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What is infertility?: Pregnancy loss
In part 1 of this series on infertility, we discussed the first scenario: when a diagnosis is made based on the amount of time a couple has been trying to conceive without success. In this article, we will discuss the second scenario: when a diagnosis is made after two or more consecutive pregnancy losses.
Pregnancy loss, or miscarriage, happens more often than you might think. According to the American Society for Reproductive Medicine (ASRM), between 15% and 25% of pregnancies do not reach full term. Some even believe the percentage may be higher, as some losses occur at very early stages, before the pregnant person even knows they are pregnant. However, only 5% of people experience recurrent pregnancy loss.
The first thing you should know about any loss is that in the vast majority of cases, it has nothing to do with anything the pregnant person did or didn't do: a loss is not your fault! There are many causes, and they are associated with the different stages of pregnancy.
First-trimester pregnancy loss
75% of losses occur during this stage and can be associated with the quality of the egg or sperm. There are two main reasons:
- Chromosomal abnormalities: when there are too many or too few chromosomes, a miscarriage is common. The probability of this occurring increases with the woman's age.
- Chemical or biochemical pregnancy: this occurs before the fifth week of pregnancy; the test gives a positive result, but the embryo does not develop.
Second-trimester pregnancy loss
These occur much less frequently and are usually not related to egg or sperm quality.
- Infections: these can be caused by viruses, bacteria, or fungi. They can lead to histological chorioamnionitis, an infection or inflammation of the placenta. Chorioamnionitis can also occur due to premature rupture of the amniotic sac. Another infection is listeriosis, caused by a bacterium sometimes found in meat or unpasteurized dairy products.
- Cervical insufficiency: little is known about the causes of this condition, but it occurs when the cervix begins to dilate before the end of the pregnancy.
- Uterine malformations: some malformations can impair the uterus's ability to expand, which in turn affects fetal development. There is also the septate uterus, where a septum divides the uterus in two; although difficult to diagnose, it can be treated surgically. Another scenario involves uterine fibroids or myomas, which appear in rare cases and can cause pregnancy loss.
- Chronic diseases: diabetes and autoimmune disorders can affect pregnancy. In any case, the most important thing is to maintain rigorous control of the condition throughout the pregnancy.
Pregnancy loss after 20 weeks
It is estimated that this occurs in only 1% of cases, and often the cause is not found. However, some causes may include:
- Placental problems: placental abruption is the most common, and although it is sometimes caused by an impact, the reason usually cannot be determined.
- Umbilical cord problems: very rarely, the umbilical cord can become tangled or compressed at this stage. When this happens, it prevents the fetus from receiving oxygen.
It is essential to keep in mind the relationship between pregnancy loss and fertility, as one loss does not imply another. The vast majority of people go on to have a healthy pregnancy after a miscarriage. And, in the case of recurrent miscarriage, there are many treatment alternatives such as fertilization in vitro, surgeries to correct uterine malformations, and there are even cases where the right medication is enough. If you have experienced recurrent pregnancy loss, schedule an appointment at Fertilidad Integral; our fertility specialists will provide you with the proper guidance.
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