https://www.databridgemarketresearch.com/reports/global-miscarriage-market

Understanding Missed Miscarriage and 3 Ways to Move Forward.
How to begin healing from the loss.
Reviewed by Vanessa Lancaster

KEY POINTS-
A missed or silent miscarriage happens early in pregnancy and often has symptoms that can be overlooked.
The most common cause of a missed miscarriage is the embryo having the wrong number of chromosomes because of aging of the eggs.
A missed miscarriage puts stress on the brain and body as the patient tries to figure out what went wrong and if it was preventable.
We were trying to get pregnant for months. I finally went to a fertility doctor and when she examined me with an ultrasound, she said I had been pregnant and miscarried very early. I am in double shock! Because I have irregular periods, I didn’t even realize I was finally pregnant, and I had no symptoms of miscarriage.

None. Now I am so nervous that I am doing pregnancy tests all the time, so afraid I’ll miscarry again that I’m not sleeping, and so very sad thinking about what might have been. I wish I never knew.

My patient was describing what’s often called a missed miscarriage or silent miscarriage. Of course, all miscarriages are traumatic, and sadness, anxiety, guilt, and depression often follow any miscarriage. Since miscarriage is common, at least one in four pregnancies result in a loss. Friends and family often underestimate its emotional impact. Furthermore, there are no established social mourning customs after a miscarriage to help a patient, or her partner, ease the loss.

A missed or silent miscarriage, however, can create additional traumas.

First, the patient may not have a support group in place because the pregnancy might have been unknown or "silent," as well as the miscarriage. This means that the patient often feels alone when they receive the news, and if they choose to share the sad news with friends and family, they will have to relive the shock every time they explain that there was both a pregnancy and a silent miscarriage.

Next, because most missed miscarriages occur early in gestation, usually in the first trimester, friends and family often mistakenly assume the loss will not be as intense as a later loss.

Lastly, because stress goes up when the ability to predict what is coming next goes down, a missed miscarriage puts both brain and body on high alert as the patient tries to figure out what went wrong and whether it was preventable or their fault. Lucky Sekhon, a reproductive endocrinologist at RMA New York and a provider in Progyny’s network, explained that self-blame is misguided because the most common cause is the embryo having the wrong number of chromosomes due to the effects of time and aging on the eggs’ repair mechanisms. Sperm can also contribute the wrong number of chromosomes, but this is less common and usually not age-related unless the paternal age is very advanced (age 50 plus years).

So why were there no early warning symptoms? “It usually means that the ovary hadn't picked up on the embryo not being viable yet and was still producing hormones like progesterone, which stabilized the lining and delayed both bleeding and the uterine cramping triggered by the bleeding,” explained Sekhon.

Sekhon added,
I would not assume that there is an underlying issue beyond the embryo being abnormal, but if two or more miscarriages have taken place, consider testing to look for underlying predispositions to forming genetically abnormal or imbalanced embryos. In fact, at a certain point in the first trimester, everybody should have a scan to ensure the embryo is implanted correctly in the uterus, is viable, and is progressing normally.

Although moving forward on a family-building journey can be difficult after a miscarriage, moving forward is often the most effective way to regain your sense of control and balance the loss with hope.

Three ways to help you move forward include:
Begin acceptance. Start by creating your own memorial or ceremony to honor the pregnancy, or think it will give you some closure after the loss.

Speak to your doctor. Talk with your doctor if your fears about future pregnancies interfere with moving forward. Ask for reassurance that the miscarriage was not the result of anything specific you did or did not do. Ask what information was gained from the miscarriage that may help future treatment be more effective for you.

Find support. If your emotions are overwhelming your ability to heal, seek professional support from those trained to help. The American Society for Reproductive Medicine (ASRM), RESOLVE, the national infertility association, and the Psychology Today are just a few of the organizations that can guide you to them.

