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Miscarriage is always an emotionally painful event. When you are looking forward to having a baby, they losing the pregnancy can break your heart. It's much worse for infertile patients ! After all that waiting, when you finally get a positive pregnancy test, you are over the moon and start looking forward to holding your baby.

However, if you then end up miscarrying, this is extremely cruel, because when someone gives you something and then snatches it away, it's much harder to cope with the pain and heartache.

Is it a miscarriage?

Sometimes patients are confused as to what actually constitutes a miscarriage. A lot of them think that once a pregnancy test is positive ( when the hCG blood level is more than 10, this means that they are pregnant ; and that if this level drops, they have had a miscarriage. This is not true a positive.

A positive hCG blood test just means that you pregnant, and if the level drops before you see a sac on the ultrasound scan, this is called a chemical pregnancy. This is not a miscarriage and no further medical intervention is needed. However, unfortunately we often see that a lot of doctors will do an unnecessary curettage ( D&C) after a chemical pregnancy to "clean the uterus". This can be harmful, because it can actually reduce fertility, by causing injury and intrauterine adhesions.

What happens if your do see a scan on the ultrasound scan and then find that there is no heartbeat ? Even under these conditions, there's no need to do a D&C - it's much better to terminate the pregnancy medically with mifegest and misoprostol.

What about the million dollar question - why did the pregnancy miscarry?

Sadly, we are often not able to answer this question accurately. This is true, whether the miscarriage occurs after IVF, or if it occurs after having sex. The fact remains that human reproduction is not an efficient enterprise, and that even women who have had 3 normal normal pregnancies in the bedroom have a 10 percent chance of miscarrying in their next pregnancy. There's nothing we can do to reduce this - and the odds remain the same, whether it's a natural pregnancy, after well timed intercourse, or if it's an IVF pregnancy.

Genetic defect 

The important thing to remember is that the commonest cause of a miscarriage is a genetic defect in the fetus and this is nature's defense mechanism to prevent the birth an abnormal baby. A miscarriage can be heartrending, but it actually means that you're capable of achieving a pregnancy ; and we know that patients who've had a miscarriage actually have a much better chance of having a healthy baby if they try IVF again.

Determined patients 

While some IVF patients give up and get disheartened when they miscarry after IVF, others become even more determined to have a baby. A lot of it depends on your approach and attitude, and how well you can deal with the ups and downs which life is going to present you with.

Read more- Miscarriage after IVF Treatment

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.

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