Recurrent Miscarriage Testing

[FiberLover]

I understand recurrent miscarriage can be a cause of infertility?

If this is incorrect, please let me know and I'll ask to have this thread moved.


I'm currently in the process of my third pregnancy loss. No sucessful pregnancies.

I understand that there are tests and things that can help, possibly?

I'd like to know what experience you have with testing for pregnancy loss, and anything that might help me here.


My story:

31, TTC since Oct, 2006.

Feb 2007, BFP, pregnancy lost at 10 weeks.

July 2007, BFP, chemical pregnancy, period only 4 days late.

September 2007, BFP, pregnancy in process of loss 5 weeks 3 days.

As far as I know I'm healthy, and DH is too. He is 30. We're both non-smoking, healthy. There is a history of autoimmune issues on my mom's side of the family, she has Rheumatoid arthritis, severe, and my sister was diagnosed with lupus (though she had one m/c and 3 sucessful pregnancies). There is also a history of undiagnosed infertility on my mom's side of the family, my aunt couldn't have children, and a great aunt. A thyroid issue also runs on that side of the family.

I'm wondering what I should do now. I'm frustrated and sad.

I also see a CNMW office for my women's health and am wondering if maybe I need to find somewhere else to go for this stuff.

How would you go about looking for a new Dr.?

Thanks in advance for your help/experience/advice and again, let me know if I should have this moved.

[mamastotwo]

Yes, with the history of lupus and infertility i would definitely go and get some bloodwork done. A Reproductive Endocrinologist is the person to see (RE). You can get pregnant it just isn't sticking and they can help you with that. You are in the right place here.

[mamatosaskia]

Hi,

First off, I am so sorry to hear about your losses. I have recently had two miscarriages and I know how devastating it is to want to be pregnant but to find that things aren't working out.

I just picked up a copy of The Infertility Cure by Randine Lewis that might be of interest. It is all about using accupuncture and traditional chinese medicine to address fertility issues. You might find the book helpful and perhaps it could be used in concert with any other approaches that your dr. or midwives suggest.

Take good care of yourself!

Jacqueline

[Got_Cloth]

IU am sorry to hear about your losses.
I read a book that I love called Is Your Body Baby Friendly. by dr Alan Beer. It is about reproductive immunology, and since you have RA in your family, ( my mom has RA too) , that is an auto immune thing.
My Naturopath ( NMD) tested me for all autoimmune things, and is well knowing of the book. I have antibodies that are compeltey out of whack, and while i dont have any autoimmune things now, they are a real possibility for the furture.

Good luck on your journey....

[ChristyM26]

Oh Michelle, I'm so sorry! Yes, I think it's time to see an RE and get testing done. They can check for clotting disorders and all types of other things that could be causing problems for you.

[christinespurlock]

you know I was looking where to go and your post just popped out. I have no problem getting pregnant. All three times it was the first month trying. Keeping the baby is my problem. And with two looses back to back I need answers. I know there is a pregnancy and loss page but I see that as more as an emotional support. Really I hope we can post here.
I'd love to go over together all of the possibilities. So I know my Ob has tried everything. As far as an RE I don't even know if we have one, I live out in the sticks.

So far I've had a
-PTT test for clotting and it came back normal
-waiting for results of Antiphospholipid antibody test (wedmd stated this is cause of 15% of m/c)
-my ob metioned giving a course of antibiotics to dh and I in case of sub-acute infection
-I plan to get thyroid tested
-and I'm hoping to take progesterone next time around.

I'm also conserdering some alternative routes but for now this is my list.

[FiberLover]

Thank-you everyone for posting.

I'm going to check out those books (I love reading, so anything here is always good).


I have an appointment on Oct. 9th with my midwife, and she mentioned we could do testing starting then, things like thyroid. I'm not sure how much testing they do, but I'm definitely going to start with her since I'm very comfortable there, and plan on going with them when I have a pregnancy that sticks.

I might move on to an RE if I feel like there are tests/things they can do that my MW office doesn't support/do.

I'm going to ask about getting tested for:

1) thyroid issues
2) clotting issues
3) possibly autoimmune stuff



Hugs to all of us in this boat. It sure is a rocky ride!

