Few things are more heartbreaking than a miscarriage. For many couples, as soon as the test is positive, the small embryo of a small age becomes a person, and when the pregnancy ends, the sensation of loss becomes very real. A separate spontaneous abortion is very common, with 25% of pregnancies ending in a loss, so many, if not most, women will suffer a loss in reproductive age. Less than 5% of women will experience two consecutive spontaneous abortions, and the number drops to less than 1% who experience three or more.

A couple who has suffered three or more losses can benefit from a complete medical examination. This article will be the first in a three-part series that analyzes current medical knowledge about causes, tests and possible treatments for abortion.

1. GENETIC REASONS

Sixty per cent or more miscarriages are due to a random (random) chromosomal abnormality, usually an absent or duplicated chromosome in the fetus. Fetal or placental tissue can be obtained during a miscarriage and can be examined for pathologies. Unfortunately, these types of problems are “accidents in nature” that occur when the egg cells or sperm cells divide, and cannot be fixed. In the future, we can learn about the hereditary tendency to abnormal cell division.

Another type of chromosomal problem occurs when one of the parents transmits an abnormal amount of genetic material to the embryo: a chromosomal analysis carried out in the blood of the parents can identify this type of hereditary genetic cause. Unbalanced translocation (part of one chromosome attached to another) is the most common inherited anomaly. To solve this problem, the couple can consider in vitro fertilization. Embryos derived from IVF can be analyzed using a procedure known as preimplantation genetic diagnosis (PGD), and only healthy embryos are selected for transfer.

2. AGE

For women over 40, more than a third of all pregnancies end in recurrent miscarriage. Most lost embryos have an abnormal number of chromosomes. The reason why age is such an essential factor is that a woman is born with all the eggs that are already stored in her ovaries. Therefore, their eggs are subject to all the wear, which happens in more than 40 years. Recently, there has been a lot of progress in egg freezing technology. It is possible that it will soon be available for women who want to postpone the delivery until half of life. Ovum donation is another widely used alternative. The risk of miscarriage associated with an ovum from a donor is related to the age of the egg donor, not the recipient.

3. MALE FACTOR

There is increasing evidence that the abnormal (intact) integrity of sperm DNA can affect the development of the embryo and possibly increase the risk of spontaneous abortion. Some medications, such as sulfasalazine, are very toxic to the male reproductive tract and cause fragmentation in the chromosomes of the sperm. DNA testing hong kong can detect levels of DNA fragmentation; levels higher than 30% are associated with a probability of no more than 1% of what a couple can get pregnant.