First pregnancy, first MC - how long before TTC?

[mme86]

Hello. This is my first time posting in BabyandBump. I found out last Wednesday, when I would have been about 8w3d that my baby's heart had stopped beating and was measuring only 7w3d. I had a scan at 7w1d and everything looked perfect. I never expected this. I miscarried naturally, and a follow-up scan yesterday confirmed that nearly everything had passed; just some small tissue and/or clots left, which seem to be clearing out.

For anyone who has gone through this, how long did you wait before TTC again? On the one hand, I don't want to wait a second longer. I want to be pregnant right away. I know that a new baby won't replace the one I've lost, I just want to feel something besides pain and numbness. On the other hand, I am so, so terrified of this happening again. I don't think I can handle going through this again, at least not so soon.

I came off birth control in April 2014, although we didn't really start actively trying (in terms of temping, timing intercourse around ovulation, etc) until this past January/February. As I charted I noticed that my luteal phase was late and short (8, sometimes 9 days long). I went to an RE and her answer was to put me on Clomid. At the time, and still now, that didn't make much sense - I knew I was ovulating, but I didn't question why she thought Clomid was the answer so I went with it. And then I got pregnant on the first cycle, so it seemed to have worked. Until it didn't. Now I'm questioning whether Clomid was the right answer at all. My husband and I are going to start working with an acupuncturist who specializes in fertility. She was very surprised when I told her I had been proscribed Clomid. We haven't had our official consult with her yet, so she hasn't reviewed my charts, etc., to determine what she thinks the issue is and what the solution will be.

So now I'm trying to figure out whether I should 1) go back on Clomid with my next period to try again immediately, 2) stay off Clomid for a few cycles to see if we can do it naturally, 3) completely wait until I get the "all clear" from the acupuncturist, which she said could be 90 days or more to get up to optimal health and actually fix any underlying hormonal issues.

Do you all have any thoughts or advice on this? I just feel so lost and confused right now.

Also, if you have any advice on how to cope, please let me know what worked (and didn't work) for you.

Thank you all so much for lending a sympathetic ear.

 

[cleckner04]

I am very sorry for your loss. I don't know a whole lot about this but didn't want to read and run so I did a quick read on this subject. Clomid can be used to help ovulate earlier in the cycle but from what I read low progesterone is a cause of luteal phase defect so I would think some progesterone supplements would've been prescribed as well. Correct me if I'm wrong anyone else.. but that's what I gathered in my quick read. But I also read if you have a loss from Luteal phase defect, it's usually very very early and would just seem like a period. So the baby wouldn't have a chance to grow big enough to see a heartbeat. Which makes me think this wasn't the cause of your MC. If I were in your shoes I would personally try right away but I am impatient. I lost my first baby as well. MMC at 9w but baby had stopped growing around 6w. I waited two cycles before trying that time. And in July of this year I lost another baby(after having two healthy babies since my first MC) and I didn't wait for a period. We just tried right away within a week of the MC and I fell pregnant right away and am now in my 20th week of pregnancy. It is a tough decision knowing when it's right to try again but I suggest going with your gut.

 

[mme86]

Thank you so much for your response -- and for taking the time to look up those questions to help me understand better! What you are saying all makes sense to me. I guess I was hoping for something I could point to (low progesterone) to blame for the MC, and something that could easily be addressed the next time I'm lucky enough to be pregnant (taking progesterone supplements). My doctor suspected this MC was probably the result of a chromosomal abnormality, which is probably true. We didn't do any testing this time around; maybe if I have any subsequent MCs.

Thank you so much for sharing your experiences with me! I'm so sorry that you have had to go through this as well -- and twice It gives me hope to know that you had two healthy LOs and a third on the way! Congratulations!! Best wishes to you and your family

 

[xxmyheartxx]

I'm so sorry for your loss
I tried straight away after both losses, I will be waiting for 3 months after this one, as it's ectopic xx

 

[mme86]

I'm so sorry for your losses. Sending you love and good vibes when you ttc again!