Sekhon reassures her patients that it’s “okay not to be okay” and that it takes time to process, heal, and grieve the loss of "what could have been." Also, it’s normal to feel very nervous if you are pregnant again, “especially up until the point where the miscarriage happened in the prior pregnancy.”

This road isn’t easy, and I remind my patients who are afraid to be optimistic because they don’t want to be disappointed again that hoping for success will not jinx their journey. Also, pessimism will not protect them from disappointment if they have another loss. Instead, I encourage them to re-label this period as pre-parenthood, not just post-miscarriage, and to remind themselves that there are many paths to parenthood. It’s important to take what you need to heal and seek professional help when needed.

INFERTILITY-
Missed Conceptions: Infertility Is Common and on the Rise.
Infertility isn’t just about not being able to conceive.
Reviewed by Lybi Ma

KEY POINTS-
Infertility is defined as not being able to get pregnant after one year of trying, or six months if the woman is over age 35.
Infertility is a difficult but common part of the human experience.
Estimates suggest that more than 100 million individuals suffer from infertility worldwide.
Fortunately, with the right support, medical and psychological hurdles associated with infertility can be overcome.
On a recent episode of her podcast "Wiser Than Me," Julia Louis-Dreyfus revealed her "devastating" experience with a miscarriage. “When I was about 28, I got pregnant for the first time, and I was crazy happy,” said the Veep star and “Seinfeld” alum. “I got pregnant easily. I felt very fertile, very womanly. And then, quite late in the pregnancy, my husband Brad and I discovered that this little fetus was not going to live.”

Louis-Dreyfus is not alone. Pregnancy loss is much more common than most people realize. About 10 to 20 percent of pregnancies end in miscarriage. However, the actual number is probably higher, because many miscarriages occur very early on, like chemical pregnancies, before the pregnancy is even detected. Pregnancy loss is a common part of the infertility journey for many people, but it is often not talked about.

Infertility is defined as not being able to get pregnant after one year of unprotected sex. Fertility is known to decline steadily with age; for women over the age of 35, infertility is defined as not being able to get pregnant after six months of trying. However, infertility isn’t just about not being able to conceive. Women who are able to get pregnant but not carry a baby to term, like Louis-Dreyfus, may also be diagnosed with infertility. Under the umbrella of infertility, there are two different types. A woman who’s never been able to get pregnant will be diagnosed as having primary infertility. Women who already have children can still experience infertility too. A woman who has had at least one successful pregnancy in the past, but can’t get pregnant again, will be diagnosed with secondary infertility.

Infertility is an incredibly difficult, but common part of the human experience. In the United States, about 12 percent of women have difficulty conceiving and carrying a child to term. One in six couples faces infertility, but after a woman turns 35, one in three couples are infertile. Estimates suggest that more than 100 million individuals suffer from infertility worldwide. And it is on the rise. As people wait longer to have children, age is a growing contributing factor toward infertility. The biological clock is real, impacting female fertility and also male fertility, which can decline with increasing age.

But being diagnosed with infertility doesn’t mean that dreams of having a child must come to an end. It may take some time, but many couples who experience infertility will eventually be able to have a child. Some will do so on their own, like Julia Louis-Dreyfus who went on to have two children, while others will need help. The right kind of treatment depends on a variety of factors, such as the cause of infertility, how long the person or couple has been trying to conceive, their ages, and personal preferences. Over 7 million women have used infertility services in the U.S. alone, while 10 million babies have been born via assisted technologies.

But people who suffer from infertility may not only need medical help but also psychological support. For women, men, and couples, infertility is an adversity that has a profound effect on their emotions and experiences. It creates sadness, anger, frustration, and loneliness, and can cause depression and anxiety. These findings emphasize that infertility is a critical condition that needs to be taken seriously. But unlike other diseases, the scars from infertility are invisible, making it easy for society to ignore. Fortunately, with the right care, both the medical and psychological hurdles associated with infertility can be overcome.