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Recurrent Pregnancy Loss (RPL)
Recurrent Pregnancy Loss is defined as having 3 or more miscarriages. However, understanding that miscarriage is emotionally and physically draining, traditional testing can start after 2 miscarriages. Unfortunately, testing and treatment options of recurrent miscarriage are very limited.
Symptoms of Miscarriage
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Spotting or bleeding in pregnancy with mild to severe cramping and or back pain leading to loss of pregnancy
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Initial test – Recurrent pregnancy loss panel
Treatment
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IUI with controlled Hyperstimulation - by making more eggs in hopes that one of the eggs will be of good quality and lead to a successful pregnancy.
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IVF+PGT - we can learn more about the cause of miscarriage and separate whether the cause of miscarriage is due to ovarian factors vs. uterine factors and personalize care from the knowledge we gain from the IVF process.
Q&A
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What is ovarian reserve?Ovarian reserve is the number of eggs left in the female. A woman makes all the eggs she will ever have before she is born, about 6 million eggs. Then at birth only 1 million is left because the eggs have already died. By puberty only 500,000 eggs are left. The egg count is constantly decreasing until menopause around age 52 when there are no more eggs left.
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What are fallopian tubes?Fallopian tubes are where the sperm and the egg meet. If the tubes are blocked, the eggs are on one side and the sperm on the other side. They cannot meet and pregnancy cannot occur.
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What is third party reproduction?Third party reproduction is when an outside person is involved to help build your family by either donating sperm, egg, or uterus to carry the pregnancy.
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How long does fertility testing take?Basic fertility testing for the woman will take 2 visits over 7-10 days at the beginning of the menstrual cycle.
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Is fertility testing covered by insurance?Some, but not all insurance cover fertility testing.
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Is it a painful process?Egg count testing is a vaginal ultrasound and blood draw. Patient’s experience minimal discomfort with both procedures. Uterine testing requires insertion of a catheter into the uterine cavity and the uterine cavity is distended with fluid. Insertion of the catheter and uterine distension can cause some cramping equivalent to menstrual cramping. Fallopian tube testing requires insertion of the catheter into the uterine cavity, distension of the uterus with fluid, then the filling and spilling of the fluid from the fallopian tubes. This procedure is usually quick with minimal pain if the fallopian tubes are open, but can also cause significant cramping and discomfort if the tubes are blocked.