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Immunotherapy

Some clinics have used a treatment called immunotherapy to stop miscarriages where there may have been several in a row. This treatment is based on the theory that a woman needs to produce special blocking antibodies to prevent her body rejecting the baby whose cells are different from her own. Normally our bodies try to reject any cells that are not ours and yet 50 per cent of a baby’s cells are the partner’s. This treatment is highly controversial. If the theory is right you may wonder why our bodies don’t just reject the sperm to begin with, as they would any foreign object.

It is thought that the immune system’s normal level of activity has to reduce slightly in order to ‘accept’ the growing baby. This reduction in immune activity is one reason why women who have rheumatoid arthritis can lose all their symptoms while pregnant. Rheumatoid arthritis is an inflammatory disorder with an auto-immune component and so benefits from a ‘quieter’ immune system. Immunotherapy treatment works like a vaccine and involves injecting the woman with her partner’s blood to help her produce these antibodies. There have been doubts as to whether the treatment actually works and concern that it may cause sterility in some women, along with other problems such as transfusion reactions and hepatitis.

Incompetent Cervix

In a healthy pregnancy the neck of the womb (the cervix) remains closed until near the birth. However, when the cervix is incompetent the neck of the womb painlessly dilates without contractions, resulting in miscarriage or premature birth. The condition may be congenital (i.e. the woman was born with it) or may be the result of a previous pregnancy. With an incompetent cervix, the miscarriage is usually later – often into the second trimester of pregnancy. The usual treatment is to hold the cervix together with a stitch. Some doctors put the stitch in before conception, others in early pregnancy, and others only after the third month. The diagnosis for this condition is difficult and the research has not led to any clear-cut conclusions as to how beneficial the stitch really is. Obviously if it is inserted too early it could stop nature miscarrying an abnormal baby.

Anatomical abnormalities

An unusually shaped womb may cause problems with implantation. Some women can be born with problems, such as a double uterus (womb), and yet can go on to have healthy pregnancies, while the same condition in others can cause them to miscarry. Surgery is a possibility if your womb is abnormal.

Abnormal Sperm

Because it is the woman who miscarries, greater emphasis has been placed on looking at problems in the female reproductive system. But if you keep miscarrying when nothing can be found wrong it is logical to wonder if the problem might be with your partner’s sperm instead. Early studies have shown that there is an increased risk of miscarriage where there are sperm abnormalities. So it really is important that both the man and woman get themselves into optimum health before conception.

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