Recurrent Miscarriage Thread

[QueenofChaos]

I haven't seen (or noticed) sperm DNA fragmentation mentioned in this thread so far (though it probably has been - I've only been able to read back dozens of pages)
So I thought it worth pointing out that dh received normal results for DNA fragmentation and we had above average expected "viable" blastocyst development.
From some reading I've done, DNA fragmentation is a recommended test for RMC situations. Just wanted to toss that out there.

Also,

I'm just wondering - for RMC couples or individuals who go through all the tests known to mankind, with all normal results, has anybody compiled a list or quick reference guide of all the more or less harmless treatments (maybe with some caveats) that can be used on the next try? Like, a kind of RMC Go For Broke Cocktail?

Stuff like:

Prenatal vitamin (and is there a #1 recommended kind)
Progesterone (injection? cream? both?)
baby aspirin
[some different kind of folic acid thing I can't remember the name of, but I guess some babies don't absorb or use the normal kind properly]

It seems I've read about 7 or 8 things commonly tried that seem innocuous, but it's been hard for me to always take good notes.

 

[petitpas]

Queen, if your twins were genetically normal then they did not die due to a genetic abnormality such as an extra chromosome. They did die for some reason, though. What was that reason if not a genetic one?

Non recurrent miscarriage is mostly due to genetic reasons. Embryos that are incompatible with life are aborted by the mother.

Recurrent miscarriage is usually due to problems with the mother/carrier. Often, these miscarriages happen before a first baby but not always. Some women, such as your GC, might carry two babies to term and then suddenly they just keep losing babies. This is because some problems are acquired/fluctuate (such as immune issues), others get worse with age (for example the effect of clotting genes).

What kind of doctor are you seeing? Are they really specialised in recurrent miscarriage? Even if they are, many do not believe in immune treatment because the trials on them are not yet complete.

There is usually an order of testing, starting with the most common reason for recurrent miscarriage (clotting) and working down the list until the least likely.
Many doctors also prescribe 'harmless' meds such as progesterone, baby aspirin, high dose folic acid and vitamin D just in case. You could ask for those for your GC if she is happy to take them.

 

[ReadynWaiting]

Petipas thanks for the breakdown. As much as I've read I'm looking for more common reasons to my rmc. I have carried 2 children to term but have had 6 miscarriages this year with no answers. The specialist I saw doesn't believe in the immune testing. I do have a slightly lower than average ovarian reserve but my naturopath doesn't believe it's too low. I have been taking a slew of supplements and getting Accupuncture 2x/wk for the past 2 months. I'm thinking once I get another bfp I'll start taking aspirin to see if it helps.

 

[Tasha]

The baby aspirin, I'd talk to your care provider as recent research suggests it's not helpful in those that do not have a clotting disorder, in fact they think it might increase your chances of miscarriage.

Methylfolate is the folate, some people can't absorb folic acid, also you want high dose so 5mg (in the uk).

 

[petitpas]

Hi Queen, sorry if my reply wasn't quite on target. I didn't see your latest post. There may be a list someone can link you to? I made my own mental list over the years based on crazy amounts of reading. I found Professor Regan's book on miscarriages very informative although she doesn't believe in immune treatment (or at least didn't when I read her book and saw her). It broke down the usual reasons for miscarriage quite well, I thought. Another good piece of reading is the green top guideline on management of recurrent miscarriages (UK obgyn guidelines). You can find that by googling.

As for the 'harmless' things to add it is important to discuss them with your doctor. As Tasha mentioned, aspirin isn't always harmless.
Progesterone used in the wrong way could perhaps cause problems, too. It is best to have your doctor on board (even if you have to present them with the research and suggest dosage/method of administration ).

ReadynWaiting, before you get to immune treatment there are a number of other standard tests you should have after three losses. Have you had any of those? Clotting, hormones (day 3/21 tests), thyroid, antiphospholipid? All of these are issues that can become a cause of recurrent miscarriage even after having successful pregnancies.

 

[ReadynWaiting]

Hi Queen, sorry if my reply wasn't quite on target. I didn't see your latest post. There may be a list someone can link you to? I made my own mental list over the years based on crazy amounts of reading. I found Professor Regan's book on miscarriages very informative although she doesn't believe in immune treatment (or at least didn't when I read her book and saw her). It broke down the usual reasons for miscarriage quite well, I thought. Another good piece of reading is the green top guideline on management of recurrent miscarriages (UK obgyn guidelines). You can find that by googling.

As for the 'harmless' things to add it is important to discuss them with your doctor. As Tasha mentioned, aspirin isn't always harmless.
Progesterone used in the wrong way could perhaps cause problems, too. It is best to have your doctor on board (even if you have to present them with the research and suggest dosage/method of administration ).

ReadynWaiting, before you get to immune treatment there are a number of other standard tests you should have after three losses. Have you had any of those? Clotting, hormones (day 3/21 tests), thyroid, antiphospholipid? All of these are issues that can become a cause of recurrent miscarriage even after having successful pregnancies.