 

[cleckner04]

Thank you so much for your response -- and for taking the time to look up those questions to help me understand better! What you are saying all makes sense to me. I guess I was hoping for something I could point to (low progesterone) to blame for the MC, and something that could easily be addressed the next time I'm lucky enough to be pregnant (taking progesterone supplements). My doctor suspected this MC was probably the result of a chromosomal abnormality, which is probably true. We didn't do any testing this time around; maybe if I have any subsequent MCs.

Thank you so much for sharing your experiences with me! I'm so sorry that you have had to go through this as well -- and twice It gives me hope to know that you had two healthy LOs and a third on the way! Congratulations!! Best wishes to you and your family

You will get your happy ending. losing babies makes me appreciate the ones I have SO much more. And every ache and pain and sick part of pregnancy is handled with a smile bc I know it can be taken away any time so I need to enjoy every second even if it's hard at times. And you will feel the same once you get past the worry that comes along with it all.

 

[Trying4first1]

I have always been told one cycle. But it's up to you. Some women wait longer just for emotional healing.
This time I am waiting months due to recurrent miscarriage testing and wedont want to risk it. It is a personal choice

 

[lesondemavie]

My heart goes out to you xxx. Miscarriage is heartbreaking and devastating and no words can make it better . With my later loss we waited 1 month and then started trying again. I think it's mostly for dating purposes, but honestly we needed the break emotionally. With my chemical, we didn't wait at all.

I just want to say that you can absolutely have a later loss from an LPD. The shorter LP may be why it takes longer to conceive as you'll need an early implanter, but that doesn't mean it can only cause early losses. An LPD may be indicative of a hormonal imbalance, which can cause later losses. Progesterone and estrogen are important for the development of organs like the heart. A loss around 6-7 weeks is likely bc the heart didn't develop well. Esp in the case of a missed miscarriage. This can be from chromosomal issues, but also from hormonal issues. You'll see mixed information from doctor's on this, but that's bc the studies aren't well controlled. Yes, if you take a sample from the general population and put them on P in pregnancy it doesn't seem to matter overall BUT if you take a group of women who have low luteal P or LPD and put them on P after O you'll start to see more significant results. If you break this group down even further by the cause of LPD and treat based on cause, you get really significant results. Supplementation with E2 after O is more controversial for a number of reasons (which I can go into if you'd like). I did find one study on baboons where they suppressed E2 which resulted in significant miscarriage rates, and then they suppressed natural E2 but supplemented and the live birth rates went way back up. The truth of the matter is that hormones won't fix chromosomal abnormalities which is the cause for about half of miscarriages BUT they can help those of us in the the other 50% with less common hormonal disorders/problems.

I learned all of this through personal experience. I suffered two losses this past year and am now currently pregnant with what I hope is my rainbow. Here is my story:

Spoiler

My LP was only 10 days, but I ovulate early. It took us 5 months to conceive the first time, but that pregnancy ended in a missed miscarriage at 8 weeks. 2 months after that I demanded to have my progesterone tested at 7 DPO. It came back super low, so my obgyn put me on 100mg of P after O. 3 more months came and went with no luck. I demanded a monitored cycle, my obgyn gave me a referral to an RE who couldn't see me for 3 months, and I demanded cd3 testing. My ob tested for just FSH and E2 and all looked good. I upped my dose of P to 200 mg/day and we conceived, but that pregnancy came and went within a week - Chemical pregnancy. My obgyn said it was probably a false positive even though I had solid lines on 4 different brands of tests for 4 days. I called the RE and they moved my appointment up to October. The next month was a bfn and then we met with the RE. We quickly found out that I had subclinical hypothyroidism and high prolactin. SCH can cause high prolactin which can in turn cause premature failure of the corpus luteum resulting in an early drop of P and E2 and thus a short luteal phase. We did a beautiful monitored cycle and everything in my follicular phase looked great - no Clomid needed. Right around O I went on levothyroxine and I started taking both P and E2 supplements after O (the CL produces both and both are important for the continuation of a healthy pregnancy). At 9 DPO, I got another BFP. We checked my hormone levels and my E2 was low so we upped the dose. My TSH and Prolactin dropped into the normal range after just 2 weeks on the levo. They've closely monitored me with weekly ultrasounds and E2/P checks. Around week 6, my hormone levels started to drop and baby wasn't progressing as well as it should. I was so nervous as that's right around when my first loss happened (even though we didn't find out until later). We upped my doses of both hormones and the next blood draw showed my levels going back up. We had a beautiful next ultrasound where baby had grown from 6+4 to 8+3 in just over a week, and the heart rate shot up from 115-118 to 162! I just had an ultrasound earlier this week and baby was measuring 11+4 with a strong heartbeat. We are starting to wean me off of E2, but my P dropped slightly this week so I have to stay on that for now.

