Brief Answer: Allopurinol causes miscarriage if taken by female Detailed Answer: I am sorry for your loss XXXX. I don't feel that the cause of miscarriage is the use of allopurinol by your partner. Allopurinol is often used in gout, chronic gouty arthritis. Commonly reported side effects of Allopurinol include fever, weakness, renal failure (acute), nausea and vomitting. Miscarriage has been reported by people on Allopurinol but that is usually in the females who are on intake of allopurinol, not their partners. The FDA has assigned allopurinol a pregnancy Category C rating, meaning this medication may not be safe to use during pregnancy. But again, the use is when the lady of the house is taking the medicine. Therefore I would conclude that Allopurinol is not the cause. Have you been evaluated for miscarriages? Do let me know and maybe I can help you with information regarding that. Sorry for the delay in response. And I am sure XXXXXXX will make a note why your earlier query could not be answered. Dr Saumya Mittal, MD

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Brief Answer: Explaining repeated loss of pregnancy (RPL) Detailed Answer: Its a bit difficult to explain everything to you. I will try my best. Do bear with long description. FIRST- WHAT IS REPEATED PREGNANCY LOSS (RPL) Recurrent pregnancy loss is the occurrence of three or more consecutive pregnancy loss. Some experts now consider recurrent pregnancy loss as two or more pregnancy losses. So you can be included for evaluation. SECOND- WHAT CAUSES REPEATED PREGNANCY LOSS (RPL) A. Most pregnancy losses result from chromosomal or genetic abnormalities. The bad gene could come from the mother (as a part of the ovum), or the father (may be a part of the sperm). Mother or father may themselves have irregularity in their own genes causing mild or no symptoms. The offspring however gets two sets of bad genes. Therefore the embryo may be severely affected resulting in a miscarriage. B. Advanced maternal age may be a risk factor for miscarriage.Genetic abnormalities always accumulate in one as he/she grows.Therefore affected ova may have more accumulated chromosomal abnormalities in elderly mothers. C. Frequently abnormality in the uterus structure or function may cause miscarriage. Sometimes the uterus is irregularly shaped from birth or this may develop with infections over time. D. Hormonal abnormalities like diabetes, hypothyroidism may affect pregnancy and cause its loss. E. Abnormalities in a mother’s clotting system may be a factor. THIRD- HOW TO TEST REPEATED PREGNANCY LOSS (RPL) Testing that may be done includes 1.karyotype analysis of both partners 2.evaluation of uterus and the uterine cavity by means of ultrasound, hysterosalpingogram, MRI. The best technique however remains hysteroscopy. 3.checking Antiphospholipid antibodies, particularly anticardiolipin antibody and lupus anticoagulant 4.Tests of hormone function- a. Thyroid function tests and thyroid antibodies b. prolactin c. Ovarian reserve tests d. sugars I would suggest that you also meet a gynecologist. If you have any query regarding this, please do feel free to contact me- Dr Saumya Mittal. MD

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