I have had karyotyping, FSH, LH, progesterone, full panel thyroid and Dh had SA. I have a req for protein c & s, factor V Leiden, prothrombin gene mutation, anti thrombin III, lupus coagulant, anticadriolipin Ab, ANA, RF, anti phospholipid Ab. My naturopath wanted me to space out my blood tests because I have poor blood building. I will be getting the next set done after af comes.
I guess I'm just frustrated after 2.5 yrs of trying and so many losses. I just want a quick fix and there probably isn't one. I appreciate any advice as so many of you ladies have been through this.

 

[QueenofChaos]

Both our karyotype tests came back normal... Our geneticist is checking to see if there is any other testing our hospital offers and whether they staff any endocrinologists.
I feel like we're back to square one. No answers. Is there some problem with us that our tests haven't detected? Is there a problem with our GC that has developed over 10 years? Was the MC a fluke? Something to do with dual implants? Will we order the right tests? Will we find something treatable? Can everybody involved endure any more losses?
Honestly, I feel 100% done again. I know these are the first losses in 10+ years, but it has brought it all back, except I feel worse than before.
Dh won't push push me to try again (we have 5 supposedly viable embryos left), but, if we can get to a point where he feels we've done everything we can do, at this point, to find answers, he'd like to keep trying. GC is willing to keep going.
We've been discussing things like finding an egg donor. Maybe the age of my eggs is a factor (38 yo)? I'd be ok with that (or less not ok). I don't care about genetics the way dh does. And then it wouldn't be my loss if something goes wrong (it would still be our loss, in a sense though). Not sure we can afford it. Or maybe co-parenting, though we don't know how that would work with one party being a married couple.
Sorry for the rambling dump. Thank you for all the supportive thoughts and advice.

 

[petitpas]

Queen, I'm not sure I understand the GC's miscarriage history. Has she suffered recurrent losses? If yes, I still think she is the one that needs testing / treating. If she has 'just' (sorry, I don't mean to belittle a miscarriage, only counting) lost the twins then perhaps there is no problem at all and it really was a fluke. Or was it a loss that was further than first tri?

Your twins' testing came back as normal genetically so that would suggest that your eggs are still ok.

It is always a very difficult decision to know whether to try again. If you didn't, what would happen to your five embies?

Ready, it looks like you have the correct tests lined up so as difficult as it seems you need to wait until you get the results.

 

[QueenofChaos]

Queen, I'm not sure I understand the GC's miscarriage history. Has she suffered recurrent losses? If yes, I still think she is the one that needs testing / treating. If she has 'just' (sorry, I don't mean to belittle a miscarriage, only counting) lost the twins then perhaps there is no problem at all and it really was a fluke. Or was it a loss that was further than first tri?

Your twins' testing came back as normal genetically so that would suggest that your eggs are still ok.

It is always a very difficult decision to know whether to try again. If you didn't, what would happen to your five embies?

Ready, it looks like you have the correct tests lined up so as difficult as it seems you need to wait until you get the results.

She has no MC history, though she lost the twins at the same time we always did. ~10 wks

 

[Tasha]

Perhaps that was just an awful coincidence though? I don't know. Just a suggestion.

 

[Trying4first1]

Hi hope
If I am honest I do not know. I have had all NHS tests and had some extras as clotting issues run in the family. What they are exactly I do not know.
If I asked for them would they send them all too me? X

I would think so Hun. I've just remembered, is it your consultant that doesn't agree with mr Shehata??

he is definately worth seeing on the NHS, can you not ask your gp to refer you x

Hi Hope
Yes he is the one who does not agree with it all.
I am willing g to give it one more go. If not I will ask for a referral of not to him then a Tommys RM clinic? That way I could take part it clinical trials!? Not sure my hospital is great as they doesn't specialise in RM X

 

[Trying4first1]

I agree with hope, you need to take another look at what you have been tested for. Normal karyotyping of the foetus means there is an as yet untreated problem with the woman carrying the pregnancy.

Trying, maybe you can request a meeting with your GP and take a notebook. Ask what clotting tests were done, antiphospholipid syndrome, FULL thyroid panel, day 3/21 hormones, scan for PCOS/uterine abnormalities, full blood count. Once all those have been done and are considered in the normal range (double check thyroid panel as normal normal range is not entirely the same as normal for fertility range) you can ask about the following: progesterone prescription just in case (doesn't harm, could help), daily baby aspirin. Try and find yourself a doctor who will prescribe immune treatment. That's the next step after all the above tests have come back normal.

Queen, the same goes for your GC.

