Board Certified and Trusted Reproductive Medicine Specialist

Dr. Bradley Miller is a Reproductive Endocrinologist who has been in practice for 18 years. Throughout his career over 2,000 babies have been born as a result of his care. He is the Managing Partner at Reproductive Medicine Associates of Michigan, one of the leading fertility centers in Michigan. Learn more about Dr. Miller and follow his blog to discover more answers to your infertility needs and questions.

Archive for September, 2012

Recurrent Miscarriage – Dr. Brad Miller

Wednesday, September 26th, 2012

It is very common for me to see patients with non-fertility issues. One example of that is recurrent pregnancy loss, which is defined by two or more failed pregnancies. If the cause is unknown, each pregnancy loss warrants careful review to determine what further evaluation is necessary. Approximately 25% of all recognized pregnancies result in miscarriage, however, less than 5% of women will experience two consecutive miscarriages, and only 1% experience three or more.

Miscarriage can result from the following:

Genetic/Chromosomal Causes (most common)

Hormonal Abnormalities

Metabolic Abnormalities

Uterine Abnormalities

Antiphospholipid Syndrome and other clotting disorders

Autoimmune Disorders

For couples with unexplained recurrent pregnancy loss it is good to know that the next pregnancy has a 60% to 70% chance of being successful. I suggest to couples before they attempt to get pregnant again that they ensure that they are living a healthy lifestyle and taking a folic acid supplement. Quitting smoking, reducing alcohol and caffeine consumption, moderate exercise and weight control are all beneficial. If you are suffering from recurrent pregnancy loss please click here.

Ovarian Reserve Testing – Dr. Brad Miller

Tuesday, September 18th, 2012

A woman’s fertility potential declines with age due to declining egg quality and numbers. As a woman ages there is a decreased ability to become pregnant and an increased rate of miscarriage. Although the ability to have a live birth decreases in all women as they become older, the precise age when women can no longer conceive varies. Approximately one-third of couples in which the female partner is age 35 or older will have problems with fertility. There are several tests that may be useful in assessing fertility potential (ovarian reserve) in women, which include the following.

  • Day 3 Levels of FSH and Estradiol
  • Clomiphene Citrate Challenge Test
  • Basal Antral follicle count
  • Anti-mullerian hormone

These tests are helpful in foreseeing a woman’s response to fertility treatment and the chance of her success compared to other women of the same age. In younger women, abnormal test results suggest that fertility potential is declining. However, they can’t tell if she will or won’t be able to conceive. It is also important to note that some younger women with normal test results will have difficulty conceiving.

Women who are older than 40 years of age with abnormal test results have a small chance of becoming pregnant naturally and after ovulation induction. These women will be counseled about the use of donor eggs or embryos, because the chances of pregnancy are primarily related to the quality of the donated eggs. Unfortunately, even with a normal ovarian reserve test, older women could have difficulty achieving a pregnancy. Furthermore, the results may vary from cycle to cycle. An abnormal test, however, generally indicates that fertility potential has diminished.

If you have concerns about your fertility potential please click here to schedule an appointment.