I fully believe that at least my first loss was due to my hormone levels, and I am so thankful to have the RE that I do. If you have a short luteal phase, it can be caused by a number of things, some happen in the FP and some in the LP. I think my problem is rare. Still I think anyone with an LP defect should demand a monitored cycle before going on Clomid or Letrozole. I also think checking your TSH, luteal P and luteal E2 is important. With that you can maybe determine where the problem is and try to address it. I also think you should have your hormones rechecked regularly if you go on supplements. I've seen some girls go on P after O and it does nothing to lengthen their LP. Out of those girls, some have gone on Clomid with success. When I went on P after O, my LP went from 10 days to 17 days! Some need to go on higher doses to see their levels bump up enough, and some even need injectibles instead for it to work. We're all so different and we need different things - not cookie cutter approaches.

I think I annoyed my obgyn, but I always need to know why something is happening. I knew in my gut that something was off, and sure enough it was...but I wasn't willing to take something without first knowing that I needed it. If they just put you on something without first figuring out your problem, then they are playing a numbers game and not treating you as an individual. Trust their advice as medical professionals, but advocate for yourself. You know your body best, and you may be in that minority who needs something different.

Sorry that was all so long-winded. I've spent the past year scouring PubMed and other scholarly articles from medical journals to better understand my body and what was happening so I could advocate for myself. My ob was completely useless, and she wanted me to just keep trying on my own until next February (a year after our MMC). In the end, I was right to push for more, and my wonderful RE is the one who quickly found the SCH. I had no clue that could cause LPD. It didn't show up once in my research.

As for coping, the only thing that really worked for me is not fighting it. If I was feeling angry, then I needed to be angry. If I was sad, then I needed to be sad. If I had no hope, then I had to just be ok with that for the time being. Getting mad at what I was feeling and trying to make myself be positive just made it worse. I had my ups and downs, and about 6 months after I was at a really big low but it didn't feel as bad. I was in a deep, dark place but that was ok for however long I needed to be there, because I knew one day when I was ready one way or another I would find my way out of the hole. Life has a way of dragging you forward whether you like it or not. You'll be ok in your own time and until then there are no rules xxx.

I hope some of what I wrote here helps you find your way forward, and that someday soon you are looking back at this all with your rainbow in your arms xxx

 

[AugustAngel15]

First off, I'm so very sorry for your loss.

I tried for a year before getting pregnant. I got my BFP and was over the moon. We had so many losses in 2015 and this was our miracle. Like you, I had a perfect scan. A week later, I started spotting and sure enough, the heartbeat was gone. I opted to pass naturally. We waited until after I got my first normal period. It took another 10 months but we got another BFP in June of this year. I am now 32.5 weeks along with a healthy happy baby girl. I wish you all the best. I know what you're going through. Thoughts are with you!

 

[MKB123]

Hi all,

We just found out that we lost our first baby at 11w2days. Its a missed miscarriage.
I am totally devastated. I am 22. This was our first pregnancy.
My Free beta HCG was 4.5 MoM , PAPP-A was 0.57 MoM. They said the placenta was swollen and had hydropic changes. The baby was moving and had a strong heart beat a week earlier I am RH positive and beta thalassemia minor, my husband does not have thalassemia. I did have flu/fever when I was 4-5 weeks pregnant, but we did not take anything except panadol. I was on folic acid and multi-vitamins since week 4. What could have caused the placenta to have swell? Was this a chromosomal thing? Will it repeat when I TTC again?