With around 15% of women experiencing miscarriage at least once in their lives and one in a hundred suffering recurrent miscarriage, the opening of a pioneering clinic in Bristol offering a unique combination of treatments not previously available in the region will give new hope to those affected
Fertility expert and gynaecologist Hajeb Kamali said: “All other considerations aside, miscarriage and particularly recurrent miscarriage is associated with an increased risk of developing depression, anxiety and even PTSDS.â€
In the UK the definition of recurrent miscarriage is three or more miscarriages, whereas in the US and across Europe the threshold is two miscarriages, which means that investigations start at a later point in this country.
An important expert review of miscarriages globally, published recently in the Lancet, recommends that a new model of care should be adopted around miscarriage care and prevention, but – largely due to resource restrictions – the NHS’s approach means currently there is no referral for specialist care until after a third miscarriage, and even after a referral there can often be a long wait to be seen by a specialist consultant.
In around half of cases, investigations may reveal a cause which could include a blood clotting disorder, hormonal disfunction such as thyroid problems, polycystic ovarian syndrome, uterine problems such as fibroids or scar tissue in the womb.
Hajeb Kamali said: “There are often lifestyle factors that can be optimised to improve the chances of a successful pregnancy in the future even following a first miscarriage.
“This means anyone who has experienced miscarriage, whether it be a first or more than one, could benefit from a review because this could provide an insight into their personal or medical history that may alter and reduce their risk of losing a future pregnancy.
“In addition some couples may simply want reassurance and support in moving forward with their attempts to build a family.
“Age plays a part: in her 20s a woman’s risk is around 10-15%, whereas for over 40s it is greater than 50%.â€
Mr Kamali, who has been lead consultant at North Bristol Trust for their recurrent miscarriage service, has joined Bristol Centre for Reproductive Medicine (BCRM) at Aztec West, where he is launching a brand new private clinic for recurrent miscarriage which will provide investigations, tests and treatments.
Diagnostic options at BCRM’s new clinic include hysteroscopy and a 3D scanner as well as advanced male investigations such as sperm DNA fragmentation.
Mr Kamali said: “The services we offer are cutting edge and comprehensive and simply not available on the NHS, nor privately elsewhere in the region.
“What we’re launching is a genuinely stand-out clinic, the only one in the region to offer a more advanced range of investigations and a dedicated bespoke service.
“What’s more, as part of the wider BCRM fertility service, we are able to offer our patients more advanced assisted conception treatments options where appropriate such as preimplantation genetic screening (PGS), a recognised treatment for recurrent miscarriage.â€
Hajeb Kamali said: “We are also actively involved in ongoing research into miscarriage, and there is ongoing and fascinating work being done in this area, such as research into the role of the maternal immune response in miscarriage.â€
BCRM is involved in innovative research covering a range of fertility issues and has one of the best success rates with IVF and other fertility treatments in the UK.    
Photo: Mr Hajeb Kamali
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