'Recurrent' Early Loss - Any Help/Advice Please!!

[Serendipity13]

Hi,

I'm 34 (nearly 35) and TTC #2. My husband is 55 and has lower than average sperm motility and my DS is 4.

In Feb this year I found out I was pregnant at 13 DPO, had some brown spotting the day after which I assumed was implantation bleeding, a drop in BBT (various forums said stop measuring as it will vary in early pregnancy) and only faint pregnancy tests but it was early days after all. I wasn't particularly anxious as I had had my BFP so just went to the GP, booked in to see the midwife etc. At 4w4d (19 DPO) I started spotting which got increasingly heavy, ran to A & E in a total panic about what to do (it was v. late on a Sun night) and they tested and said I wasn't pregnant... I was totally shocked and devastated. Saw my GP in the morning who was pleasant but not terribly helpful, and suggested maybe I should try and view it as a late period rather than a miscarriage!!

So I cried lots, read lots, and eventually accepted that one miscarriage is very common. We kept trying and third cycle later I got pregnant again. This time I was much more anxious and testing every day etc, but this time my lines were getting darker and my BBT kept rising. Cue forward to 4w4d and I start spotting again, lighter this time and only pink but still spotting quite a bit. I go to my GP who refers me to the EPAU at my local hospital who run bloods at 4w5d... My HCG is only 39 and my progesterone 3.2. I have since started bleeding more heavily and passed a fair sized clot which I can only assume was my baby! I am booked into my GP later today to talk to them and see what happens next, although I suspect that as they only have one confirmed they won't do much.

Again I have been reading lots and I decided to post on here to try and get some advice. I realise that so many of you have suffered so many more losses than I have, but I am just terrified something is wrong and I don't know what to do! With my DS everything was very straight forward, no medical intervention to speak of and I have not used any form of birth control since (but not been actively trying until Sept last year) so I don't see what physically could be an issue.

But there is so much information out there about immunological issues that I really don't understand and the more I read the more panicked I get... But I'm also a great believer in advocating for yourself and I want to try and understand what might be happening, and whether something has now fundamentally changed since having my little boy or if two miscarriages can really be just bad luck.

So if anyone has any advice or questions you think I should be asking PLEASE PLEASE let me know... I need to feel I'm doing something constructive right now and this whole area is some incredibly complicated!

Thank you so much x

 

[LacePrincess]

Posting because I want to know too!!

Unfortunately I don't have any advice for you, I wish I did. As little as they understand about fertility issues, they understand repeat losses even less. It's very frustrating.

Me and my husband are 36. We've had 4 losses - one chemical, one early loss at 6.5 weeks, one missed miscarriage at 7w, and now I'm going through our fourth early loss. The last three losses were all within the last year.

My RE can't tell me why it's happening. We've gotten tested for everything - thyroid, clotting panels, immune antibody stuff, everything. I'm on baby aspirin and progesterone just in case and it still didn't work this time. My husband has bad morphology though (4% on strict Kruger) and my RE thinks the bad sperm is creating bad embryos. At first he blamed my eggs but if my eggs were bad they shouldn't even be fertilizing.

So yeah I'm having such a hard time now since they're running out of reasons and tests! "Just try and hope it's different" is not a good plan. Ugh. Right now we're doing karyotyping (me and DH having living children together which was why we didn't do it before) to check for translocations, and I'm being referred to a hematologist to see if Lovenox/Heparin might be for me.

In your case, you need to get referred to a RE for help for sure, and push for the RPL panel. Some RE's will resist if you haven't had 3 losses but push for it! Also they should be testing your thyroid. Try baby aspirin and ask for prog supps, your prog does sound low so that would be an easy fix.

I'm at the point where I'm actually really wondering if there's something to the theory that having firstborn boys means higher risk of m/c later. I keep reading sooo many stories of boy moms having repeat losses later. I have 3 boys myself. Unfortunately even if it were true, the only treatment is IVIG (controversial and expensive) or IVF with PGS (also expensive!)

