When You’re Not Carrying to Term: Everything You Need to Know About Miscarriage Prevention

Approximately 15-25% of all pregnancies end in a spontaneous abortion, which is the natural death of an embryo prior to 20 weeks of gestation. The cause is most often due to chromosomal and genetic abnormalities, meaning the fetus was not viable outside of the uterine environment. When a person experiences two or more miscarriages in a row, the term recurrent pregnancy loss is used.  A proper work-up, family history and assessment for risk factors can help with future miscarriage prevention.

 

Important Naturopathic Considerations for Miscarriage Prevention:

 

Proper Clinical Assessment

It is our role at Naturopathic Doctors to help educate patients on the common risk factors associated with miscarriage. We will investigate diet and lifestyle factors, and screen for biological and pathological markers related to miscarriage. The most effective approach for miscarriage prevention, especially in cases of recurrent loss, often involves co-management with specialists at a fertility clinic. It takes a team approach to ensure that we leave no stone unturned and figure out the best solution to help you carry to term.

Autoimmunity-

Autoimmunity, especially undiagnosed autoimmune conditions, is a huge risk factor for miscarriage and pregnancy related complications. Autoimmunity refers to when our own immune system attacks our cells and tissues. It is important to screen for and receive proper diagnosis for conditions such as Hashimoto’s Thyroiditis, Antiphospholipid Syndrome and Celiac Disease. This is done by performing relevant physical exams, ordering blood work and clinical assessment of signs and symptoms. Treatment often includes a combination of herbal, nutritional and medical therapy to help manage inflammation and maintain a healthy pregnancy.

Hormonal Imbalance-

Low levels of progesterone can lead to improper development of the endometrium, the lining of our uterus. This can result in a shortened luteal phase after ovulation, which is termed ‘luteal phase defect’ (LPD). When LPD occurs, the uterus is not prepared to maintain a pregnancy and miscarriage can occur. Think of the uterus as a fluffy duvet- it needs to be thick and inviting for an embryo to implant after fertilization has occurred. By assessing for and treating LPD, we can help balance your hormones and prepare the uterus for a healthy pregnancy. Supplementing with vaginal progesterone suppositories has been shown to reduce the risk of miscarriage following IVF in women with LPD.

Genetics-

Women who have a genetic mutation in the methylenetetrahydrofolate reductase (MTHFR) enzyme has difficulty converting folic acid into its active form, 5-methyltetrahydrofolate (5-MTHF). Insufficient levels of 5-MTHF can lead to high levels of the amino acid homocysteine in our body. Elevated homocysteine causes inflammation in our blood vessels throughout our body. This increases the risk for blood clots and recurrent early pregnancy loss due to vascular complications.Treatment focuses on testing homocysteine levels in the blood, and targeted nutritional support to reduce homocysteine if necessary.

If you or someone you know is struggling to maintain a healthy pregnancy, you do not need to suffer in silence. You deserve a proper workup and to get the answers you need. I offer complimentary consults for all patients to learn about my approach to integrated fertility treatments, and how I can best help you on your fertility journey. Let’s make your goal of a healthy baby turn into a reality.

References
Toth, B., et al. “Recurrent miscarriage: diagnostic and therapeutic procedures. guideline of the DGGG (S1-Level, AWMF Registry No. 015/050, December 2013).” Geburtshilfe und Frauenheilkunde 75.11 (2015): 1117.
Check, J. H. “Luteal phase support for in vitro fertilization-embryo transfer–present and future methods to improve successful implantation.” Clinical and experimental obstetrics & gynecology39.4 (2012): 422-428.
Nelen, Willianne LDM, et al. “Hyperhomocysteinemia and recurrent early pregnancy loss: a meta-analysis.” Fertility and sterility 74.6 (2000): 1196-1199.
2019-01-24T16:54:50-05:00