Recurrent Pregnancy Loss

DR. MICHAEL VERMESH: Recurrent pregnancy loss, defined as loss of two or more pregnancies in a row, is an emotionally loaded field. It is considered infertility even though those couples may achieve pregnancies, however, they may not be able to achieve live birth. That particular condition is more devastating than not achieving a pregnancy. This is the true definition of a rollercoaster in our field. They go from extreme joy of achieving pregnancy to the bottom of depression when the pregnancy is lost. Couples with recurrent pregnancy loss will typically wish to undergo any sort of treatment, no matter how aggressive, and how demanding to achieve their goal. We have been able to help most of these couples and because of recent advances in our field; we are able to help almost every one with recurrent pregnancy loss. Recurrent pregnancy loss is typically due to abnormalities within the embryo. However, some of their losses are due to abnormality of the uterus, to abnormality of the sperm, to some immunological problems with the women and other causes such as hormonal and so forth. We are able to help women with immunological problems by providing them immunosuppressant and other methods of therapy. We're able now to help men, couples in whom the cause of loss is problems within the sperm, by performing in-vitro fertilization and subjecting the sperm to specialized treatment. We're able to help couples in whom the loss is due to chromosomal problems in the embryos or to unknown causes by performing in-vitro fertilization, undergoing PGD, or Pre Implantation Genetic Diagnosis assessing the wellbeing of the embryos and then implanting the normal embryos in the woman's uterus. In women in whom there is an abnormality of the uterus, typically we'll perform a procedure, surgical procedure which is quite simple, an outpatient procedure, which will allow them to carry a pregnancy to term. In women who are unable to carry the pregnancy, despite all the methods of treatment, the last resort will be to use a surrogate who will keep their genetic child within her uterus. What we find that of all the methods of treatment in our office, the ones that are the most rewarding to the couple and to us are the women with recurrent pregnancy loss who finally achieve the goal of pregnancy and live birth.