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Reproductive Medicine
This program offers a number of reproductive health services for women and their partners in the areas of pregnancy loss, infertility, premature ovarian failure, endometriosis, and menstrual irregularities. In addition, this program provides comprehensive evaluations of women with complex medical problems such as arthritis, vascular and clotting disorders who are contemplating pregnancy. Diagnostic services include gynaecologic/early obstetrical ultrasound and office hysteroscopy. We offer three types of services:
Recurrent Pregnancy LossThe Recurrent Pregnancy Loss Clinic assists women and couples experiencing three or more miscarriages, a late pregnancy loss, or women over thirty-five with two miscarriages. A team of health professionals, including doctors, nurses and technologists work together in our team. We provide care for women and couples from throughout B.C. We offer the following services:
- Consulting to investigate and manage recurrent miscarriage and late pregnancy loss
- Education and close monitoring.
- Referrals for emotional support, grief and loss counselling
Miscarriage is the loss of a pregnancy before twenty weeks. It occurs in about fifteen percent of all pregnancies. Many miscarriages take place in the first twelve weeks of pregnancy, sometimes even before a woman knows she is pregnant.
Miscarriage is often an upsetting event and with repeated miscarriages, a woman or a couple can find themselves on an emotional roller coaster. Some Reasons for Recurrent Pregnancy Loss:
- Chromosome problems
- Hormonal factors
- Problems with the uterus
- Immune system disorders
- Unexplained
There is sometimes more than one reason for recurrent pregnancy loss so investigations need to be complete. There may be other causes we cannot yet identify. Possible Tests and Procedures:
- Blood tests
- Hysterosalpingogram (an x-ray of the uterus and tubes)
- Endometrial biopsy (a sample of the lining of the uterus)
- Hysteroscopy (looking inside the uterus)
- Laparoscopy (looking inside the abdomen)
Investigations can often take about two months. Once all the information is gathered, the physician will discuss possible treatment options with you. What to Expect The Women's Health Centre clerk will call you to set up an appointment when we receive a referral letter from your family physician or specialist. The nurse clinician will then contact you to discuss your history and gather information. Allow at least one hour for your first appointment. We strongly encourage you to bring your partner (or support person). Your physician will review your history and may do a physical exam. Possible tests and procedures will be discussed. There will be lots of time to ask questions. Emotional Support The loss of pregnancy can result in feelings of grief. For many, the emotional healing that follows a pregnancy loss takes longer than the physical healing. Your feelings of grief may be different from those of your partner and the healing process may progress at a different speed. We can assist you with referrals for counselling that can help one or both of you. Two services you can contact are:
- Pregnancy Loss Support Group at BCWH (604) 875-3788
- Family Services Vancouver (604) 731-4951
What about the Next Pregnancy? Future pregnancies should be planned, diagnosed early, and watched carefully. The sooner prenatal care is started, the sooner you can receive any special care you may need. Many women and couples find that the next pregnancy is a time of heightened anxiety and fear. Early close monitoring may help to relieve some of these concerns. Again, counselling can help. Ongoing obstetrical care will be arranged through your referring physician at about twelve weeks of pregnancy. Advances in Research Research about recurrent pregnancy loss is ongoing so that new diagnostic and treatment methods are gradually being developed. The Recurrent Pregnancy Loss Clinic is committed to this research. You may wish to consider participating in one of these research projects. For The Future Even if a couple has had many pregnancy losses, a healthy successful pregnancy still may be possible. The Recurrent Pregnancy Loss team is dedicated to helping you achieve a successful pregnancy. Special Needs Gynecology Clinic Special Needs Gynecology serves women with premature ovarian failure, menstrual difficulties, and challenging contraceptive and perimenopausal concerns. Resources The Women's Health Centre has books and pamphlets about miscarriage and recurrent pregnancy loss for you to read. For more information, check out the Family Resource Centre for information about ASA and Heparin Information, Heparin Injection, Hysteroscopy, Laparoscopy, D&C and After Pregnancy Loss.
Information about Ectopic Pregnancy: A Guide for Patients from the American Society for Reproductive Medicine is at http://www.asrm.org/Patients/patientbooklets/ectopicpregnancy.pdf Support Books Coming to Term: Uncovering the Truth About Miscarriage by Jon Cohen, Houghton Mifflin Company, 2005. Empty Arms and Miscarriage: A Shattered Dream by Sherokee Ilse, Wintergreen Press. Miscarriage: What Every Woman Needs to Know by Leslie Regan, Orion Publishing Group, 2001. To access this Program you will require a referral by your physician. You can contact the clinic nurse at (604) 875-3628 or fax (604) 875-3136.
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