EP22 - A holistic approach to recurrent miscarriage

Your Fertility Hub

In this episode, Karenna talks to Dr Lora Shahine, a Reproductive Endrocronologist from Pacific North West Fertility in Seattle. As well as an IVF specialist, Dr Shahine is also the Director of the Center for Recurrent Pregnancy Loss and author of two books (see links below)

In this in-depth interview, we delve into the whole range of approaches to recurrent miscarriage including medical, (TCM) Chinese medicine, lifestyle and emotional factors. We unwrap some of the confusion in this area and help you feel more confident in your next steps on your journey.

We start by discussing the possible tests that can be performed to identify any possible anatomic, hormone, immune or genetic issues. Dr Shahine is keen to stress that in over 50% of cases an answer isn’t found from the tests and that the most common cause of miscarriages is a chromosome imbalance in the embryo.

Dr Shahine then recommends discussing with your doctor some other approaches in early pregnancy such as taking aspirin or progesterone (a natural immunosuppressant), early ultrasounds and also for conception moving into IVF to enable selection of the embryos and elimination of genetic abnormalities.

We also discuss research published by Dr Shahine that has shown a link between recurrent pregnancy loss and having diminished ovarian reserve so she encourages you to have your FSH and AMH levels checked too. It is believed that this is because the number and quality of eggs are lower with diminished ovarian reserve, leading to more chromosomal abnormalities and miscarriages.

“Recurrent miscarriage can be a window into egg quality.”

The interview goes on to discuss egg health and ways you can positively impact egg health through diet, supplements and reducing your exposure to environmental toxins and how a TCM practitioner can assist you to make these lifestyle changes and with specific supplements for you.

Finally, we discuss the emotional aspect of multiple pregnancy losses and how women can often feel scared to try again, scared of tests showing a problem and scared of tests NOT showing a problem. We agree how important it is to build a solid team around you to support you on both the medical and emotional side.

Dr Shahine concludes the interview referencing an excellent study that can help women and couples to have the confidence and resilience to ‘keep trying’ as the odds of achieving a healthy pregnancy remain high even after recurrent miscarriages.

In this episode:

• What is recurrent miscarriage or pregnancy loss?
• The importance of grieving a loss
• What tests can be used to identify any possible medical reasons
• The most common reason for miscarriages
• Recommendations for trying again and early pregnancy
• How egg health and diminished ovarian reserve could be factors
• How TCM (traditional Chinese medicine) can help
• The importance of emotions in dealing with pregnancy loss and trying again
• Building a support team around you

You may also like:

• EP11 - Finding ways to remember babies lost through miscarriage or late-term baby loss
• EP17 - Finding direction on your fertility journey (free meditation)
• Grief is just love with no place to go (Blog)
• Why is miscarriage still a dirty little secret (Blog)

Links mentioned in the podcast:

• Your Fertility Toolbox - Free resources, tools and exclusive community for emotional support during infertility
• Dr Lora Shahine’s website and Instagram
• Dr Shahine’s excellent book on the topic ‘Not Broken: An approachable guide to miscarriage and recurrent pregnancy loss.’
• ‘Planting the Seeds: An integrative approach to fertility care’ by Dr Shahine and Stephanie Gianarelli
• 1999 Brigham Study into pregnancy outcomes following recurrent miscarriages

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