Miscarriage: Key Questions and Concerns for Couples

Miscarriage-related issues

Hello Doctor, I have undergone blood tests and a hysterosalpingography for gynecological issues, and there were no significant findings, but I have low progesterone levels.
After becoming pregnant, I took the medication prescribed by the hospital, but during the six-week ultrasound, the doctor noted that the embryo was slightly small.
At seven weeks, a heartbeat was detected, but the doctor mentioned it was weak.
By eight weeks, the heartbeat had stopped, and the embryo had not grown.
During this period, I did not experience any bleeding.
I am currently scheduled for a surgical abortion.
I have requested the hospital to perform chromosomal testing on the embryo.

I would like to ask the doctor:
1.
If the chromosomal test results of the embryo show abnormalities, should both partners undergo chromosomal testing?
2.
Should I also have blood tests to check for immune-related issues?
3.
If both the embryo's chromosomal test and my immune tests are normal, is there still a possibility of miscarriage?
4.
When we refer to an embryo being "not viable," does that solely mean chromosomal abnormalities, or are there other factors that could lead to miscarriage? Thank you for your response, Doctor.

Xiao P, 30~39 year old female. Ask Date: 2015/11/05

Dr. Lin Wenbin reply Obstetrics and Gynecology

1.
If this situation occurs repeatedly, both partners should consider undergoing chromosome testing.

2.
Autoimmune testing should be conducted first, followed by consideration of chromosome testing.

3.
It is certainly possible; many miscarriages occur without an identifiable cause.

4.
An embryo being unviable does not necessarily indicate a chromosomal abnormality; there are many factors during pregnancy (such as infections, physical stress, etc.) that can lead to miscarriage, and it does not always mean the embryo is unviable.

Reply Date: 2015/11/05

More Info

Miscarriage, or spontaneous abortion, is a complex and emotionally challenging experience for couples trying to conceive. Understanding the potential causes and implications of miscarriage can help couples navigate their concerns and make informed decisions moving forward. Based on your situation, let's address your questions in detail.

1. Chromosomal Abnormalities and Testing: If the chromosomal analysis of the embryo reveals abnormalities, it is indeed advisable for both partners to undergo genetic testing. Chromosomal abnormalities are a common cause of miscarriage, accounting for a significant percentage of early pregnancy losses. These abnormalities can arise from various factors, including maternal age, which increases the risk of chromosomal issues in eggs. Genetic testing for both partners can help identify if there are any inherited conditions that may contribute to recurrent miscarriages.

2. Immune System Testing: If the chromosomal analysis returns normal, it may be beneficial to explore immune-related issues. Some women may have autoimmune disorders or other immune system irregularities that can affect pregnancy. Conditions such as antiphospholipid syndrome (APS) can lead to recurrent miscarriages due to blood clotting issues. A thorough evaluation by a specialist, including blood tests for autoimmune markers, can provide insights into whether your immune system may be playing a role in your pregnancy losses.

3. Possibility of Miscarriage Despite Normal Results: Even if both the chromosomal analysis and immune tests return normal, there is still a possibility of miscarriage. Miscarriages can occur due to a variety of factors, including hormonal imbalances, uterine abnormalities, environmental factors, and lifestyle choices. For instance, insufficient progesterone levels (as you mentioned regarding your luteal phase) can lead to an inability to maintain a pregnancy. Other factors such as stress, infections, and exposure to toxins can also contribute to pregnancy loss.

4. Understanding "Unhealthy Embryos": The term "unhealthy embryos" often refers to embryos with chromosomal abnormalities, but it can also encompass other factors. For example, embryos may be considered "unhealthy" if they fail to implant properly or if there are issues with the uterine environment that prevent a successful pregnancy. Factors such as uterine fibroids, polyps, or congenital uterine anomalies can also affect embryo viability. Additionally, maternal health conditions, such as uncontrolled diabetes or thyroid disorders, can impact embryo development and pregnancy outcomes.

In conclusion, navigating the emotional and medical complexities of miscarriage requires a comprehensive approach. It is essential to work closely with your healthcare provider to explore all potential causes and to develop a tailored plan for future pregnancies. This may include genetic counseling, hormone therapy, lifestyle modifications, and regular monitoring during subsequent pregnancies. Remember that you are not alone in this journey, and seeking support from healthcare professionals, counselors, or support groups can be invaluable during this challenging time.

Similar Q&A

Understanding Unexplained Miscarriages: Causes and Next Steps

I have been married for two years and have experienced two pregnancies, both of which ended in miscarriage at around 2.5 to 3 months, leading to the decision to undergo a therapeutic abortion (the first pregnancy in June 1999 and the second in June 2000). Initially, when I found ...

Dr. Wang Hanzhou reply Obstetrics and Gynecology
Most miscarried fetuses have inherent issues, and in such cases, progesterone is ineffective. Couples with a history of two miscarriages may undergo blood chromosomal testing, which can reveal that 2%-10% of them have chromosomal abnormalities. If the uterine lining is irregular,...

Understanding Infertility: Key Questions and Concerns for Women

Hello, I have a few questions: 1. I have had a miscarriage in the past and have been trying to conceive for the last five months without success. Could my previous pregnancy contribute to infertility? Should I undergo infertility testing? Does my partner need to participate in ...

Dr. Huang Jianxun reply Obstetrics and Gynecology
Infertility is defined as the inability to conceive after one year of regular unprotected intercourse. Ovulatory bleeding is generally considered a normal physiological phenomenon and does not affect fertility; however, it may indicate hormonal imbalances.

Understanding Chromosome 9 Issues After Miscarriage: Genetic Concerns and Next Steps

Previously, my wife (34 years old) was pregnant (first pregnancy). After about 6 weeks, an ultrasound showed a heartbeat, and we received the baby handbook. However, at around 10 weeks, she experienced abnormal bleeding, so we rushed back for a check-up. It turned out that the ba...

Dr. Chen Zhiyu reply Obstetrics and Gynecology
Regarding your concerns, here are the responses: 1. You should not blame yourself. The chances of chromosomal abnormalities during pregnancy increase with advanced maternal age. Such defects are often naturally eliminated during the embryonic development process. Excessive measu...

Understanding Miscarriage: Key Questions for Expecting Mothers

I'm sorry to disturb you, but I hope Dr. Huang can answer my questions. I previously asked a question, but the information was incomplete. This time, I may be clearer. My previous question is <a href="https://adoctor.tw/article/138919">#138919</a>. Most...

Dr. Huang Jianzhong reply Obstetrics and Gynecology
The last menstrual period was from July 13 to July 17, and my cycles have been very irregular, ranging from 35 to 55 days. Recently, I have been experiencing severe abdominal pain, which is worse than menstrual cramps, so I took a pregnancy test and it confirmed that I am pregnan...