Services Offered

Caring Team Approach

At the University of Chicago Medical Center, we understand the difference between a woman having trouble getting pregnant and having trouble carrying a baby to full-term. Because of this, we take a multidisciplinary approach to help women who have experienced recurrent pregnancy loss (RPL). Our team includes specialists, primary care physicians, ultrasound technologists, and several research scientists. Our RPL specialists work closely with physicians from:

• Genetics
• Rheumatology
• Hematology
• Ultrasound
• Maternal Fetal Medicine

In addition to caring for our patients medically, we also take care of their emotional needs. Nurses, social workers, and a genetics counselor are all available for consultation and support.

Comprehensive Consultation

In a one-hour initial appointment, you will meet our expert RPL physician, Dr. Mary Stephenson, to discuss your medical history, have a series of blood tests, and plan a course for further evaluation. Dr. Stephenson will review your partner's medical history as well, so if possible, your partner should attend the initial appointment.

Diagnostic Procedures

Dr. Stephenson may suggest diagnostic tests and procedures to help determine the causes of your pregnancy loss or losses. These procedures may include several of the following:

• Genetic tests
• Hormonal tests: A minimally invasive procedure called an endometrial biopsy can be performed to evaluate the uterine lining.
• Anatomical evaluation: To see whether a septum (wall) or scar tissue is present in the uterus. A woman may undergo one or more of the following tests:
• Hysterosalpingogram or "dye test": A small amount of dye is injected into the uterus and then an X-ray is taken.
• Hysteroscopy: The inside of the uterus is viewed using a tiny microscope inserted vaginally into the uterus.
• Sonohysterogram: Fluid is injected into the uterus, followed by a vaginal ultrasound.
• Autoimmune tests: Blood tests measure autoantibodies--immune system proteins that attack the self and can interfere with pregnancy.

Treatments

Depending on your diagnosis, our experts will supervise state-of-the-art treatments that may include:

• Progesterone or clomiphene citrate to treat an endometrial factor. An endometrial factor is a problem with the development of the uterine lining, which nourishes the early pregnancy.
• Outpatient surgery to treat uterine abnormalities, such as a septum scarring.
• Low-dose aspirin and heparin injections to treat antibody problems such as antiphospholipid syndrome (APS).

Support During Pregnancy

Together with the couple, we develop an individualized RPL management plan. When pregnant, the patient will be offered close monitoring during the first trimester with early ultrasounds, visits with an RPL doctor, and ready phone access to our RPL nurses. Because a subsequent pregnancy after RPL is considered high-risk, our patients may be followed by one of our high-risk pregnancy specialists. We also follow-up after delivery to see how mother and child are doing. Even after successful pregnancies, patients can return to the clinic, if they decide to try again.

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