Recurrent pregnancy loss – could silent endometriosis be the cause?

Recurrent pregnancy loss creates a difficult and painful reality for hopeful parents. 

And, often, this reality becomes an increasingly frustrating one, when it feels like we’re getting nowhere with understanding why it keeps happening, and aren’t moving our journey forward.

This Endometriosis Awareness Month, we’re back partnering with the incredible ReceptivaDx™ team, whose dedication to advocacy and understanding the causes and latest treatment around unexplained infertility, IVF failure, implantation issues and more led them to create the ground-breaking ReceptivaDx™ BCL6 Test.

Delivering cutting-edge results, the test identifies a protein marker called BCL6 that’s linked with uterine lining inflammation associated with endometriosis, as well as flagging progesterone resistance – a common reason for recurrent pregnancy loss, and implantation failure.

With all this in mind, we wanted to know;

• What’s the latest on endometriosis and fertility in 2024?
• Is there an endometriosis miscarriage link?
• Could recurrent miscarriage be a flag for silent endometriosis?
• How could a silent endometriosis test help guide treatment?
• What are the questions to ask a physician, to move things forward?
  
  

Before you dive into the details, connect with ReceptivaDx™ to learn more and book your test. TRB readers can get $75 off – just use code TRB23 on your test request form.

Recurrent miscarriage can be complex and is rarely clear-cut. Self-advocacy is so key, wherever you are on your journey, so let’s get informed, together.

Understanding endometriosis and fertility – where are we at, in Endometriosis Awareness Month 2024?

Endometriosis is an inflammatory condition where endometrial tissue grows outside of the endometrial cavity. 

It currently impacts an estimated 2 – 10% of women in the US between the ages of 25 and 40, and you’ve probably heard of the textbook symptoms (think pelvic pain and heavy periods) – but it’s still not as clear cut as this when it comes to diagnosis.

Right now, the average time to confirm endometriosis is still around 10 years.

Silent endometriosis, a (still) overlooked fertility puzzle piece

As the name suggests, silent endometriosis isn’t usually accompanied by any ‘typical’ signs or symptoms so can often get overlooked, especially during baseline fertility assessments with your OBGYN.

And on top of that, silent endometriosis is thought to impact about 20 – 25% of us who are struggling with fertility. 

Symptoms or no symptoms though, data over the last 7 years continues to show that if endometriosis goes undetected and untreated, fertility problems are likely to persist, even with IVF. 

So, knowing all of this, where does recurrent miscarriage come into the picture?

Is there an endometriosis miscarriage link? 

The short answer is yes – but it’s not always straightforward to make the connection.

There are many reasons why a miscarriage may occur. Many happen due to very early-stage chromosomal abnormalities, and often, there’s nothing we can do to stop it from happening.

However, endometriosis – silent or not – can cause inflammation and a build-up of scar tissue in the lining of the womb, as well as leading to the formation of adhesions and cysts. These are thought to have the potential to disrupt the implantation of the fertilized egg, resulting in early pregnancy loss, or miscarriage later on in the first trimester.

There are also several hormonal imbalances associated with endo, including progesterone resistance.

Progesterone is key for key for keeping inflammation in the endometrium down, and it has been suggested that having lower endometrial progesterone could disrupt the early development and maintenance of pregnancy.  

Recurrent miscarriage – a flag for silent endometriosis? 

When it comes to the recurrent pregnancy loss endometriosis connection, the latest research tells us there may be a link with higher levels of the BCL6 protein. 

One recent study found that elevated BCL6 levels may be a contributing factor in recurrent pregnancy loss, and ReceptivaDx™ note that in patients they support who’ve experienced recurrent miscarriage, 50% have had some form of endometrial inflammation, and a positive BCL6 test.

The good news is that after endo is detected and treated, successful pregnancy rates sit in the range of 52 – 64%, compared to 11 – 20% with no treatment.

So, how can we go about advocating for ourselves, and steering our fertility team towards the right kind of testing, if we’re trying to heal and move forward after recurrent pregnancy loss?

Next steps, and advocating for ourselves

If any of this has resonated with you so far, know that recurrent pregnancy loss doesn’t have to represent a full stop on your fertility journey.

Self-advocacy – be that focusing on what you can control or the questions you can ask – can be so helpful when it comes to next steps and finding a way forward.

Here are three tips to bookmark for your next consultation, to get endometriosis (silent or symptomatic) into the conversation.

1. Inform your doctor that you would like to rule out possible endometriosis

Let them know that you would like to rule out or detect possible endometriosis based on your symptoms, and intention to get pregnant.

Provide information on, and ask for, the ReceptivaDx test.

A test like the ReceptivaDx™ test can help physicians and patients narrow down the causes of unexplained fertility, either detecting endometriosis, or removing it from the list – without resorting to an invasive (and expensive) diagnostic laparoscopy.

2. Talk through your treatment options, in case of a positive result

Typically, there are two different treatment options offered after an endometriosis diagnosis. These are;

• Hormone treatment to suppress the inflammation, and slow down endo growth
• Laparoscopic surgery to scope for problem areas, and remove affected tissue

Removing endometriosis from the womb lining can absolutely increase your chances of conception, even without IVF. Head to ReceptivaDx™ for more information and the latest stats on this.

Work with your physician to help you put together a plan. This is your journey, and you have choices. 

3. Pay attention to how you’re feeling

Take note of your physician’s responses, and keep an eye on how you’re feeling, too.

Experiencing multiple miscarriages is really tough, both physically and emotionally.

You deserve to feel like your team is working proactively with you, and keeping all your options open – whether that’s for a silent endometriosis test, further hormonal monitoring, or specific genetic testing.

Looking to get tested for silent endometriosis? The ReceptivaDx™ approach for 2024 is simple. Learn, empower and advocate. Connect with them to start getting answers to your questions, and book your test today.