{"id":8538,"date":"2023-12-20T08:00:00","date_gmt":"2023-12-20T07:00:00","guid":{"rendered":"https:\/\/www.dexeus.com\/fertility\/avortaments-de-repeticio-quins-passos-cal-seguir\/"},"modified":"2024-09-05T10:55:35","modified_gmt":"2024-09-05T08:55:35","slug":"avortaments-de-repeticio-quins-passos-cal-seguir","status":"publish","type":"post","link":"https:\/\/www.dexeus.com\/fertility\/ca\/blog-fiv\/avortaments-de-repeticio-quins-passos-cal-seguir\/","title":{"rendered":"Avortaments de repetici\u00f3: quins passos cal seguir?"},"content":{"rendered":"

Tenir un avortament espontani \u00e9s bastant freq\u00fcent. Es calcula que entre un 10-20% dels embarassos acaben en un avortament,<\/strong> i \u00e9s possible que la xifra sigui m\u00e9s alta perqu\u00e8 moltes vegades ocorren fins i tot abans de saber que hi ha un embar\u00e0s.<\/p>\n

En la majoria dels casos la causa \u00e9s d’origen embrionari<\/strong>. L’embri\u00f3 no es desenvolupa correctament o no \u00e9s viable, per tant, l’embar\u00e0s no progressa i el cos finalitza el proc\u00e9s de manera natural. Per aix\u00f2 els metges ho consideren un fet puntual i no li donen m\u00e9s import\u00e0ncia. Per\u00f2, qu\u00e8 ocorre quan es produeix m\u00e9s d’una vegada?<\/strong>, hi ha altres causes que puguin provocar-ho? i quin protocol cal seguir en aquests casos?<\/p>\n

Segons explica la Dra. N\u00faria Murcia<\/a>, especialista en Reproducci\u00f3 Assistida de Dexeus Dona<\/strong> a<\/strong> Manresa i Barcelona<\/strong>, \u201ca partir de dos avortaments consecutius \u00e9s aconsellable consultar a un expert<\/strong>, tant per l’impacte que suposa des del punt de vista emocional com per realitzar algunes proves que ajudin a trobar la causa o a descartar alguna patologia\u201d, indica.<\/p>\n

Les dones d’edat avan\u00e7ada presenten un major risc <\/strong>d’avortament, perqu\u00e8 amb el pas dels anys hi ha una p\u00e8rdua de la qualitat dels \u00f2vuls que condiciona una major taxa d’alteracions cromos\u00f2miques en els embrions, una de les causes m\u00e9s freq\u00fcents d’avortament. Per\u00f2 hi ha dones joves que tamb\u00e9 experimenten avortaments de repetici\u00f3, \u201caix\u00ed que cal estudiar cada cas de manera individual<\/strong>\u201d, indica la Dra. Murcia.<\/p>\n<\/p>\n

Quina pot ser la causa?<\/strong><\/p>\n

\u201cEl que fem habitualment \u00e9s realitzar algunes proves per a comprovar si hi ha algun problema concret que estigui impedint el desenvolupament embrionari i l’evoluci\u00f3 de l’embar\u00e0s\u201d, explica la Dra. N\u00faria Murcia. \u00c9s molt important valorar l’edat de la pacient, el seu historial cl\u00ednic i el de la parella masculina (si en t\u00e9), els antecedents familiars, etc., ja que les causes poden ser molt diferents:<\/p>\n

–El m\u00e9s habitual \u00e9s que es tracti d’un problema d’origen embrionari.<\/strong> Aquesta \u00e9s la causa de m\u00e9s del 50% dels casos d’avortament.
–Alteracions cromos\u00f2miques en els progenitors<\/strong>. Aquestes alteracions poden passar desapercebudes, per\u00f2 poden donar lloc a embrions amb alteracions que no siguin compatibles amb la vida.
–Malformacions uterines cong\u00e8nites<\/strong>. La causa pot ser un problema uter\u00ed no detectat a nivell estructural, que pot interferir en la correcta implantaci\u00f3 i desenvolupament de l’embri\u00f3.
–Miomes.<\/strong> No tots els miomes comporten un risc d’avortament, dependr\u00e0 de la seva localitzaci\u00f3, grand\u00e0ria i n\u00famero.
–Problema endocr\u00ed<\/strong>. Una disfunci\u00f3 de la gl\u00e0ndula tiroide correctament tractada no suposa un factor de risc, per\u00f2 \u00e9s important tenir un bon control, ja que si no pot condicionar una major probabilitat de tenir un avortament.
–Obesitat i baix pes:<\/strong> s\u00f3n altres factors que poden afavorir el risc d’avortament.
–S\u00edndrome antifosfol\u00edpida<\/strong>. \u00c9s un trastorn autoimmune que provoca co\u00e0guls de sang i trombosi. La pres\u00e8ncia d’aquests co\u00e0guls pot ocasionar problemes en el flux i la circulaci\u00f3 de la sang. Aquest problema es pot tractar amb f\u00e0rmacs anticoagulants.<\/p>\n