Now I'm so desperate I'm thinking about naturopaths and holistic nutritionists and TCM. Which I don't even believe in!

Bottom line is, two m/c could be just bad luck, or it could be more......you should at least try to get tested or at least get prog supplements. I hope more people will post as I'm pretty desperate for answers too.

 

[Serendipity13]

Hi, thanks so much for coming back to me... I'm really struggling today and it's just nice to hear from someone who understands!

I will push for a referral, but as they never even documented my earlier m/c I'm not sure they will... Don't know if you are UK based or not but if you are you will know that the NHS doesn't vary their referral criteria much!

I am interested in what you say about bad sperm as I also wondered about this after my first m/c given my husbands sperm issues but my GP told me it wouldn't be linked! What did you mean by 4% strict Kruger?? I thought the normal level for morphology was 4%? My husbands latest test was 3%... Is this bad then? No one really explained it to us!!

I have to say I am generally fairly alternative but I am just really scared to try anything right now (medical or otherwise) in case I make my situation worse somehow!! I have read Maca root is good for sperm issues so I may look into that a bit more.

I will ask about checking my progesterone levels again as they weren't sure at the hospital if it was low because it was a non viable pregnancy or vice versa if that makes sense. I also wonder if it's significant that both losses have happened at identical times for me??

Anyhow I guess all we can do is keep trying and keep sharing info... Thank you so much again for your response and I'm sorry for your losses X

 

[Serendipity13]

Hi, thanks so much for coming back to me... I'm really struggling today and it's just nice to hear from someone who understands!

I will push for a referral, but as they never even documented my earlier m/c I'm not sure they will... Don't know if you are UK based or not but if you are you will know that the NHS doesn't vary their referral criteria much!

I am interested in what you say about bad sperm as I also wondered about this after my first m/c given my husbands sperm issues but my GP told me it wouldn't be linked! What did you mean by 4% strict Kruger?? I thought the normal level for morphology was 4%? My husbands latest test was 3%... Is this bad then? No one really explained it to us!!

I have to say I am generally fairly alternative but I am just really scared to try anything right now (medical or otherwise) in case I make my situation worse somehow!! I have read Maca root is good for sperm issues so I may look into that a bit more.

I will ask about checking my progesterone levels again as they weren't sure at the hospital if it was low because it was a non viable pregnancy or vice versa if that makes sense. I also wonder if it's significant that both losses have happened at identical times for me??

Anyhow I guess all we can do is keep trying and keep sharing info... Thank you so much again for your response and I'm sorry for your losses X

 

[LacePrincess]

Well you'll have to check your records what protocol was used for your husband's sperm analysis. Kruger is just the name of the type of sperm analysis. 4%+ is 'normal' but my RE considers our morphology a big problem even at 4%. 3% isn't good!

Definitely followup on the prog, that can lead to early losses. Two can still just be a run of bad luck but if you can get tested, why not? And even if you can't get tested then prog is one of those 'might not help but can't hurt' things so I'd be pretty pushy to get some of that if you can.

I'm not in the UK, no. I'm in Canada, so not familiar with how the NHS works, sorry!

 

[Sweetkat]

I am really sorry for your losses.

I am lurking here as have had 2 losses (one at 8&4 discovered at 9&3) and one where the baby didn't grow past 4-5 weeks but I miscarried at 8 weeks.

I am now pregnant again but as an approaching the 8-9 week mark am terrified sth will go wrong again.

I am 35 and my OH is late 40s. He has low morphology (6-7% in two different tests) and we also have one DD together who is nearly 3.

I haven't had any testing done but I wonder whether low morphology does produce bad embryos? I literally cannot describe how terrified I am of another MC. Have had 3 scans so far and baby measuring 4 days behind, which is making me more worried.

I found the following about recurrent losses:

https://www.glowm.com/section_view/heading/Genetic and Nongenetic Causes of Pregnancy Loss/item/318

I hope we all have heathy babies soon and no more losses.

