Experienced pregnancy loss? Undergoing test after test at a fertility clinic? Eager and hopeful to find a solution and sustain a pregnancy?
In “1 million pregnancy losses suffered annually in United States,” Dr. Harvey Kliman discusses how prevalent pregnancy loss is, that there is nothing wrong with you, and 90% of pregnancy losses are due to some genetic issue.”
One of the most common “diagnoses” when it comes to infertility is “chronic endometritis,” Kliman said.
The problem with that?
We are aware that “infertility is unfortunately an area that is ripe for exploitation of these patients,” said Kliman.
When a patient is diagnosed with that, the problem is: “Chronic endometritis is not really an entity,” he explained. In addition to that, “patients get treated for this condition.”
What led to this modern-day common diagnosis?
While it is a complex biology, “it’s a misrepresentation of what is actually happening in the normal endometrium,” Kliman said.
“For reasons I am not sure, a long time ago somebody looked at an endometrium and said ‘I think that’s a plasma cell. (A plasma cell is a cell that makes antibodies), and they called it chronic endometritis.’”
A basic understanding of the endometrium?
“The menstrual cycle, the lining of the uterus changes every single day across the 28-day idealized cycle.” When you “look at an endometrial sample, you will find immune cells in the endometrium which are normally there as part of preparing the endometrium for pregnancy,” Kliman continued.
Kliman has had numerous patients come to his practice and report they have been diagnosed with chronic endometritis. He feels bad for individuals who have had this happen to them.
“They have been treated with antibiotics for a year.”
“They had repeated biopsies.”
Kliman said he has to inform those patients that “these immune cells are a natural, normal part of the menstrual cycle and there is nothing to treat.”
“I feel really bad for those patients that doctors get their hands on,” diagnose them with chronic endometritis, and prescribe medication and have them undergo treatments.
“I have so many recurrent pregnancy loss patients that have been put on Lovenox, which is a Heparin, because the doctor thought the reasons for the losses was due to a clotting disorder.”
Let’s circle back and remind ourselves of Kliman’s key insight that “the #1 cause for pregnancy loss is due to genetic abnormalities.”
Do clotting disorders cause pregnancy losses? Kliman said,
- I see evidence of a clotting disorder less than 2% of the time when I look at pregnancy losses (through examining the tissue in the lab from a D&C or natural loss at home). In those rare cases heparin may be indicated. In all the other 98%, heparin is not indicated.
If you would like to have Yale University examine the tissue from your pregnancy loss, see below for further information.
- When patients are still having losses, even on Lovenox, this proves that that wasn’t the problem in the first place.
Successful conception, a healthy pregnancy, and welcoming a baby into the world is multi-faceted.
I hope this article encourages you to spend ample time in researching, meeting, and choosing to be guided in your pregnancy journey by the best doctor in your area.
It was an honor to interview Dr. Harvey Kliman. Kliman is a research scientist in the department of Obstetrics, Gynecology, and Reproductive Sciences at the Yale University School of Medicine as well as the Director of the Reproductive and Placental Research Unit. He has received many awards and recognition, including the Star Award Stillbirth Research in 2019.
Yale University and Stanford University are the two centers conducting important research to better understand the relationship between genetics and pregnancy losses.
Helpful media articles can be found at Kliman’s website here: https://medicine.yale.edu/profile/harvey-kliman/?tab=news.
Information related to pregnancy loss and submitting your tissue to Kliman’s team can be found here:
https://medicine.yale.edu/obgyn/kliman/placenta/pregnancyloss/.
This website does not provide medical advice. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. It is for informational purposes only. Always seek the advice of a medical professional or other qualified health care provider on any health matter or question.