Com veus es tracta d’un tema una mica complex, en qu\u00e8 no hi ha unes directrius clarament determinades, perqu\u00e8 \u00e9s dif\u00edcil establir una relaci\u00f3 de causa-efecte<\/strong>. \u201cEl que jo aconsello a les pacients en aquests casos \u00e9s que consultin i es deixin guiar per l’especialista. Tenir dos o fins i tot tres avortaments de repetici\u00f3 no significa que una parella no pugui tenir un embar\u00e0s que evolucioni favorablement, i fer-se m\u00e9s o menys proves tampoc permet sempre trobar una causa concreta. Per aix\u00f2 l’experi\u00e8ncia professional<\/strong> i l’estudi i valoraci\u00f3 de cada cas<\/strong> \u00e9s la millor guia per tractar de buscar solucions i reduir el risc d’un nou avortament\u201d, conclou la Dra. Murcia.<\/p>\n<\/p>\n

\n
\n

Quines proves es recomanen?<\/strong><\/p>\n

Per esbrinar quina pot ser la causa, \u00e9s possible que el teu ginec\u00f2leg o ginec\u00f2loga et recomani realitzar alguna de les seg\u00fcents proves:<\/p>\n

–Estudi de la cavitat uterina a trav\u00e9s d’una ecografia transvaginal en 3D, una histerosc\u00f2pia o resson\u00e0ncia magn\u00e8tica.<\/strong> L’objectiu \u00e9s descartar possibles problemes f\u00edsics o estructurals.
–Cariotip<\/strong>. Es tracta d’una prova gen\u00e8tica que permet examinar el conjunt complet dels cromosomes d’una persona.
–Factor endocr\u00ed.<\/strong> Si es descarta un problema uter\u00ed i no es detecta cap anomalia a nivell cromos\u00f2mic, ja que pot ser que la causa sigui de tipus endocr\u00ed i que estigui relacionada amb una disfunci\u00f3 de la gl\u00e0ndula tiroide.
–Test endometrial<\/strong>. Existeixen tests espec\u00edfics per valorar la microbiota endometrial encara que no es recomana la seva posada en pr\u00e0ctica de manera sistem\u00e0tica, nom\u00e9s en casos determinats.
–Estudi de trombof\u00edlies.<\/strong> \u00c9s molt important la valoraci\u00f3 de la s\u00edndrome antofosfol\u00edpida que hem esmentat abans. Es pot valorar ampliar l’estudi de la coagulaci\u00f3 segons els antecedents personals o familiars de trombosi o tromboemb\u00f2lies venoses.
–Seminograma<\/strong>. Si la teva parella \u00e9s masculina, \u00e9s possible que recomanin realitzar un estudi del semen o seminograma, que permet observar la morfologia i mobilitat de l’esperma i quantificar la seva concentraci\u00f3.
–FISH d’espermatozoides i test de fragmentaci\u00f3 del DNA<\/strong>. La primera \u00e9s una t\u00e8cnica que permet analitzar el contingut cromos\u00f2mic dels espermatozoides. En cas que l’ADN de l’esperma tendeixi a fragmentar-se, podria ser el motiu dels avortaments de repetici\u00f3.
–Diagn\u00f2stic gen\u00e8tic preimplantacional (DGP).<\/strong> S’aconsella en cas de rec\u00f3rrer a un tractament de reproducci\u00f3. Aquesta t\u00e8cnica permet realitzar un estudi de l’embri\u00f3 per detectar si presenta alguna anomalia o alteraci\u00f3 cromos\u00f2mica. La seva aplicaci\u00f3 fa possible seleccionar aquells que estan lliures d’anomalies per transferir-los a l’\u00fater, amb la finalitat de reduir el risc d’avortament.<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Tenir un avortament espontani \u00e9s bastant freq\u00fcent. Es calcula que entre un 10-20% dels embarassos acaben en un avortament, i \u00e9s possible que la xifra sigui m\u00e9s alta perqu\u00e8 moltes vegades ocorren fins i tot abans de saber que hi ha un embar\u00e0s. En la majoria dels casos la causa \u00e9s d’origen embrionari. L’embri\u00f3 no […]<\/p>\n","protected":false},"author":1,"featured_media":5442,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,64],"tags":[],"class_list":["post-8538","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sin-categorizar","category-uncategorized-ca"],"yoast_head":"\nAvortaments de repetici\u00f3: quins passos cal seguir? | Dexeus Fertility<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.dexeus.com\/fertility\/ca\/blog-fiv\/avortaments-de-repeticio-quins-passos-cal-seguir\/\" \/>\n<meta property=\"og:locale\" content=\"ca_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Avortaments de repetici\u00f3: quins passos cal seguir? | Dexeus Fertility\" \/>\n<meta property=\"og:description\" content=\"Tenir un avortament espontani \u00e9s bastant freq\u00fcent. Es calcula que entre un 10-20% dels embarassos acaben en un avortament, i \u00e9s possible que la xifra sigui m\u00e9s alta perqu\u00e8 moltes vegades ocorren fins i tot abans de saber que hi ha un embar\u00e0s. En la majoria dels casos la causa \u00e9s d’origen embrionari. 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