Chapter 58: Early Pregnancy Loss

Hilgers TW

Pregnancy Early Pregnancy

Chapter 58: Early Pregnancy Loss

Hilgers TW

The Medical and Surgical Practice of NaProTECHNOLOGY, 797-801, 2004

RRM Academy Synopsis

Early pregnancy loss appears much lower than older estimates claimed

A 2004 NaProTECHNOLOGY textbook chapter argues that early pregnancy loss is much lower than the 50 to 78 percent older estimates. The chapter cites two studies of healthy women who tested urine daily while trying to conceive. In one, 22 out of 100 pregnancies ended before clinical detection. In the other, 25 out of 100 ended early.

Key Findings

The 50 percent figure traces to 4 of 8 ova, recovered before implantation, judged abnormal, in a study of 211 hysterectomy patients. The chapter calls the 78 percent estimate's assumptions untenable.
In animal studies kept near natural conditions, spontaneous fetal loss stayed under 15 percent and preimplantation loss ran 1 to 3 percent.
Wilcox and colleagues tested daily urine for hCG in 221 healthy women trying to conceive. They identified 198 pregnancies, and 22 percent ended before clinical detection.
A 1999 Wilcox study followed 189 pregnancies: 75 percent lasted at least six weeks and 48 (25%) ended in early loss.
In that study, the data suggested early loss rose with later implantation: 13 percent by day 9, 26 percent on day 10, 52 percent on day 11, 82 percent after day 11.

RRM Context

The chapter says high early-loss estimates have been used to justify IVF. Women charting with the Creighton Model FertilityCare System (CrMS) spotted signs of very early pregnancy that once went unnoticed, the chapter reports.

Our editorial summary of this paper, not the article's abstract.

Abstract

This chapter challenges the claim, traced to the 1956 work of Hertig and Rock, that early human pregnancy loss is very high, and reviews later studies by Wilcox and colleagues. Hilgers argues that the original claims of 50 to 78 percent early pregnancy loss are not compatible with current studies and notes that such data are often used to justify in vitro fertilization. In Pope Paul VI Institute data from women charting the CrMS, clinical signs of pregnancy were present in every cycle with a positive β-HCG test. Combining early β-HCG testing with an analysis of rising Peak +11 progesterone levels across 775 cycles, the chapter reports an estimated early pregnancy loss of 0.67 to 2.2 percent, which it describes as consistent with studies in mammals.

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Miscarriage and Recurrent Pregnancy Loss: The Workup Most Women Never Get

Miscarriage affects approximately 15% of clinically confirmed pregnancies. Recurrent pregnancy loss (RPL), defined as two or more clinical losses, affects 2 to 5% of couples. Most causes are diagnosable and treatable. This guide covers what the standard workup misses, what RRM-trained clinicians evaluate, and what outcomes look like after cause-based treatment.

22 min read

Topics

Pregnancy › Early Pregnancy › Miscarriage · Diagnostics › Cycle Biomarkers › Cervical Mucus Monitoring

Thomas W Hilgers

Tom Hilgers, T Hilgers

Hilgers et al. 2004, Hilgers 2004

Chapter 58: Early Pregnancy Loss

Early pregnancy loss appears much lower than older estimates claimed

Key Findings

RRM Context

Abstract

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Topics

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