Pregnancy after Miscarriage|Can You Get Pregnant Naturally with One Fallopian Tube? -Dr.Aruna Kumari

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Can I have a healthy pregnancy after a previous miscarriage? Yes, definitely it is possible. The risk of spontaneous miscarriage in 10 to 20% of healthy couples is there in the normal population also. So, a previous miscarriage will not always lead to complications. But yes, pre-conceptionally, certain tests will be done for the patient to see if any pre-existing diseases are there, and the husband’s semen analysis will also be done. If any pre-existing disease is present, like uncontrolled hypertension or diabetes, that will be controlled and treatment will be started. Hypertension has to be controlled to bring the blood pressure less than 140/90 and HbA1c preferably less than 6.5. The ideal is less than 5.7, but at least preferable is less than 6.5. If any other diseases exist—sometimes we feel, “This is the first miscarriage, why should we test so many things?” The patient also feels this, sometimes we ourselves think it too. But many diseases like antiphospholipid syndrome, anti-nuclear antibodies, and thrombotic diseases can be identified by testing some basic tests. Medical guidelines do not recommend extensive testing based solely on clinical history. However, if the patient has any family history of early thrombotic events, then it is better to do advanced testing. Otherwise, the basic tests for the woman and husband’s semen analysis are good enough to proceed with pregnancy planning. Folic acid, vitamin B12, and vitamin D supplements will be given to prevent any neurodevelopmental or brain development, or skull bone formation defects. These things can be prevented. Apart from this, early in pregnancy, as soon as conception occurs, we usually start progesterone support. Sometimes we may start the echocardiogram if the woman is older than 35 years or if in the previous miscarriage the yolk sac did not develop. In such cases, we start the echocardiogram and evaluate them. If a woman repeatedly becomes pregnant but no yolk sac develops—such as in blighted ovum or very early pregnancy failures—we may ask for a karyotype test. If these tests are done, usually the outcome will be very good. Many times, a previous miscarriage could have been an ectopic pregnancy. One tube might have had to be removed because the pregnancy ruptured. The woman may ask, “With one tube only, will I be able to conceive?” Yes, definitely. The month you ovulate on that side, follicle tracking can be done and you can plan naturally. Conception depends on the correct timing of ovulation and fertilisation. Timed intercourse and monitoring of the follicle also help many couples with a single tube to conceive. Hence, after any miscarriage or ectopic pregnancy, meet the doctor before planning for the next pregnancy, get properly evaluated, then take the supplements properly, and maintain your BMI and a healthy lifestyle as a couple—both partners. In recent trends, smoking and alcohol consumption are also seen among women. When you are planning for pregnancy, at least three to six months prior, change your lifestyle, have a healthy lifestyle, maintain your BMI, and get preconceptional evaluation before planning the next pregnancy so that the outcome will be very good.
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