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What could cause recurrent loss of pregnancy ?

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Internal Medicine Specialist
Practicing since : 1998
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I had a missed abortion in 2007. Everything was normal and I had gone for a routine check up to the doctor when I was expected to have completed 11 weeks. The doctor adviced me to undergo an ultrasound. The ultrasound report revealed that there was no heartbeat and the baby had grown till 8 weeks and thereafter the heartbeat stopped. I again conceived in 2008 and had a delivery in 2009. Throughout this pregnancy everything was normal and I had no problems. Then I gave birth to a healthy daughter. In 2011, I again conceived and the home pregnancy test was positive. The doctor adviced for an ultrasound when I complete 8 weeks. When I went for the ultrasound the doctor could not hear the heartbeat and mentioned that the growth was till 4 weeks and 5 days. I was adviced to wait for a week's time so that the ultrasound can be repeated because there was a possibility that the conception date was later and if we wait for a week the heartbeat might come. But few hours after the transvaginal ultrasound I started bleeding everytime I passed urine. The next day cramping also started with lot of pain in legs and back. The doctor then told me that the natural process of abortion has started and I need to take abortion tablets to have this cleaned completely. The doctor also mentioned that this looks like a Y chromosome issue and everytime I am pregnant with a boy I will face similar problem. She adviced me to undergo hormone tests next time before planning pregnancy. Is it so that if I am carrying a boy it will always be a difficult and high risk pregnancy? Please help, I am really worried.
Thu, 26 Apr 2012 in Abortion and Stillbirth
Answered by Dr. Jasvinder Singh 28 minutes later
Hello Veenu,

Thanks for posting your query. I am sorry to hear of the repeat pregnancy loss but it is not completely due to male fetus or the fetus causing XY chromosomes. There are many other causes responsible for a pregnancy loss in first trimester and 50% of these miscarriages are due to chromosomal abnormalities. Of the chromosomal abnormalities, the majority are autosomal trisomies, monosomy X , triploidy and tetraploidy. In simple terms it means that the egg or sperm had the wrong number of chromosomes, and as a result, the fertilized egg can't develop normally.

It is true that after two miscarriages, the pregnancy becomes high risk but if a careful evaluation is done then it does not happen. Apart from chromosomal defects, the other possible causes of a first trimester miscarriage are endocrine defects (like corpus luteum defects), thyroid disorders or diabetes in mother, infections in the mother (TORCH), genetic problems, uterine or cervical problems or immunological factors.

I suggest you to consult a gynecologist and get a through physical and pelvic examination done. Along with these, certain investigations are needed which include:

Blood sugar levels, ultrasound and CT scan of uterus and cervix, genetic study of both the partners, hormone levels of the mother like FSH, LH, PROLACTIN, estrogen and progesterone levels at different stages of the menstrual cycles, cervical swab and blood tests for TORCH infections and a detailed sperm analysis.

These investigations may help in confirming the cause and an early precaution the next time you conceive.
Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

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