Urgh, I remember getting the test results for my normal babies. It's a bit gutwrenching, isn't it? Especially when you see the gender . Those little babies did not die in vein, though. Their results are a vital clue in how to treat you from now on so that your next pregnancy is not lost

Hi petitpas
I think that will be our next step for sure. I am willing to give the baby asprin a go along with regular scans. At least we can then say that we gave it a go.
Apparently my thyroid is all ok. Never had day 3 bloods before however. Had some day 21 bloods after my 2nd MC which weren't great but it was because I wasn't ovulating yet.
Me and DH are letting ttc take a back seat at the moment anyway. Normally we BD like crazy but this cycle we only BD 3 days and 1 day before ovulation during my fertile Window. We have said that if thats not enough then so be it. We are so fed up of BDing when an ovulation test says we should and hate the whole sex on schedule. So it may take us a lot longer to conceive again but at least we will enjoy it and not feel as pressured. Wish I adopted this approach ages ago

 

[Hope39]

I never Bd like crazy, well maybe at first but defo not after 5 years and 6 losses , lol

A lot of the time I only dtd the once and that was enough xx

 

[Trying4first1]

Thank you hope. That is reassuring. Me and DH just can't sustain that much BD anymore.
Only thing I have found is that in the months we have conceived we did a lot of BD. But then again we did that other months and nothing so I guess that was coincidence xx

 

[blueblue]

Trying - my GP gave me a print out of all the tests. A referral to the Tommy's clinic sounds like a good idea. They do a lot of research, I was really impressed when I saw the list of different studies: click on "Individual miscarriage research projects" at the bottom of this article:

https://www.tommys.org/our-organisa...ge-research/early-miscarriage-research-centre

Hope you get some answers soon x

 

[Tasha]

This is a link about getting a referral to the early miscarriage clinic.

https://www.tommys.org/our-organisa...s/tommys-national-centre-miscarriage-research

I will say I have absolute faith in them. My protocol was made by Professor Brosens, he looked after me at imperial college (queen charlottes) but when he moved I actually followed him up to Coventry eventually, even Dr Shehata (Epsom) had given up on me but they made a different protocol and that got me through the first twelve weeks (and actually the protocol continued until birth). From ten weeks my consultant near my home was professor Bennett (he also features on there) and he was amazing, so supportive, listened to my instincts etc. So if any of you girls are considering this, do it. I got my rainbow after sixteen miscarriages and two stillbirths thanks to those two men.

I go to Warwick a month today to talk to professional on a post grad course to hopefully inspire them with my story to make them as passionate as helping women like me and you all, and hopefully make a difference.

 

[Orangepie]

Hi Ladies,
I have had many about 6 early miscariages at 4.5 x3 , 5, 7, 8 weeks. I have been getting testing done and research done to find out the cause. I managed to get a diagnosis. I have started a blog with all the information on, have a read it could help you too

It wont let me post the link just yet because it says I have to make ten posts first. Well this is my first.

Your welcome to follow my journey and comment on my blog.

Baby Luck To All xx

 

[nocturnalstar]

Hi ladies,

I havent posted much before but I have been following the thread for a while!

I have had two missed micarriages, one blighed ovum and one found at 11 weeks with the baby measuring 7 weeks and needed a d&c for both. I am currently having my third miscarriage. I am about 6 1//2 weeks pregnant but my positives have been faint from the start so I have known things are not good for a while.

I had a scan today which showed a completely empty, 'normal' uterus and no sign of pregnancy. However the tests are still positive and I have had no bleeding at all since my last period. I have had my HCG bloods today and will have them again in two days to check that they are decreasing and not increasing. I am really worried that there might be something else wrong and that they may have missed an ectopic or something. Has anyone had a miscarriage like this? Its just so different to my others.

Thank you xxx

 

[Hope39]

Hi Ladies,
I have had many about 6 early miscariages at 4.5 x3 , 5, 7, 8 weeks. I have been getting testing done and research done to find out the cause. I managed to get a diagnosis. I have started a blog with all the information on, have a read it could help you too

It wont let me post the link just yet because it says I have to make ten posts first. Well this is my first.

Your welcome to follow my journey and comment on my blog.

Baby Luck To All xx

Welcome orangepie

How are you treating your thyroid antibodies?

I was diagnosed with them too back in 2010 x

 

[dairymomma]

Nocturnalstar-I had a miscarriage just like that. Bloods at 6+4 and 6+6 showed my levels were extremely low but rising. I went for an ultrasound at 7+1 and it showed an empty uterus with a thickened lining. I started bleeding that morning though so it wasn't a surprise that they didn't see anything. I likely passed the sac right after the ultrasound (like literally after. I walked out of radiology, walked into the bathroom, and after a few minutes of pretty horrendous cramping, *something* came out and my cramps stopped. We don't know for certain but my doctors feel like this was my first blighted ovum (I've had 4 more since.) and the sac was too little and probably in my cervix or something so they couldn't see it on the scan.

orangepie-welcome. Sorry you find yourself here but I hope your diagnosis helps you get to your rainbow!

AFM-blood tests came back normal or negative so the only clotting issue we're currently dealing with is related to my MTHFR. Whew. And since AF started yesterday, we're officially back to ntnping now. Nervous and excited at the same time...