Case of the month Aug '08: Episode #1
When I met Harold and Irene, I quickly learned that their story was different from those of other patients. Unlike other couples who had trouble getting pregnant, Harold and Irene had gotten pregnant easily on their own four times in the past three years. Their problem was pregnancy losses.
Irene was 31 years old and Harold was 35. They were Korean, but had grown up for most of their lives in the US. After getting married three years ago, they immediately got pregnant. They lost that pregnancy and got pregnant again seven months later with similar results. In their second year of marriage, they once again had two pregnancies and losses. After a lot of frustration, their OB referred them to me.
We started by reviewing the concept of miscarriage. I explained that miscarriage was a very common part of life, with about 1 out of 6 pregnancies ending in miscarriage. So having ONE miscarriage was not anything unusual, sort of like getting into a minor car accident. However, if it gets to be a pattern, then it’s time to step back and see what’s wrong. Again, if someone gets into a minor traffic accident, you don’t make a big fuss, but if someone gets into four accidents in two years, then that raises many questions regarding their vision, judgment or driving ability. With four consecutive pregnancies all resulting in losses and not a single healthy baby born, it was definitely long overdue to explore the medical issues of this couple’s problem.
As you know, I like to structure all problem-solving in an organized fashion. For infertile couples, I divide the problems into issues of sperm, of eggs and of anatomy, as you can tell from our previous case stories. For recurrent miscarriage, I divide the problems into those of anatomy, genetics, hormones, blood clotting antibodies and infectious causes.
Check here for episode 2
