From an emotional perspective, miscarriage is a very painful event. When you are eagerly looking forward to having a baby, and then lose the pregnancy, it can literally break you. This situation becomes a lot worse for infertile patients. The extended treatment, the injection, all the waiting, the positive pregnancy test- all of this gets you into very high spirits and a miscarriage just brings it all crashing to the ground.

It becomes extremely difficult to cope with the pain and heartache. At time, patients are confused about how a miscarriage actually occurs. Most are under the impression that once their pregnancy test comes out positive (when the hCG blood level is more than 10, it means that they are pregnant; and if this level drops, they’ve had a miscarriage) In reality, this isn’t a true positive. When your blood test shows up positive, the only thing it indicates is that you’re pregnant.

If the level drops before you see a sac on the ultrasound scan, it’s called a chemical pregnancy. This isn’t a miscarriage and you won’t need any further medical intervention. Unfortunately, there are a number of doctors who will unnecessarily do a curettage (D&C), post a chemical pregnancy saying that it "cleans the uterus". This is actually harmful as it can have a negative impact on fertility as it causes injury and intrauterine adhesions.

So, what happens of you do an ultrasound scan and it’s found that there isn’t any heartbeat? Even under these conditions, a D&C isn’t necessary. In this situation, its best to medically-terminate the pregnancy with mifegest and misoprostol.

So why exactly did the pregnancy occur?

Unfortunately, we aren’t able to provide an accurate answer to this question.  Regardless of whether the miscarriage occurs post IVF or after having sex, the fact is that human reproduction isn’t an efficient enterprise. Even women who’ve had three normal pregnancies also have a 10% chance of miscarrying during their next pregnancy; and there really isn’t anything that we as doctors can do, to reduce this. The odds continue to be the same, regardless of whether it was a natural pregnancy, after well timed intercourse, or an IVF pregnancy.

Genetic defect 

The most important aspect to keep in view is that in most instances, it’s a genetic defect in the fetus that causes a miscarriage. It’s the body’s natural defense mechanism to prevent an abnormal baby from being born. No matter what the reason  for a miscarriage, it can be  heartbreaking; however , what  it indicates is that you are capable of achieving a  pregnancy. We also know from experience that patients who’ve had a miscarriage have a far better chance of giving birth to a healthy baby, in case they try again.

Determined patients 

While there are some patients who will give up and lose hope if they miscarry post an IVF, the situation just makes them more determined to have a baby. In most cases, it just depends on how you look at the situation and how well-equipped you are to deal with the ebb and tide of life.

Read more-Miscarriage after IVF Treatment

Not happy with the attention you are getting from your IVF clinic? Need more information? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you!

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

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