At the Medical Center “Doctor Aizyatulova’s Reproductive Medicine Clinic” – AIS, you can receive a full range of medical services for pregnancy planning, preparation, and management, including high-risk pregnancies, as well as treatment of recurrent pregnancy loss.

Pregnancy Planning

A successful course of pregnancy and childbirth largely depends on prior preparation. The professional team of the Medical Center “Doctor Aizyatulova’s Reproductive Medicine Clinic” – AIS will develop an individual examination program especially for you and help carry out optimal preconception preparation, taking into account all factors that may affect conception and the carrying of a child. Our clinic provides comprehensive and multidisciplinary diagnostics for both partners, including modern laboratory tests, instrumental studies, and consultations with specialized experts. Pregnancy planning is especially recommended for couples with suspected infertility, women over 35 years of age, women suffering from recurrent pregnancy loss, as well as those with chronic gynecological or extragenital diseases. In addition, prospective pregnancy planning using cryopreservation technology (freezing of eggs, sperm, and embryos) is possible. Why is a pregnancy planning program needed? During pregnancy, a woman’s body undergoes significant changes. All life-support systems work under increased load to create conditions for the normal development of new life. Therefore, it is extremely important to prepare the body for future pregnancy. Pregnancy planning programs are aimed at assessing the condition of the female and male reproductive systems, evaluating ovarian reserve and forecasting changes in reproductive potential, early diagnosis of diseases, identifying causes that prevent pregnancy, and detecting infections dangerous for the future baby. An important component of planning is screening for major DNA mutations responsible for most incurable genetic diseases. Screening makes it possible to create a genetic passport of the parents, identify matching DNA defects in spouses, determine potential gene damage in the fetus even before implantation, and ensure the birth of a healthy child. The programs of the Medical Center “Doctor Aizyatulova’s Reproductive Medicine Clinic” – AIS include specialist consultations and all necessary functional and laboratory tests, which you can complete within our medical center.

Pregnancy Management

At the Medical Center “Doctor Aizyatulova’s Reproductive Medicine Clinic” – AIS, pregnancy management is carried out in accordance with the Order of the Ministry of Health of Ukraine No. 417 dated July 15, 2011. The Medical Center “Doctor Aizyatulova’s Reproductive Medicine Clinic” – AIS offers a wide range of pregnancy care programs:

• Management of physiological pregnancy;
• Management of pregnancy achieved using assisted reproductive technologies;
• Management of multiple pregnancy;
• Management of pregnancy in women from the “risk group” (with chronic diseases, complications, and disorders).

* Due to the decision of the Main Accreditation Commission under the Ministry of Health of Ukraine to assign the Medical Center “Doctor Aizyatulova’s Reproductive Medicine Clinic” – AIS the 1st accreditation category, you will be able to obtain maternity leave documentation at our clinic.

Recurrent Pregnancy Loss

Identifying the causes of spontaneous miscarriage and planning pregnancy in cases of recurrent pregnancy loss is a complex multilevel task that requires comprehensive diagnostics of both partners. In addition to standard examinations, diagnostic procedures are prescribed to exclude immunological infertility factors, thrombophilia, congenital anomalies of the female reproductive organs (intrauterine septum, bicornuate uterus, etc.), and the couple’s karyotype is studied. Pregnancy loss is defined as spontaneous termination from conception up to 36 weeks and 6 days. Two or more consecutive miscarriages are considered “recurrent pregnancy loss.” Specialists of the Medical Center “Doctor Aizyatulova’s Reproductive Medicine Clinic” – AIS will provide professional assistance at all stages of treatment and preparation for the birth of a long-awaited baby. Our advantages:

• Treatment of recurrent pregnancy loss is based on the principles of evidence-based medicine;
• Consultations are provided by highly qualified obstetricians-gynecologists and reproductologists — international-level experts in diagnosing and treating causes of pregnancy loss;
• Patients receive all necessary high-precision diagnostics;
• Advanced reproductive technologies and state-of-the-art equipment are used;
• After treatment, pregnancy development will be monitored by an experienced and attentive physician;
• Patients are provided with psychological support and maximum comfort.

