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Link Between Three Months Before You Conceive and Miscarriage

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“No treatment we can do after conception is as powerful as something we may do ahead of pregnancy,” says Dr. Ruth Lathi. “I think that’s one thing we are trying to change is preparation for pregnancy, or what some people call the ‘pre-trimester.’ The three months before you conceive is probably the most important determinant of outcome of pregnancy, or at least that’s our philosophy.”

The Director of the Recurrent Pregnancy Loss Program at Stanford University, Lahti has done extensive research on miscarriage. Weight is the second strongest predictor of miscarriage risk after age, she says. In a preliminary study of those who lost weight versus those who didn’t lose weight, the patients who lost weight subsequently had a lower miscarriage rate.

In a study on environmental toxins, BPA (an industrial toxin from plastic) in particular, Lathi found that women who have higher blood levels of BPA had a higher risk of unexplained miscarriage as well.

“If for whatever reason - your weight, your diet, your exposures - you have a bad egg, I can’t make a bad egg good by adding in progesterone or any other treatment that I might consider,” Lathi says. “We really want to look at all those factors before you get pregnant and optimize as much as we can in the environment before conception, because once pregnancy is established, the history is written, we just don’t know what it is yet,” she explains.

The Reproductive Loss Program at Stanford is a team of providers from seven different specialties who work together to develop guidelines and treatments and care for complex patients with RPL. RPL a diagnosis that is multi-factorial and can present to any one of these specialties: hematology, immunology, genetics, psychiatry, pathology, endocrinology and maternal/fetal medicine or high risk obstetrics. The program provides a point person who is the go-to person for the patient and collaborates with the other specialists in the group.

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