FERTILITY PROBLEMS: CAUSES OF MISCARRIAGES
Infections
This could be a one-off situation where the mother has caught a severe infection during the early part of pregnancy and it is unlikely to recur in a subsequent pregnancy. Or the miscarriage could be due to a genito-urinary infection which needs to be treated before conceiving again to prevent another miscarriage. Mr. Ronnie Lamont, consultant obstetrician and gynecologist at Northwick Park Hospital, believes that bacterial vaginosis may trigger miscarriage or premature birth. A study he conducted with 800 women found that those with bacterial vaginosis had five times the risk of late miscarriage (16-24 weeks), and those who delivered early (24-37 weeks) also had the infection.
Some infections do not cause a miscarriage but a congenital abnormality (where the baby is born with a defect or malformation). For example, German measles (rubella), contracted in early pregnancy, can lead to babies born with congenital blindness, deafness and mental retardation. A simple blood test can tell you whether you are rubella immune, meaning that you have had German measles or have been vaccinated in the past and so have rubella antibodies in your blood to prevent you from getting it again.
Fertility Drugs
One of the most commonly prescribed medicines for fertility problems is clomiphene citrate which is used to induce ovulation. Ironically, though it may increase a woman’s chances of conceiving, it also increases the chance of a miscarriage by 20-30 per cent. It is thought that the clomiphene can interfere with the womb lining, preventing the fertilised egg from implanting. Other techniques used to induce ovulation, like gonadotrophin treatment, can also increase the miscarriage rate.
It is important not to be underweight or overweight when trying to conceive. Girls don’t begin to menstruate until their bodies are composed of at least 17 per cent fat. Studies have shown that 50 per cent of women who have a Body Mass Index (BMI) below 20.7 are infertile. A BMI of approximately 23-24 would be ideal for conception.
Women with anorexia and girls who exercise to the extreme (such as athletes and gymnasts) can lose their menstrual cycle because of the reduction of fat and therefore become technically infertile temporarily.
At the other extreme, it is known that obesity increases the risk of miscarriage.
Problems with excess weight can also be linked with polycystic ovaries (PCO) which can make conception more difficult. Miscarriages are more likely to occur in women with this condition. However, in a study of women with PCO “who were asked to change their diet, the rate of miscarriages dropped from 75 per cent to 18 per cent for the same women once they had lost weight.
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Tags: Women’s Health