Our expert says:
Your problem is a combination of first and second trimester miscarriages and the causative factors in each are fairly different. I am rather surprised that your gynaecologist did not offer you the encirclage or stitch in your last pregnancy, as this would be highly recommended in patients with a previous uterine septum as well as a previous trimester miscarriage. I would recommend that you undergo careful fertility treatment by way of in-vitro fertilization and consider that option of pre-genetic diagnosis (Pgd) of embryos looking for common chromosomal defect before transferring only the healthy embryo/s in to the uterus (womb). The reason for my recommendation is that all stages of the fertility process should be carefully controlled and monitored as certain treatments, which must be instituted shortly before implantation, during implantation as well as in the first 8-10 weeks after pregnancy has been established. Once your pregnancy gets beyond 10 weeks it would be prudent to insert a encirclage or stitch and to continue monitoring the pregnancy very throughout.
Answered by: Dr M.I. Cassim
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