Women with miscarriage have good chance of birth

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Stockholm, Sweden: Women who suffer from unexplained recurrent miscarriage (RM) need to know how long it might take them to achieve a live birth if they are not to lose hope and give up trying for a baby. There is currently no evidence-based treatment for RM, and therefore accurate counselling on the chances of achieving a live birth is essential, a Dutch researcher told the annual conference of the European Society of Human Reproduction and Embryology today (Monday). Dr. Stef Kaandorp, from the Centre for Reproductive Medicine, Academic Medical Centre, Amsterdam, The Netherlands, said that his group’s research was the first to look at time to natural conception in women with RM, and that its results would help health professionals to advise and treat patients appropriately. In a subset of the ALIFE study, which investigated the effect of aspirin alone or combined with low-molecular-weight heparin, compared to placebo, on the live birth rate in women with unexplained RM, the researchers looked at the length of time between the moment of randomisation to the moment of the first day of last menstruation before the subsequent pregnancy. 251 women were included in the subset, and the mean age at the time of diagnosing unexplained RM was 34 years. The women had all had at least two miscarriages with an upper gestational age of 20 weeks. 213 women became pregnant during the period February 2004 to July 2009. 139 had a live birth, 69 a miscarriage, two an ectopic pregnancy, two a termination of pregnancy and one had an intra-uterine foetal death. The median time to a subsequent pregnancy, irrespective of outcome, was 21 weeks. The cumulative incidence of natural conception was 56% after six months, 74% after 12 months, and 86% after 24 months of which 65% resulted in a live birth. The researchers now intend to follow up their work by looking at the time it took to achieve a live birth as opposed to simply time to pregnancy. “This will be important in counselling these women for their future pregnancy attempts,” said Dr. Kaandorp. “We hope that our work will encourage health professionals to avoid non evidenced-based and potentially harmful treatments for couples. For example, aspirin and low-molecular-weight heparin are still being used, even though the ALIFE study showed clearly that there is no evidence that they are helpful. Abstract no: O-022, Monday 10.15 hrs CEST (Hall A4)