Fifty percent of repeated miscarriages are unexplained. The good news though is that seventy percent of women go on to have a healthy baby after two miscarriages! There is a theory that when there are recurrent pregnancy losses (RPL)  the immune system may be playing a role. The uterus  has its own immune system which it uses to recognize the embryo, implant and help it create a placenta.  Some women may have an issue with this process even if the immune system in their blood shows normal.

Unfortunately, to date, there are only a few proven effective treatments to treat the immune system when it is impacting the ability to stay pregnant.  We turn to Dr. Genevieve Genest, reproductive immunologist to discuss what women can do to increase their chances of taking home a baby in the case of unexplained recurrent pregnancy loss and multiple failed IVF Embryo Transfers.  We cover the effectiveness of progesterone, blood thinners; (baby aspirin, low molecular weight heparin), steroids such as prednisone, intralipids and IV-IG, Hydroxychloroquine. She also covers some of the treatments which have NOT been shown to be effective but are still being used.

Dr. Genevieve Genest  is not only the leading immunologist and  head of Canada’s first university based reproductive Immunology clinic but also a person who has experienced losses of her own.  She cuts out a lot of the confusion around many of the treatments for recurrent pregnancy loss and shares openly about how many of the treatments and procedures touted to prevent recurrent pregnancy loss are based on limited scientific evidence.  She even shares the importance of diet, lifestyle factors, supplements, and acupuncture, all of which she used during her personal journey.

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Dr. Genevieve Genest Bio

Bachelor's in Microbiology and Immunology McGill

MD degree at Université de Montréal

Internal Medicine Residency at Université Laval

Allergy-Immunology fellowship at McGill University

Reproductive immunology fellowship at University of Toronto

Ongoing PhD in experimental medicine at McGill

Now at McGill University Health Center where she heads Canada’s first university based reproductive Immunology clinic

Director of the Reproductive Immunology Fellowship program McGill

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8835837/pdf/ijms-23-01333.pdf (Progesterone: A Unique Hormone with Immunomodulatory Roles in Pregnancy)

Related Episodes:

Episode 48  Bleeding during pregnancy- will I Miscarry? (ft. Dr. Kim Garbedian)

Episode 49 How To Prevent a Miscarriage (ft. Dr. Kim Garbedian)