[kristenok18]

Please also ask to look at your progesteron levels. I'm a little fuzzy on it, but I think you can look at levels 7dpo to check if your body is producing enough. Low progesterone is responsible for a great deal of m/c, but it's something that's not routinely tested for. It's something that's easily supplemented, either with injections, pills, or suppositories.

[FiberLover]

Originally Posted by kristenok18

Please also ask to look at your progesteron levels. I'm a little fuzzy on it, but I think you can look at levels 7dpo to check if your body is producing enough. Low progesterone is responsible for a great deal of m/c, but it's something that's not routinely tested for. It's something that's easily supplemented, either with injections, pills, or suppositories.

Good plan...but I also understand the progesterone issue to be somewhat controversial?

As in, if the pregnancy is failing, the progesterone levels will be lower automatically, so it is difficult to decipher if it is in fact cause or effect.

But also, progesterone won't hurt, so adding some can't be bad either...

[christinespurlock]

So my hcg levels are falling fast. I tested twice and with preggo test and barely could see a line after a minute. My guess is I'm going to O in two weeks. (fast after m/c) My thyroid, clotting, and lipid antibody all came back normal. And we are going to take progesterone next time. So I'm so so stuck at when to try again. I really want to 'get back on track'. My OB wanted me to wait. I don't know I've tried to research and really I could not find data that it will increase my chance of m/c. I just don't know what to do. What are you doing?

[bri276]

I had two miscarriages, and then after my daughter was born, I found out why- I have a chromosome disorder. it's relatively rare, but it's worth checking after three miscarriages in a row.

I'm sorry for what you're going through- I hope there is nothing wrong, but at the same time, it would be a little nice (at least it was for me) to know there is a REASON and "here is what you can do about it".

[christinespurlock]

Originally Posted by bri276

I had two miscarriages, and then after my daughter was born, I found out why- I have a chromosome disorder. it's relatively rare, but it's worth checking after three miscarriages in a row.

I'm sorry for what you're going through- I hope there is nothing wrong, but at the same time, it would be a little nice (at least it was for me) to know there is a REASON and "here is what you can do about it".

I'm sorry. Is there anything you can do about a chromosome disorder?

[peppercat]

I have had four miscarriages this year (three of them very early). I am getting tested for all mentioned above, plus blood sugar. My OB, however, basically thinks it's just a metter of my age (39) and, given the early miscarriages, may well be an implantation problem (more common as we get older). I do have a beuatiful three-year old boy, so it's not all that bad!

[LisaG]

Just wanted to add that when they check your thyroid make sure they test for thyroid antibodies (there are 2 kinds). I would also recommend they check your histamine levels and do a full thrombophilia (blood clotting) panel.

Blood sugar is another one to have checked as someone else mentioned. I'd also want to have genetic testing done if I'd had 3 miscarriages (we had it done after 2 to rule out one more thing).

Good luck

[ChesapeakeBorn]

Hugs to all of you. It is nice to know that we can find comfort and support in each other's company. I too am embarking on this journey of trying to determine the causes of my miscarriages and troubled pregnancy with DD. Both of my m/c were occult (several days following implantation). The doctor does not think it is a chromosomal issue as we have no such family history and we have a healthy DD. My sister and great-grandfather have/had Lupus. My grandmother lost 5 babies due to thyroid dysfunction.

This is the labwork done thus far (still awaiting results):
-TSH
-Free T3/Free T4
-ANA
-Anticardionlipin antibodies (includes IgM, IgA, and IgG)
-Lupus anticoagulant
-CBC
(-Also had my progesterone checked at 11 DPO when I found out I was pregnant. I was told that the level was 19 and that was good. My HCG at the time was 12.6)

In addition, I am 10 lbs. underweight despite my best efforts and an extremely healthy, protein-rich, mainly organic diet. I am always hungry. I have always had about a 40 day menstrual cycle with short, light periods. I started progesterone suppositories when I found out that my HCG levels plateaued this time, but they have not gone back up. I think the progesterone was too little too late or not the culprit.

