Treatments for Repeated Miscarriages
Preventing Recurrent Miscarriages: CHR’s Special Expertise
Multiple miscarriages, along with implantation failures and low ovarian reserve, can be a sign of an underlying immunological issue, which can make becoming pregnant and keeping a pregnancy difficult. Preventing immunological miscarriages and treating immune-related infertility require specialized expertise and knowledge of these conditions that most REIs simply do not possess, so if you have suffered multiple miscarriages, it’s important to seek out a specialist.
Fortunately, with the right diagnosis and treatment, a successful pregnancy is possible,but it’s crucial to have a correct diagnosis and to take steps to proactively manage the condition. At CHR, our physicians apply multiple layers of preventive treatments to protect early pregnancies from miscarriage risks.
Treatment for Repeated Miscarriages
One of the reasons why immunological pregnancy loss has remained such a controversial and divisive subject is that investigators have not been able to reach consensus about how to treat affected patients. Some authorities argue that, since we have no proven treatment, why even bother with diagnosing these patients?
Indeed, it is correct that in certain situations we do not have a proven treatment. For example, no established treatment exists to normalize the increased miscarriage risk with autoimmune thyroid disease . Some authorities have suggested that treatment with intravenous gamma globulin (IVIg) was effective in this situation; however, a majority of studies were unable to confirm this. In other clinical situations, for example in the presence of APA/RAFS, many studies, including some from CHR, have demonstrated that a variety of treatment approaches may be quite effective. These include aspirin, corticosteroids, heparin and, on occasion, intravenous gamma globulin (IVIg).
At CHR, we believe that most patients with repeated pregnancy losses can conceive and keep the pregnancy to term, if diagnosed and treated in a proactive manner.
CHR’s Approach: Individualized Treatments Adjusted to Patient’s Current Immune Status
CHR's treatment philosophy in this area is centrist. While some colleagues on one extreme propagate the aggressive use of high-dosage medications including gamma globulin in practically all patients, and colleagues on the other extreme reject all treatments, we, based on our own data, and 30 years of experience with thousands of affected patients, have come to strongly believe in the individualization of patient care, based on the very specific immune conditions present in patients at any given time.
Physicians who really understand abnormal immunological functions know that immunological states are never static. Patients with abnormal autoimmune function, whether they have overt clinical autoimmune disease or suffer from only sub-clinical autoimmunity or generally hyperactive immune system, go through periods of exacerbations and remissions. Therefore, to treat every patient in the same way at all times does not make sense!
Therefore, treatment at CHR is adjusted to the actual immune status of the patient, as she goes through pregnancy. As a consequence, over 99% of our patients are off most medications by the time they reach approximately 20-23 weeks gestation. And because they do not have to take medications for the remainder of the pregnancy, the known, and frequent, complications from these medications are only very rarely seen.
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.