possibly resolve whether past historical problems with pregnancy may have been derived from the embryo itself, or from something in the maternal anatomical/physiologic environment.
By putting a very early pregnancy ‘under the microscope’ so to speak, we may actually be able to take some proactive steps in the process of fertilization and embryo implantation to optimize the chance of having that ultimate desired outcome – a healthy baby.
While "All things happen for a reason," that doesn’t mean that you have to just sit there and take an outcome without question or analysis. Yes, we (you) may be able to affect the course of natural events, to some degree anyway, in efforts of improving a final outcome. How comfortable you may be in wanting to pursue such intervention is not a light subject either, and one to which we are sensitive for all patients at the REACH program for fertility in North Carolina.
The path to clarification and resolution in the study of an individual’s history of recurrent miscarriage is not a quick process. In this current era of instant information access and expectations for immediate gratification and resolution, I fear that people are losing sight of the reality that the human body, and arguably life itself, is a constant ongoing dynamic of normal vs abnormal, optimal vs suboptimal, and then there is all the gray area within those spectrums. Patience, calm, logic and valid information are required to hopefully, eventually come to a beneficial outcome.
My favorite author, Emily Dickinson, was no stranger to setbacks along the path to pleasant outcomes in that simpler time, long ago –
"For each ecstatic instant, We must an anguish pay, In keen and quivering ratio, To the ecstasy" -c. 1859