 

[LacePrincess]

So very sorry to hear about your experience, Sweetkat. Fx for your current bean.

It is controversial whether morphology affects the embryo. Some RE's seem to believe it does, others don't. My RE says there's a study (I don't have the citation, sorry) that says bad morphology can definitely create abnormal embryos. More specifically, that DNA fragmentation creates abnormal sperm (morph problems) which then are good enough to fertilize but not normal. Makes sense to me.

In our case it would seem it's gotten worse as we've gotten older. My first son was conceived when we were 24 in 4 months. My second boy was conceived at age 26 but it took 9 months, and my third son was conceived at age 28 and it took 14 months! So it would seem it fits that my DH's sperm issues have gotten steadily worse as we've gotten older.

Honestly not sure what will help. DH is now taking Fertile Pro, vit D, vit C, methylfolate and coq10. I hope something will work. It's costing us a fortune in vitamins every month, I swear like $150-200 which is just ridiculous!

 

[Sweetkat]

LacePrincess sorry for your losses too.

I have also read stuff online that links MCs to bad morphology which is in turn linked to DNA fragmentation.

I wonder whether there is no chance of healthy babies at all with bad morphology?? There seem to be couples who have healthy babies with really low morphology.

What's really frustrating is that nobody knows for sure what's causing the MCs. I never had a single issue with my first pregnancy but then to have two losses in a row is so upsetting.

Fx for healthy babies

 

[Serendipity13]

Hi both,

I'm also really sorry for your losses Sweetkat... fingers crossed this one sticks!! 🙂
Thanks so much for the info, I'll be sure to do some reading on that as it makes sense to me that both partners could cause the issue. Although my OH is older, we conceived with DS when he was nearly 51 and he is otherwise very healthy... Non smoker, doesnt drink much, exercises regularly etc.

The good news is my GP has actually agreed to refer me 'early' on the basis of the two loses rather than wait for a third, so that gives me some hope tonight that I might get an answer... Although I won't get seen for 4-6 weeks now it feels like I'm doing something useful and that's what I need... I just feel so helpless otherwise X

 

[LacePrincess]

LacePrincess sorry for your losses too.

I have also read stuff online that links MCs to bad morphology which is in turn linked to DNA fragmentation.

I wonder whether there is no chance of healthy babies at all with bad morphology?? There seem to be couples who have healthy babies with really low morphology.

What's really frustrating is that nobody knows for sure what's causing the MCs. I never had a single issue with my first pregnancy but then to have two losses in a row is so upsetting.

Fx for healthy babies

I don't know, I wish I did!

I didn't have issues with any of my successful pregnancies either. They took longer and longer to conceive but I never had so much as a chemical before I turned 30.

I wonder if it's a combination of my husband's morph/fragmentation getting worse with age.....and the fertility treatments I'm on making it too easy to implant anything that fertilizes? Or somehow my body isn't good at not implanting bad embryos? Who knows, really.

We're going to be doing another ivf cycle soon, with ICSI, which fx will solve the problem *if* morphology is the reason. If that doesn't work I'm thinking IUI with donor sperm (DH is perfectly okay with that.) If that still doesn't work then.....I don't know.

Morphology seems to be the hardest thing to fix, unfortunately.

Serendipity - that's great you're getting referred! Fx you'll like your RE. And yes definitely having a plan will make you feel better. One of the most frustrating things with my current loss is that we're running out of new things to try which makes me feel very hopeless.