I am a little overwhelmed as to what else I should do. After glancing at this does anyone have any suggestions about further tests I should have done?

Many thanks and best wishes to you all!

[LisaG]

ChesapeakeBorn - I'd make sure they check for thyroid antibodies (didn't look like that was on your list), especially with your family history. It is possible for your TSH to be in the normal range and to have antibodies present. You're at higher risk for miscarriage with thyroid antibodies (especially if they're high). Sometimes the antibodies will increase in early pregnancy causing chaos so it's important to a) know if you have them at all and b) have your levels checked frequently so medication dosage can be adjusted if needed.

Also wondering why they didn't check for Factor V Leiden and MTHFR - blood clotting disorders they usually check for when looking at ANA and anticardio.

[bri276]

I'm sorry. Is there anything you can do about a chromosome disorder?

It's okay and yes, you can do IVF with PGD, where they test the embryos before transfer to ensure normal chromosomes

The doctor does not think it is a chromosomal issue as we have no such family history and we have a healthy DD.

We have no such family history either, and I know personally one other mother with a healthy child who suffered secondary infertility in the form of recurrent miscarriages (over 10 in a row), because her husband has a chromosome disorder- a balanced translocation, the same as I have. Balanced translocations, from what I've read, happen in 1/500 people.. According to standard genetic counselling, they'll say you have a 1/4 chance of a normal pregnancy- but for some people, they seem to conceive a much higher ratio of chromosomally abnormal embryos, leading to either miscarriage or a child born with a chromosome disorder.

Not to say I think you have that or that I think you should even be tested for one, but a lot of people think a family history is necessary and it's not, it can just happen spontaneously.

Good luck to everyone!

[ebony_vbac]

one thing is that you can be rh negative after your first pregnancy and if you never got the shot your body would see future pregnancies as invasions in your body and try to fight it ie a miscarriage. aslo you could have low progesterone levels. i dont know anything controversial about it but i had 3 miscarriages after i had my c section baby and i had to take progesterone. i didnt start taking it till 7.5 weeks up to 18 weeks and i had a healthy full term baby

[whateverdidiwants]

Originally Posted by ChesapeakeBorn

-ANA
-Anticardionlipin antibodies (includes IgM, IgA, and IgG)
-Lupus anticoagulant

In case they didn't warn you, these tests take 4 to 6 weeks to run, so don't assume that no news is good news. Also, if you do test positive for a clotting disorder, they'll probably want to repeat the test after a month before they'll prescribe blood thinners.

Good luck!

[ChesapeakeBorn]

:

Thank you all so much for your insight. Bri276 - I'm glad you mentioned something about the chromosome disorder. I was simply going on what my doctor said "You have a healthy daughter so I wouldn't worry..." but I have really learned that you need to be your own advocate and do your own research. I will most certainly inquire about balanced translocation.

whateverdidiwants - funny you should mention how long the tests take. I was just thinking that I hadn't heard back from them yet so that probably means everything was normal! I'm glad you mentioned the waiting times - you'd think the doctors would have told me that!

So the other tests I may have done are:
-blood sugar (but I'm not sure what type)
-thyroid antibodies
-Factor V Leiden
-MTHFR
-protein s deficiency
-full thrombophilia panel (not sure if my tests included this)
-chromosome disorder (including balanced translocation)
-ultrasound for polyps or scar tissue from IUD
-sub-acute infection
Missing anything?

If I am going to proceed with TTC, I want to do everything possible to avoid another m/c so I might as well leave no stone unturned! This will help us make the decision of whether or not to try again. If it is treatable, we may only wait a cycle or 2. If it is not treatable, then I will not feel comfortable proceeding forward. If they find nothing, I guess I will use progesterone and follow my OB and acupuncturist's advice of waiting 3-4 months. During this time, my acupuncturist wants to do an intensive treatment involving weekly abdominal massage, acupuncture, and chinese herbs (I had only just begun this when we got pregnant this month). It will be hard to be actually TTA during this time. It just seems backwards given our goal, but when or if we do get pregnant again, then at least I can say I tried absolutely everything.