Making Miscarriage Less Mysterious

Miscarriage. Painful and heart wrenching, but altogether too common, miscarriages occur in about 15-20% of all pregnancies. (American Congress of Obstetricians and Gynecologists) Until recently, researchers were unable to tell which pregnancies were the most likely to miscarry and which pregnancies could possibly be saved through targeted intervention. A recent study, however, may enable fertility researchers to now accurately predict which pregnant women are more likely to miscarry. (European Society of Human Reproduction and Embryology)

“This research has, for the first time, offered us a robust tool to begin to attempt to rescue pregnancies threatening to miscarry, when, currently, all we can do is fold our hands and hope for the best,” said Dr Kaltum Adam, of St Mary’s Hospital in Manchester.

Until these preliminary findings, there was, according to Dr. Adam, “no way of predicting which threatened miscarriages will result in the end of the pregnancy and so we are unable to target attempts to rescue the pregnancy at the right women or to offer them counseling.” (ESHRE)

After studying the outcomes of 112 women who were six to ten weeks pregnant and at risk for miscarriage, Dr. Adam and her team developed a Pregnancy Viability Index (PVI). This new tool looks at the levels of bleeding and of the pregnancy hormone human chorionic gonadotrophin (hCG) to determine the viability of the pregnancy’s continuance. By the end of the study, the PVI accurately predicted which pregnancies would continue in 94% of cases and which pregnancies would miscarry in 74% of cases. (ESHRE)

The PVI will help avoid unnecessary interventions and testing, such as repeated ultrasounds and blood tests, to be avoided. Dr. Adam explains, “The use of the PVI will negate these in the vast majority (80%) of these women, as we will be able to reassure them of a high likelihood of pregnancy continuation and that there is little additional value in doing further testing…. Furthermore, psychological counseling and support could be targeted at the women most likely to miscarry, in order to reduce anxiety levels and improve their overall experience.” (ESHRE)

Dr. Adam anticipates that the PVI will allow for a better understanding of why the remaining 20% of at-risk pregnancies end in miscarriage.

“We are hopeful that by identifying factors that impact significantly on pregnancy outcome we will be able to gain a better understanding of the process of threatened miscarriage,” she said “This, in turn, may enable us to design more effective interventions to rescue these pregnancies.” (ESHRE)

No additional equipment is required to apply the PVI, which Dr. Adam trusts will lend itself to the PVI becoming a widely used tool in fertility clinics and doctors’ offices alike. As such, the PVI will likely have a positive outcome on sustaining the pregnancies conceived naturally, through IVF, and through embryo donation and adoption. (ESHRE)

The PVI may also improve the chances of women struggling with recurrent miscarriage (RM) of experiencing a live birth. Another study released during the ESHRE meeting in Stockholm found that already two of out three women with RM experience a live birth after being referred to a specialist. (ESHRE)

Research regarding the cause for miscarriage may also be helpful for families pursuing embryo donation and adoption.

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