 

[Aurora CHK]

Hi ladies,

I'm just going through my fifth consecutive early loss (all at between 4 and 5weeks). My husband has moderate DNA fragmentation (plus poor rapidity, motility and count but normal morphology) which I suspect is the cause. I've been tested for absolutely everything under the sun at least twice and while I have fairly low AMH (fewer eggs than typical for a 36 year old), very slightly elevated killer cells and a couple of problems with processing folic acid, vitamin B and glucose, they can't find anything 'Aha!' with me that is leading to the same repeated problem. I get dosed with aspirin, clexane, steroids, activated folic acid, and progesterone for my pregnancies - plus this time I had an intralipid infusion (experimental new treatment to immune-suppress you so that killer cells don't intervene) and still had exactly the same problem. Consultants still tell me it might just be 'bad luck' so I am hopeful that this is all that your two losses are (awful and painful that they are, of course ) and that you will go on to have a healthy pregnancy really soon.

 

[LacePrincess]

Hi Aurora, so very sorry to hear about your recent loss.

I'm so frustrated for you (and myself!) to keep hearing that 'bad luck' line. After awhile bad luck isn't a good enough explanation!! I get the 'your eggs are old and crap' line too.

I think that it's sperm for us too, not sure what to do aside from donor sperm but I'm not sure we're ready for that yet. We thought about exploring IVIG but it's staggeringly expensive and uncertain whether it would even help.

I guess if it's really the sperm the only way around it would be IVF/PGS or donor sperm.

 

[Serendipity13]

Thanks for all the useful info Auroa and I'm so sorry to hear about your losses... Two has been bad enough, I'm not sure I could deal with the five you have experienced! I know it's relatively early days for me still but I was just never expecting this when we started TTC # 2... I thought I would have my baby by now and I find it all so frustrating and frightening!! I'm still waiting for my consultant appointment but I have my first acupuncture session later so I'm looking forward to seeing how that goes.

 

[mom2beoftwins]

I’m sorry for your losses.

Have you been tested for endometritis (it’s different than endometriosis, basically it’s a bacterial infection in the uterus). It is associated with recurrent pregnancy loss and treatable through antibiotics, but not a lot of doctors test for it. You can read more about it by searching for the article: "Chronic endometritis due to common bacteria is prevalent in women with recurrent miscarriage as confirmed by improved pregnancy outcome after antibiotic treatment” (Sorry; I’d post a link, but this site won’t let me since I’m new to forums).

I had three miscarriages before the doctors finally tested me for endometritis. I then went on antibiotics for three weeks. I made a lot of other changes as well, such as adding acupuncture, changing my prenatal to Thorne Basic Prenatal to address my MTHFR mutation, and going on Clomid to increase the size of my eggs and delay my ovulation. My first cycle trying after treatment I became pregnant with twins and am currently in my third trimester of that pregnancy. I detail everything I did on my blog, but since I’m new to this forum the moderator won’t let me post links. If you google “recovering from miscarriage mumbo jumbo” it should bring it up, probably as the second site (it’s called “Overview: Recovering from Miscarriage”). I know this is a weird thing to search for, but it’s the only way I can figure out how to search for it and I have some really good tips in there for other things to try.

I hope that you and all of the other wonderful women who read this thread will go on to have healthy babies. Best of luck!

 

[Serendipity13]

Hi Mom, thanks for the info... I will certainly ask about that when I finally get my referral through. And congratulations on your pregnancy... Twins, how exciting!! 😀

I have also started acupuncture yesterday as I tend to prefer natural treatments - in the first instance at least. How many sessions did you do? I have agreed to do 6 initially but it's so expensive I don't know how many more I'll be able to do after that.

Thanks for the link to your blog, I'll be sure to check it out x

 

[Sweetkat]

So my worst nightmare has come true, another MMC at 10 weeks.

I am convinced that it's to do with OH's sperm and 6% morphology. My OH was late 40s when DD was conceived (now early 50s) although i said 40s in earlier post (absent minded).

It can't be a coincidence that we are all miscarrying and all our OHs have issues with morphology. I am having a D&c on Friday . Then some tests 6 weeks after that and will then go privately for more tests (read good things about Dr Shehata in Epsom and London).

Sigh

 

[darcie]

Clomid worked for me. I had 3 losses and then fell pregnant on clomid and my baby stuck