However, a report released by the American College of Obstetricians and Gynecologists (ACOG) shows that although a common concern of patients, environmental factors rarely have been linked to sporadic pregnancy loss, and no associations between environmental factors and recurrent pregnancy loss have been established.
"Miscarriages are not uncommon and are believed to occur with as many as 1 out of every 4 pregnancies," says Dr. Jeffrey Braverman, Reproductive Immunologist & IVF Specialist and Founder of Braverman Reproductive Immunology in New York. "Often the woman will miscarry very early in pregnancy, sometimes even before she knows that she has conceived." According to Dr. Braverman, although many women experience one or two losses, most are able to conceive a child that is carried in a healthy pregnancy to term. However, in cases of recurrent pregnancy losses women continue to miscarry over and over again with each pregnancy.
Although genetic abnormalities of the embryo are identified as the cause for 60 percent of these cases, it's not necessarily true once the heartbeat is detected. Dr. Braverman advises patients who have not gotten pregnant with high quality embryos, those who have experienced miscarriage of a genetically normal fetus or have suffered a loss after the heart beat has been detected, and those with a family history of auto-immune diseases and miscarriage to seek a consultation with a reproductive immunologist, or fertility doctor who specializes in immunologic causes of infertility.
"Patients usually come to our center after multiple miscarriages and unsuccessful treatment elsewhere," says Dr. Braverman. An internationally known and respected physician, Dr. Braverman specializes in the treatment of recurrent miscarriages and reproductive immunology. "There are different types of miscarriage, different treatments for each, and different statistics for what your chances are of having one. Most miscarriages occur during the first 13 weeks of pregnancy. Pregnancy can be such an exciting time, but with the great number of recognized miscarriages that occur, it is beneficial to be informed about the causes and treatments of recurrent miscarriages." For more than 20 years, Dr. Braverman has been treating patients with all complications related to Recurrent Pregnancy Loss and has become one of the world's leading authorities in the field Reproductive Immunology.
Dr. Braverman adds, "Today, we know a great deal about the exact workings of the immune system and how it affects a pregnancy. In fact, the mother's immune system plays a critical role in the acceptance of an embryo. At Braverman Reproductive Immunology, we evaluate patients for immune related miscarriages as well as all other possible causes of miscarriages."
Immune Disorders & Recurrent Miscarriages
Immune disorders are a hot topic in reproductive medicine these days. Your immune system is made up of a large network of cells, tissues, and organs working together to fight off germs and infections and respond to allergens in the environment. But the immune system doesn't always work the way it should.
In some immune system disorders, the immune system can't fight off infections. In other disorders, it incorrectly identifies parts of the body as a threat and attacks the body's cells the same way it would attack an invading germ. Allergic reactions fall to one side of this spectrum, with life-threatening diseases like lupus and multiple sclerosis at the other end of the scale. What happens in all of these disorders is that the immune system loses its ability to discriminate between "safe" and "harmful."
Some couples trying to conceive may be diagnosed with immunologic incompatibility, or allogeneic issues, which are detrimental to their fertility. Genes from both of the parents that are passed on to their growing embryo may not properly communicate to the mother's immune system and her body may mistake the embryo as a foreign invader. As a result, the embryo may not implant or may miscarry.
"Many doctors assume the cause of miscarriages is genetic or chromosomal abnormalities dismissing all other possible causes and in many cases putting the mother through unnecessary repeated episodes of pregnancy loss," says Dr. Braverman.
According to Dr. Braverman, identifying the root cause is the crucial starting point in miscarriage prevention. "If we know that immune disorders are causing a woman to miscarry, there are preventive measures we can take. It's precisely when an embryo is chromosomally normal that we need to look at the maternal immune system. Her immune system needs to be investigated as a cause."
Diagnosing Immunologic Infertility
A number of factors can impact a woman's ability to carry a healthy pregnancy. Predisposition to immunologic abnormalities such as autoimmune disease, abnormal development of ‘inflammatory' cytokines in the mother's blood, elevation of activated immune cells, immune response to proteins in sperm, or failure to generate protective cells that a mother makes when pregnant can be associated with improper immune tolerance in the mother for the embryo. Celiac disease, Crohn's disease, Multiple Sclerosis, Polycystic Ovarian Syndrome (PCOS), Endometriosis and Lupus are all examples of conditions that can lead to rejection of an embryo if not properly treated. Stress and dietary factors may also play a role in the mother's immune tolerance of the pregnancy.
Preventing Immune Disorder Related Pregnancy Loss
Dr. Braverman says patients who suffer from recurrent miscarriages should first be sure there are no genetic causes of the miscarriage. "By identifying the likely source of the problem, treatments can be given that help to correct them. The goal is trying as much as possible to assist in the immune tolerance that must be created. Most important is that we have ruled out genetic issues as the only cause for the failures and miscarriages. Once this is done we can focus on the immune system as one of the most likely causes of the failures or losses," says Dr. Braverman. Without generating immune tolerance in these patients, the immune system will attack the embryo much like an organ transplant patient who suffers rejection of the organ and this can occur at any time during the pregnancy. www.preventmiscarriage.com
About Dr. Jeffrey Braverman and BRAVERMAN Reproductive Immunology
Dr. Braverman is the founder and Medical Director at Braverman Reproductive Immunology with offices in Long Island and Manhattan. An internationally known and respected physician, Dr. Braverman specializes in the treatment of recurrent miscarriages and reproductive immunology.
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