Miscarriage: Seeking Specialty Care, Page 2

Do You Have To Lose So Many Before Finding Out Why?

The short answer to this is "no". This is where being a savvy medical consumer comes in to play. Some doctors and insurance companies will refuse any sort of diagnostic testing before two or three miscarriages. Find out after your first loss where your own insurance and physician draw the lines.

If you have good cause to suspect there is an underlying treatable condition affecting your ability to carry a pregnancy, you have the right to appeal related policies.

Good Causes To Appeal Less Aggressive Policies

First, understand the potential precursors for all pregnancy loss:

Structural

  • uterine malformations
  • growths in the uterine interior e.g. fibroids
  • uterine synechiae (scar tissue)
  • endometriosis
  • incompetent cervix

Hormonal

  • Luteal phase defect
  • Thyroid dysfunction
  • Other hormonal imbalances & endocrine disorders, such as diabetes mellitus, hyperprolactinemia

Genetic

  • chromosomal arrangement problems, such as balanced translocation, of either partner
  • other chromosomal abnormalities

Immunological

  • autoimmune disorders such as lupus, some forms of thyroid disease
  • maternal presence of certain antibodies, such as antiphospholipid, anticardiolipid, antithyroid

Environmental

  • maternal DES exposure in-utero
  • maternal age (mid-30's and older)
  • other maternal factors such as overt stress, malnutrition, disease & infection

Next, if you feel that any of the above factors may have played a part in your miscarriage, bring that to the attention of your doctor. It may be possible that there is corrective or preventive treatment for your situation, treatment which may prevent more loss. However, many of the above causes cannot be known until detected by specific testing.

In your appeal for more aggressive diagnosis, be sure to emphasize the length of time, effort, and money you have already spent on trying to conceive, and also your (maternal) age, as these issues can impact a practitioner's decision in your favor.

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