Recurrent Miscarriage Testing - Page 2

[whateverdidiwants]

Originally Posted by ChesapeakeBorn

:

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!

For some reason, they never tell people that. I learned the hard way about how not waiting for all the test results can cause problems.

My RE bullied me into taking a cycle of Clomid to try to move up my ovulation date (I normally ovulate around day 20), saying that maybe a hormone level was wrong with my eggs and that's why I was miscarrying. I actually took 5 days of pills and went and had ovarian ultrasounds and was only 2 days away from getting the go-ahead to have sex when my APA results came back with a positive result - 3 times higher than normal.

Like you, I had thought "it's been a month since the first appointment, so that must not be the problem or else he wouldn't have put me on clomid!". After the nurse told me about the APA results, I did some quick research and called her back and told her that I was *not* going to ttc that cycle, clomid or no, because I would just miscarry anyway, she was incredibly nasty to me and insinuated that I was going to mess up their statistics because it was going to count as a failed cycle.

If they had been up front about how long the tests would take - and that they'd have to be confirmed with a second test - there's no way I would have agreed to the clomid in the meantime.

[ChesapeakeBorn]

whateverdidiwants - I too ovulate around CD 20! Actually, for this pregnancy, I ovulated exactly on CD 20. My acupuncturist believes that his treatment will help to shorten my cycles. I guess we'll see if I go that route.

What did your RE mean when she said she thought a hormone level was wrong with your eggs? Did she mean they were not at the right stage of development when released or did she mean that the release was not in sync with other hormones necessary to support pregnancy?

Thanks again for your help.

[whateverdidiwants]

Originally Posted by ChesapeakeBorn

What did your RE mean when she said she thought a hormone level was wrong with your eggs? Did she mean they were not at the right stage of development when released or did she mean that the release was not in sync with other hormones necessary to support pregnancy?

IIRC (and forgive me, it's been over 6 years) he thought that ovulating that late meant my eggs were already deteriorating by the time they were released. In retrospect, I think he was one of those "if you don't have a 28 day cycle there MUST be something wrong with you" people.

[LisaG]

ChesapeakeBorn - is your acupuncturist doing abdominal massage while you're TTC? My understanding is that you don't want to have abdominal work done if there's a chance you could be pregnant (not that there's anything concrete to really back it up, seems to be more about erring on the side of caution).

One other test I can think of is an HSG (hystosalpingogram) - it they're wondering about polyps, I'm wondering how much they can see from an ultrasound vs. an HSG. Ultrasound is certainly easier - and I don't know the answer just posing the question. HSG will also show (more accurately) any "weirdness" of the uterine cavity like a uterine septum or bicornuate uterus that may not be picked up on an ultrasound.

[mamastotwo]

One thing I was tested for after a couple miscarriages that I don't see on anyone's list is mercury. You can have a high level and be asymtomatic. My level was fine so i don't know what you do, do if your level is high though. Good luck!

[LisaG]

Originally Posted by mamastotwo

One thing I was tested for after a couple miscarriages that I don't see on anyone's list is mercury. You can have a high level and be asymtomatic. My level was fine so i don't know what you do, do if your level is high though. Good luck!

If it's high you can detox through a variety of methods: chelation, chlorella or far-infrared sauna are some.

If you live around coal burning plants or have silver fillings that can put you at higher risk for high levels of mercury.

The best way to test for it is through a DMPS challenge test - you pee in a container for 12-24 hours. Hair analysis is another method - although not as accurate because mercury can be stored in your tissues and not show up as high in your hair.

[ChesapeakeBorn]

Wow. What a wealth of information you all are! Thank you so much for your advice.

LisaG - I told my acupuncturist that I was concerned about doing abdominal massage after ovulation and he tried his best to convince me that light masssage would not cause any problems. However, I was not comfortable with it and so refused the massage after I ovulated. I also gave him a list of acupuncture points that were contraindicated for pregnant women. He agreed with some, but not others, but he still didn't do any of them on me.

So this is the blood work done thus far:
-Protein S
-Protein C
-Factor II DNA (includes Factor V Leiden)
-Antithrombin III
-Homocysteine
-Free T3/Free T4
-TSH
-Anticardiolipin antibodies (includes APA)
-Lupus anticoagulant
-CBC

The ANA and TSH came back normal. The jury's still out on the rest. My OB did not think it necessary to check the thryoid antibodies, blood sugar, or screen for chromosomal disorders (e.g. balanced translocation), a sub-acute infection, polyps, or scarring from childbirth and my IUD. She also was not concerned that I have a 40 day cycle, ovulating on CD 20. I am going for a second opinion. Another doctor I spoke briefly with said that was his biggest concern - ovulation is not in sync with the uterine lining. He wants to do a biopsy of the endometrial lining and a hystosalpingogram.

Who does toxicity testing (e.g. mercury)? Is that something order through your doctor or a private company?

[LisaG]

Alright, I'm taking a deep breath. Pardon my bluntness, but if it were me, I'd fire your first doc. Sigh.

Question about your TSH - what are is your level? Because normal is a really wide range and some studies show that optimal conception ranges are 1.0 and below which is the low end of normal. Not many docs are savvy about that and think that if you're in the normal range all is well. Which is a bunch of.....well, you get the idea. You can learn all you ever wanted to know about the thyroid and then some at http://thyroid.about.com/

If you ovulate on Day 20 and cycle length is 40 days, at least your post luteal phase is good - although that seems like a long post luteal phase and I don't know if there are any downsides to that or not.

Blood sugar does play a role with miscarriages and infertility and it's not like it's a billion dollar test to run.

Here's the thing, if it were me and miscarriage was occuring so soon after implantation I'd wonder what's going on with the lining and the contour of the uterine cavity. So I think the recommendation of your 2nd opinion doc is right on.

As for the mercury testing - a "regular", mainstream doc is highly unlikely to give this any credence and will usually only look at blood levels. I'm sure they consider this to be way off the radar screen in regards to infertility and MC. You would really need to find some type of holistic physician (check out ACAM to see if there's a holistic physician near you).

I don't think that mercury is very often a primary cause for MC. What high levels of mercury can do is impact the immune system and contribute to autoimmune issues and the autoimmune issues can lead to MC. So, if it were me and I didn't have autoimmune stuff going on, I wouldn't make my mercury levels a priority.

Oh, and lastly, about your acupuncturist. He's probably right that light massage to the abdomen post ovulation isn't going to interfere with anything (and may help improve uterine circulation) - but it's one of those things where one person says avoid at all costs and someone else says it's no big deal.

Good luck!

[ChesapeakeBorn]

Thank you, Lisa, for all of your input. I am thinking about switching doctors - right now I am just running everything by my mom's OB/GYN who is very smart and experienced. He has a whole different take on things. Anyways, I really appreciate all of your insight. It is so helpful!

[Girlprof]

I agree with Lisa's last post and I want to ad a recommendation of a book. "Coming to Term" by Jon Cohen - his wife had 4 miscarriages, tons of testing, and three healthy children, including an "oops". He's a popular science writer by trade who turned his attention to miscarriage after personal experience. The book is very clearly written and easy to understand.

One thing he ends up advocating is a lot of TLC, meaning ultra-supportive care providers. I totally agree with him on this though I think the scientific jury may be out on the issue. In any case, the book is really clear and helped me get a good understanding of the various potential causes of miscarriage and the reasons why it's so hard for doctors and scientists to figure out what is going on.

Sarah

[ChesapeakeBorn]

Thank you for the book recommendation, Sarah. I will definitely order a copy!