Recurrent Pregnancy Loss
Sometimes couples do not have an issue with getting pregnant but do have problems with maintaining a pregnancy. The American Society of Reproductive Medicine defines recurrent pregnancy loss as two or more failed pregnancies. After a clinically recognized pregnancy has been established, a woman’s chance of losing that pregnancy is about 15–25 percent. Statistically, fewer than five women out of a hundred will have two consecutive pregnancy losses, and only one woman out of a hundred will have three or more consecutive miscarriages.
There are quite a number of factors from the female side that can contribute to pregnancy loss, such as uterine abnormalities, cervical incompetence, blood clotting abnormalities, hormonal issues, infections, immune system problems, and chromosomal abnormalities. Also, the older a woman is, the greater her risk of miscarriage. A thorough evaluation by a fertility specialist is therefore the first step for women suffering from recurrent unexplained pregnancy loss.
A few male-factor issues have also been implicated in elevating the risk of recurrent pregnancy loss. These include chromosomal abnormalities in the father as well as elevated levels of sperm DNA fragmentation. If the results of the woman’s evaluation are fairly normal or if miscarriages continue after treatment of the woman, then testing of the male partner is appropriate. This would include checking the man’s karyotype ("Genetics" section) and sperm DNA testing ("Advanced Sperm Testing" section).
If abnormal genetics testing is found, then sometimes IVF combined with pre-implantation genetic diagnosis (PGD) can be used to only transfer embryo's without specific genetic abnormalities (See "Genetics section above for more information on PGD). Abnormal levels of sperm DNA fragmentation can sometimes be improved with the interventions in the Sperm Boot Camp.