repeated miscarriages and two issues: uterine scar tissue and MTHFR?

[daurelia]

Hello again everyone, boy, I'm turning into a regular around here :(

A couple of weeks ago I had a second miscarriage after 12 months of infertility. Yeah, I know, it sucks. You all know it sucks. So glad these boards exist so I feel a little less alone in all this while everyone around me has a baby no problem.

I've been seeing an RE who has me putting TTC on hold for the time being while they do some more diagnostic stuff.

I have had lots of diagnostics including a saline ultrasound and a zillion blood tests and they have found two potential problems.

1) something in my saline ultrasound looked like uterine scarring-- uterine synechiae is the official term. They are going to wait a month and look at it again, but if it is indeed scarring they will need to do a hysteroscopy to remove it. I'm a little freaked out as I've never had real surgery before (they'd need to put me "under", which scares me a bit). But what really worries me is that I am not seeing any literature that claims removing uterine scarring improves fertility. I am trained in public health, I know how to read medical research, and I am not seeing anything convincing on Pub Med. Does anyone know of any evidence that this is a legit thing that can solve infertility? I'll settle for anecdotal, even, if you know anything. And if any of you have had a hysteroscopy please let me know about it.

2) I also was found to be positive for MTHFR, two copies of the gene, the blood clotting genetic mutation. From my research it seems relatively harmless, but some REs suspect it can contribute to infertility and miscarriage especially when you have two copies of the gene. Again, same as above, I'm not finding any solid evidence of this anywhere. Does anyone know anything about MTHFR and miscarriage/infertility? I'd like to read up on this more before I discuss with my doctor further.

Thanks again everyone for being such a great resource. I am so grateful for this board and for all of you.

[toothfairy2be]

Hi daurelia- I'm so sorry to hear about your second miscarriage. Makes it harder to know you have to wait a while to see if anything comes up. I can't remember all of your story so I'm just going to throw some other ideas out there. Did you post on the endometriosis board before? If so, I'd ask for a laproscopy with the hysteroscopy, endometriosis can cause higher miscarriage rates due to elevated prostaglandins. As far as the surgery went, I had no complications with the anesthetic but the first few hours out of surgery were the hardest. I had some nausea (gave me zofran), a little rash on my chest (gave me benedryl, which knocked me back out), and pain in my shoulders/chest from the carbon dioxide. If you just have a hysteroscopy you shouldn't have that problem because they won't fill you up with gas. After the first day I was pretty normal, not 100% for about a week, but again, with a hysteroscopy you shouldn't have too much discomfort. I don't know what it means as far as TTC. We were advised to wait 6 weeks. The only other thing I can think of (and only because I was just diagnosed so it is at the front of my mind) is anti-thyroid antibodies. I'm not sure how/why they effect things (especially since my TSH was completly normal, I'm not close to hypothyroid). But women with Anti Thyroid Anitbodies have a 25% miscarriage rate and 70% lower fertilization rate. It is easily treated with thyroid medicine so that is an easier fix. I know there are a few women here with that have had recurrent miscarriage testing that may have more info. I wish you the best of luck in the future!

[deborahbgkelly]

Daurelia- You might want to also post this in the TTCAL threads: http://www.mothering.com/community/f/455/trying-to-conceive-after-loss

I am also homozygous for the MTHFR mutation and they are having me on blood thinners (Lovenox and baby aspirin) until 36 weeks the next time I get pregnant, in addition to extra folic acid and extra B6 and B12. I lost my twins in March due to IUGR from placental thrombosis. I have an anecdotal story of how the blood thinner protocol helped someone. A friend of mine had 2 miscarriages, went to see an RE to find out why she was having recurrent losses. They never found anything specific, but decided to try Lovenox and baby aspirin anyway. She stayed on them throughout the first trimester and has a beautiful little girl now.

[MTHFRease]

There's definitely a relationship between MTHFR and Infertility, both for men and women.  It is suspected it is through the mechanism of high homocysteine that there is trouble.  I don't know if I can post the URL, but I have a few posts about it.