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Hi Dr. I Had 2 Miscarriage 1 In Last Year

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Posted on Mon, 1 Jul 2019
Question: Hi Dr. I had 2 miscarriage 1 in last year and 1 in past month into week 5 and 6 after that I have done lab tests ANA, lupus anticoagulant and cardiolipin test recently (result attached). can you tell me what could be reason for repeated miscarriage in my case?
doctor
Answered by Dr. AJEET SINGH (3 hours later)
Brief Answer:
AUTOIMMUNITY AND MISCARRIAGES

Detailed Answer:
Hi...
Welcome to Ask a Doctor Service.
I am Dr Ajeet XXXXXXX

You have been tested for auto immune disorders to rule out the possible role of an auto-immunity as a cause of your recurrent pregnancy loss.
The actual mechanism by which autoimmune diseases cause pregnancy loss is not well known but here the antibodies are formed against body's own tissues,misinterpret them and attack them.This immune reaction cause an inflammation in the uterus and makes it unreceptive for proper implantation of the embryo.

Cardiolipin antibodies test detects antibodies formed in response to cardiolipins,a phospholipid (type of fat) present in blood.You have been tested negative for it.

Lupus anticoagulant (LA) is an anti phospholipid antibody found in patients of lupus and here blood coagulability increases.You have been tested negative for it.

An antinuclear antibody test looks for autoimmune diseases such as lupus,scleroderma, rheumatoid arthritis etc.
You have a weak positive test result of ANA which is reflective of suspicion of some auto immune mechanism involved in your pregnancy wastage.

An abnormal increase in circulating ANA has been linked with unexplained infertility,endometriosis,implantation failure and repetitive miscarriages.

Kindly meet your fertility expert as these test interpretations should be clinically corelated and read in context of your fertility history,symptoms,physical examination, and other tests like hormonal level..

Hope that I havwe answered your query.If you have any doubts,please let me know.
Stay healthy and stay blessed.
Regards.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. AJEET SINGH (1 hour later)
Thank you doctor. According to you what kind of lab test or treatment required for future pregnancy?
doctor
Answered by Dr. AJEET SINGH (53 minutes later)
Brief Answer:
AUTOIMMUNITY AND MISCARRIAGES

Detailed Answer:
Hi....
I would be more than happy to guide you during the course of your fertility treatment.

You might be subjected to some advance tests like Serum Homocystine levels,Antibody panels,cortisol levels etc during your next visit to the fertility clinic.

Various treatment modalities are used now a days to combat the fertility issues due to autoimmunity.
To reduce the hypercoaguability associated with autoimmune syndromes,
use of a medication that prevents blood clots (blood thinners) such as heparin, sometimes combined with low-dose aspirin,are
prescribed (at times throughout the pregnancy ).This increases the blood flow to uterine capillaries and there are increased rates of successful implantation.

Various research have shown that loading doses of vitamin B6 and B12 and commercially available omega 3 fatty acids supplements increase chances of successful pregnancy (by improving homocystien and folate metabolism).

Low dose steroids like prednisone or at times methyl prednisolone are used to suppress immunity and save the gestational sac from immunological attack.They are the mainstay of treatment.
Sometimes immunosuppressents like Azathioprine are used for the same purpose.
At times IVIG(Immunoglobulin therapy) and lymphocyte immunization therapy (LIT) are used.These are often used in combination IVF and other assisted reproductive technology (ART)

Happy living.
Regards.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. AJEET SINGH

General & Family Physician

Practicing since :1994

Answered : 2151 Questions

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Hi Dr. I Had 2 Miscarriage 1 In Last Year

Brief Answer: AUTOIMMUNITY AND MISCARRIAGES Detailed Answer: Hi... Welcome to Ask a Doctor Service. I am Dr Ajeet XXXXXXX You have been tested for auto immune disorders to rule out the possible role of an auto-immunity as a cause of your recurrent pregnancy loss. The actual mechanism by which autoimmune diseases cause pregnancy loss is not well known but here the antibodies are formed against body's own tissues,misinterpret them and attack them.This immune reaction cause an inflammation in the uterus and makes it unreceptive for proper implantation of the embryo. Cardiolipin antibodies test detects antibodies formed in response to cardiolipins,a phospholipid (type of fat) present in blood.You have been tested negative for it. Lupus anticoagulant (LA) is an anti phospholipid antibody found in patients of lupus and here blood coagulability increases.You have been tested negative for it. An antinuclear antibody test looks for autoimmune diseases such as lupus,scleroderma, rheumatoid arthritis etc. You have a weak positive test result of ANA which is reflective of suspicion of some auto immune mechanism involved in your pregnancy wastage. An abnormal increase in circulating ANA has been linked with unexplained infertility,endometriosis,implantation failure and repetitive miscarriages. Kindly meet your fertility expert as these test interpretations should be clinically corelated and read in context of your fertility history,symptoms,physical examination, and other tests like hormonal level.. Hope that I havwe answered your query.If you have any doubts,please let me know. Stay healthy and stay blessed. Regards.