Miscarriages and repeated implantation problems

Doctors diagnose "recurrent miscarriages" if 2 to 3 or more of a woman's previous pregnancies have ended in a spontaneous abortion at any stage of gestation.
 

The classification of clinical forms of this pathology depends on the gestational age at which it occurred. We refer to:

• spontaneous abortion or miscarriage (<27 weeks);
   
• premature birth (28-37 weeks).

There is a distinct clinical form defined as a frozen pregnancy, in which the dead fetus remains in the uterine cavity. 
According to statistics, one in five pregnancies ends unsuccessfully, which raises concerns among doctors and leads to the search for methods and means to prevent embryonic death.
 

Causes of pathology

Contributing factors causing recurrent spontaneous abortions include:

• hereditary or newly acquired genetic abnormalities;
   
• hormonal imbalance caused by endocrine pathologies;
   
• penetration of an infectious agent, particularly in the first trimester;
   
• "failure" of the immune system, leading to autoimmune pathologies;
   
• thrombosis of the vessels of the umbilical cord and/or placenta;
   
• uterine pathologies of various etiologies.

Implantation issues with IVF and artificial insemination

Embryo implantation is one of the most critical stages of the pregnancy process. In the case of IVF and other methods of artificial insemination, implantation issues can become the main cause of recurrent miscarriages. The implantation process can be complicated by a number of factors:

1. Quality of embryos: Despite selecting high-quality embryos for implantation, the possibility of chromosomal abnormalities remains high, especially in older women or those with a history of miscarriage.
    
2. Endometrial problems: The thickness and structure of the endometrium (the inner layer of the uterus) play a key role in the success of implantation. If the endometrium is underdeveloped or abnormal, embryo implantation can be difficult.
    
3. Hormonal imbalances: The hormonal medications used in the IVF process can disrupt the natural hormonal balance, making implantation difficult.
    

Early diagnosis of complications

Early diagnosis plays a key role in preventing complications associated with IVF and recurrent miscarriages. Doctors use various methods to monitor the early stages of pregnancy:

• Preimplantation genetic diagnosis (PGD): This procedure allows for the identification of genetic abnormalities in the embryo before implantation, which helps reduce the risk of miscarriage.
   
• Ultrasound: Regular ultrasound in early pregnancy allows for monitoring the condition of the fetus and the development of the placenta.
   
• Doppler: This method is used to assess blood flow in the vessels of the placenta and umbilical cord, which is important for the early detection of thrombosis and other complications.
   
• Monitoring hormone levels: Hormonal tests help detect imbalances early and adjust treatment to maintain the pregnancy.
   

Recurrent miscarriages and implantation issues during IVF require an integrated approach to diagnosis and treatment. The success of initiating and maintaining a pregnancy after IVF depends on many factors, including the quality of the embryo, the condition of the endometrium, hormonal balance, and the absence of genetic and immune complications. Early diagnosis and close medical monitoring are essential to reduce risks and achieve a positive pregnancy outcome.