Repeat Abortions - UR International

Sometimes we have embryos of good quality and yet we do not achieve a viable pregnancy due to repeated implantation failures. In other cases we achieve pregnancy, but it is not evolutive due to repeated miscarriages.

To address these reproductive problems, our fertilisation centre has a unit specialised in Implantation Failure and Repeat Miscarriage, where specific tests are applied to diagnose the cause of these complex cases related to unusual pathologies and infertility of unknown origin.

The study of the causes of repeat miscarriage (RTA) is aimed at patients with the loss of two or three consecutive pregnancies before the 20th week of gestation, with a foetal weight of less than or equal to 500 grams, individualising each case and considering different factors such as the woman’s age, the circumstances surrounding early gestational losses, or personal and family history, among others.

Genetic causes and treatment

The fundamental causes related to RA are genetic factors and antiphospholipid syndrome. Genetic abnormalities and chromosomal alterations in the embryo account for 50% of miscarriages. Maternal age is the most common cause of infertility, as the older the mother, the lower the quality and quantity of oocytes.

The Vistahermosa Reproduction Unit carries out the study of the embryo with the advanced Preimplantational Genetic Diagnosis, as well as the analysis of the chromosomes to qualify them and select the optimum ones or the woman’s implantation capacity for the development of the pregnancy to term.

The Preimplantational Genetic Test is a set of state-of-the-art techniques in which a genetic study of the embryo is carried out before its implantation in the mother’s uterus, with the aim of selecting those embryos free of chromosomal alterations.

The karyotypes of the male and female are used to find out if there is any structural alteration in any of the chromosomes that predisposes to miscarriage. In the male, tests such as FISH are carried out, which allows the visualisation, distinction and study of the chromosomes and any anomalies they may present, as well as sperm DNA fragmentation.

In women, image analysis through hysterosalpingography, ultrasound or hysteroscopy to study the anatomy of the uterus allows the presence of malformations such as a uterine cavity divided into two parts by a central septum, myomas, polyps, fibroids, scar tissue adhesions or cervical insufficiency, which occurs when the cervix is unable to support pregnancy, opening prematurely and causing miscarriage.

Immunological causes and treatment

Other causes of repeated miscarriages are related to alterations in the mother’s immune system that provoke an abnormal response during pregnancy and attack the foetus as a foreign body.

During gestation, the implantation and growth of a different being begins in the woman’s body, the result of the genetic endowment of the mother and father. Sometimes maternal tolerance can be altered and put the development of the foetus at risk. A state of tolerance between the immune systems of the mother and the embryo is important for a successful pregnancy.

Antiphospholipid syndrome causes alterations in maternal blood clotting that impede placental formation or foetal development, requiring a multidisciplinary medical-obstetric approach and therapeutic intervention based on a combination of acetylsalicylic acid and low molecular weight heparin injections.

Its treatment will be associated with the characteristics of the patient and the associated pathology. The medical solution to these immunological problems that cause embryo implantation failure is very complex. The different factors that prevent good implantation must be assessed as a whole and in a personalised way. Our unit specialising in Reproductive Immunology studies the metabolic, immunological and endocrine mechanisms involved in this decisive phase of pregnancy and subsequently seeks the ideal treatment for each couple.

Current medical, biological and technological advances help us to identify the causes of repeated miscarriages in order to apply the appropriate treatment and ensure that our patients can fulfil their dream of becoming parents.