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Had miscarriage. Antibody and thrombosis test normal. No chromosomal abnormality in products of conception. Next step?

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Practicing since : 2005
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I've been married since Dec 2007. I had my first two first trimeser miscarriages in 2008 & 2010 respectively. In both these cases there was no feotus seen, just the blood and urine test was positive. The second two miscarriages I had in July 2011 and Feb 2012. In both these cases feotus was visble but it stopped growing after the 7th week and there was no heartbeat. I've done all the tests possible such antibodies, thrombiosis etc and everything is normal. The products of conception were also tested for the last two times but there was no chromosomal abnormality found. Can you tell me what would you advice as the next step that can be done to be assured that next pregnancy will be a succesful one.
Posted Tue, 22 May 2012 in Menstruation and Miscarriage
Answered by Dr. Rhea Chanda 2 hours later
Thanks for the query.
Recurrent pregnancy loss is a something not easily defined.You have had most of the tests done and are negative. Karyotyping of both parents should be done before conception.In most cases of recurrent pregnancy loss, there is usually a chromosal abnormality found.When you conceive next time,you need urgent antenatal care right from the day your test is positive.You seem to be having missed abortions all these times.If required you may need admission until further notice.There can be anatomical,infectious(rubella,herpes simplex,toxoplasmosis etc), environmental, endocrine,hematological causes for RPL.Its difficult to pinpoint the cause without extensive evaluation.Once you get pregnant, you need to be on hormone supplementation and strict bed rest. Its not possible to say what step will cause the next pregnancy to be successful without extensive evaluation.

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