Causes of pregnancy loss Most often, the problem is based on several negative factors. The age of future parents affects the quality of eggs and sperm. The older the couple, the higher the risk of pregnancy loss due to genetic factors. These risks are also increased in women with premature ovarian failure. Risk factors for pregnancy loss:

Factors	Impact on pregnancy course	Prognosis
Genetic	Genetic abnormalities of the embryo prevent normal development, leading to early pregnancy loss	Such an anomaly usually does not recur, and the woman later gives birth to a healthy baby
	Chromosomal disorders occurring in the woman’s body result in genetic information being passed to the embryo, making it non-viable	This may cause recurrent pregnancy loss
Anatomical	Abnormalities in the structure of the female reproductive organs — saddle-shaped, unicornuate or bicornuate uterus, adhesions, fibroids, synechiae. These deviations interfere with embryo implantation or disrupt normal blood supply to the fetus	After treatment of such conditions, the chances of carrying a pregnancy significantly increase
Isthmic-cervical insufficiency (ICI)	Cervical insufficiency develops after repeated intrauterine interventions (abortions, curettage) or trauma (cervical tears during childbirth). During pregnancy, increased intrauterine pressure leads to dilation of the internal cervical os, rupture of the fetal membranes, and miscarriage	May cause recurrent pregnancy loss. ICI is treatable, after which carrying and delivering a healthy child becomes possible
Infectious	Sexually transmitted infections (gonorrhea, syphilis, chlamydia, etc.) acquired before or during pregnancy cause embryo damage and death. Influenza, bronchitis, pneumonia, and other infections and inflammatory processes are also dangerous for the fetus	Treatment and prevention of infections allow a woman to conceive and carry a pregnancy again
Implantation and placentation disorders	Occur due to an inadequate immune response, when the woman’s body perceives the embryo as foreign. Causes include antiphospholipid syndrome, autoimmune diseases, chronic endometritis, genetic thrombophilia. These processes can lead to early pregnancy arrest or placental dysfunction, negatively affecting fetal development in the 2nd and 3rd trimesters	Comprehensive diagnostics and correction of immune disorders promote successful conception and pregnancy maintenance

To determine the causes of pregnancy loss, patients undergo a full range of outpatient services:

• Expert-level diagnostics;
• Individually designed comprehensive pregnancy management programs;
• Participation of leading specialists — obstetricians-gynecologists, reproductologists, geneticists, and others.

Types of pregnancy loss:

Type of pregnancy loss	Definition	Gestational age
Biochemical pregnancy	Cessation of embryo development at the implantation stage, resulting in spontaneous termination of pregnancy	Up to 6 weeks
Non-developing pregnancy (“Missed miscarriage”)	Sudden cessation of development and death of the embryo/fetus	Up to 12 weeks
Antenatal fetal death	Sudden death of a normally developing fetus at later gestational stages
Early spontaneous miscarriage	Spontaneous termination of pregnancy due to fetal or maternal pathology	Up to 12 weeks
Late spontaneous miscarriage		13–21 (+6) weeks
Preterm birth	Birth of a child before term	From 22 weeks to 36 weeks and 6 days

Comprehensive examination of the couple and pregnancy preparation based on results includes:

• Genetic examination of the couple — karyotyping, testing for hereditary and acquired thrombophilia, immune status assessment;
• Genetic counseling — to evaluate hereditary causes of recurrent pregnancy loss;
• Assessment of hormonal status and ovarian reserve;
• Evaluation of implantation and placentation disorders, including:
  • Antiphospholipid syndrome;
  • Genetic thrombophilia;
  • Immune aggression factors.
• Cytogenetic examination of abortive material to detect chromosomal abnormalities;
• Partner’s semen analysis to assess genome and epigenome integrity;
• Infection screening (STIs, TORCH infections);
• Endometrial assessment including ultrasound monitoring and pipelle biopsy;
• Instrumental diagnostics — expert pelvic ultrasound and evaluation of other organs;
• Selection of pregnancy preparation strategy — expectant or active (IVF with ICSI and preimplantation genetic testing);
• Preconception preparation — correction of identified disorders using vitamin-mineral therapy, anticoagulants, hormone therapy, immunomodulators, etc.

If the causes of pregnancy failure are identified and corrected in a timely manner, the chances of successfully carrying and giving birth to a healthy baby increase significantly. Our clinic uses only evidence-based medicine principles. Treatment plans are developed individually based on examination results:

• Improvement of partner’s semen parameters;
• Anti-inflammatory treatment, including antibiotics if indicated;
• Normalization of endometrial growth;
• Correction of genetic and acquired thrombophilia factors;
• Hysteroscopy / laparoscopy if indicated, etc.

Prevention of Pregnancy Loss

Management of patients with recurrent pregnancy loss is a comprehensive set of measures aimed at reducing potential risks. In case of threatened miscarriage or miscarriage occurrence, immediate consultation with a specialist is required. Key preventive measures include:

• Comprehensive examination of the couple before planned pregnancy;
• Risk group assessment;
• Exclusion of ICI risks;
• Adequate psychological support;
• General preconception preparation;
• Pregnancy management by obstetricians-gynecologists specializing in immunological aspects of reproduction and hemostasiology.