If you have experienced more than one miscarriage, a second trimester miscarriage, or a stillbirth, we understand that you may have concerns about your next pregnancy. At NYU Langone’s Pregnancy Loss Prevention Center, our team of reproductive endocrinologists, geneticists, maternal–fetal medicine specialists, and experts in ultrasound diagnosis and autoimmune disease works together to determine the cause of a previous miscarriage or stillbirth. Our team also develops a care plan that can increase the odds of a successful pregnancy.
There are many factors that can affect a pregnancy. Certain medical conditions, such as diabetes, hypertension, thyroid conditions—including hyperthyroidism, hypothyroidism, and thyroiditis—and autoimmune diseases such as lupus can increase the risk of pregnancy loss. Managing these conditions prior to conception can limit your risk.
For some women, surgery to correct an irregularly shaped uterus, remove fibroids, or manage endometriosis can be beneficial. Surgery to stop the cervix from opening and triggering preterm labor can also help decrease the risk of pregnancy loss. Correcting hormonal imbalances can also help.
Chromosomal abnormalities that lead to conditions such as Down syndrome are a common cause of miscarriage in women older than age 35. Using preimplantation genetic testing in conjunction with in vitro fertilization can increase the chances of a healthy pregnancy.
Most women need to visit our office three times. During the first consultation, our doctor talks with you and your partner about your concerns, experiences, and medical history. If you need emotional support, we connect you with our psychiatrist, social worker, and bereavement team, all of whom specialize in working with couples who have experienced pregnancy loss.
The doctor performs a physical exam and orders any necessary diagnostic tests. These may include blood tests, ultrasound, testing of the endometrial lining, and a sonohysterosalpingogram, an imaging test that allows your doctor to see the shape of the uterus.
During the second visit, you review the results of these diagnostic tests with your doctor. We discuss your ovulation cycle and teach you to know when you are most fertile. This can be done by using ovulation predictor tests and basal body temperature charting, which identifies subtle increases in temperature that can indicate ovulation has occurred. Additional testing might be requested at this time.
You receive the final report and recommendations for care during the last visit. We refer you to your obstetrician or to specialists, such as surgeons or maternal–fetal medicine specialists, who can provide the advanced care you need. We follow up with all patients to determine the success of the treatment strategy.