[pedi08]

<p>I am reading various posts on here and wondering what kind of testing do have done, if any? I have been diagnosed with unexplained infertility. We conceived a son 2 years ago thru IVF on our first time. IUI's etc did not work. He was born premature 31 weeks. My cervix shortened (not dilated). I nursed for over a year and we TTC that whole time and for about 5 months after we weaned with no luck went back to IVF, attempted a fzn cycle but eggs didn't make it thru thaw. Next cycle fresh did not work, next cycle frozen ended in a MC early after a positive blood test. I never had any kind of d&C (is that ok?) Next cycle, fresh ended at 22 weeks. We lost our twins at 22 weeks. I had a short cervix again 2 point something, went into dr office for reg appt and subsequently was admitted to hospital dilated 1 and went into labor and gave birth all within 24 hours of that. Within our grieving we feel like we are also mourning never having another baby. We don't even want to go thru IVF again, but since we don't know why I cant conceive we don't know what we will do. Although the losses are so recent, we can't help but talk about this. We asked the dr my likelihood of carrying a baby to term and he said with a singleton its highly possible to get to 31 weeks like I did with my son. To us, that seems irresponsible on our part because although our son is perfect to us, we went thru a great deal early on, NICU etc, and we feel irresponsible going forward with that hope.</p>
<p> </p>
<p>So I just feel confused and lost. The dr said they have no new info. I asked if the loss at 22 weeks gave them more info on me. My cervix dilated this time, so maybe I would be classified as incompetent cervix but I still dont fit that category. But regradless, it gives no info on infertility and why I cannot conceive. Any advice?</p>
<p> </p>

 

[Milk8shake]

<p><br>
 </p>
<div class="quote-container"><span>Quote:</span>
<div class="quote-block">Originally Posted by <strong>pedi08</strong> <a href="/community/forum/thread/1285215/info-on-tests-i-should-look-into-after-1-mc-and-late-loss#post_16112819"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a><br><br><p>So I just feel confused and lost. The dr said they have no new info. I asked if the loss at 22 weeks gave them more info on me. My cervix dilated this time, so maybe I would be classified as incompetent cervix but I still dont fit that category. But regradless, it gives no info on infertility and why I cannot conceive. Any advice?</p>
<p> </p>
</div>
</div>
<p>Sorry for your losses. With your history of cervical shortening, I would say that your cervix is a problem. Any future pregnancies should be regularly monitored, especially through the second tri. You can put in a prophelactic cerclage at about 12 weeks, to help guard against shortening. It is also possible to have that placed prior to pregnancy. There are two types: transvaginal, and transabdominal. I understand that TAC is kept for cases with proven cervical shortening.</p>
<p> </p>
<p>As far as infertility, I know little about the common tests, but I would think it very important that you have your uterus/tubes/ovaries assessed by ultrasound/SHG/MRI for abnormalities. Uterine abnormalities, such as a septum can relate to both infertility and pregnancy loss. Hopefully someone else can jump in about the infertility tests, but if you have your uterus assessed, they can also look for lining issues, fibroids, etc.</p>
<p> </p>
<p>I understand the feeling of irresponsibility. I would really encourage you to be fully evaluated before attempting another pregnancy, in the hope that it will save you further heartache.<br>
 </p>

 

[pedi08]

<p>Thanks I knew about the cerclage but it was not rec. for either pregnancy. I am not classified as "incompetent" for whatever reasons they have. No fibroids and my lining is always really good. I also have had the tests thru IVF for my uterus and ovaries but never an MRI. I should ask about that one.  I had the SHG and it came back normal. I had one other one too, can't recall the name. It was painful. Nothing has ever showed up on any tests. Also when I am not pregnant and for a good part of it my cervix is normal. 1st time it was seen at 27 weeks, this time 21 weeks or so, but it was twins so they are saying the twin factor negates incompetent cervix as well.  I will ask about TAC however and even the other one because I want to be equipped with all knowledge. Thank you for the info. </p>

 

[Milk8shake]

<p><br>
 </p>
<div class="quote-container"><span>Quote:</span>
<div class="quote-block">Originally Posted by <strong>pedi08</strong> <a href="/community/forum/thread/1285215/info-on-tests-i-should-look-into-after-1-mc-and-late-loss#post_16116034"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a><br><br><p>Thanks I knew about the cerclage but it was not rec. for either pregnancy. I am not classified as "incompetent" for whatever reasons they have.</p>
</div>
</div>
<p><br>
It's great that you have had all the tests. I really don't know much about the infertility stuff though.</p>
<p> </p>
<p>If I were you, I think I would be looking for a second opinion.  Did you have pain or contractions with either delivery?</p>
<p>I'm just wondering why your doc doesn't consider incompetency. Generally speaking, IC is basically a painless dilation - that is one of the hallmarks. Also, the times for your dilation fit the criteria. I really don't think that the twins is a relevant factor.</p>
<p> </p>
<p>I'm surprised that you weren't recommended emergency cerclage or at <em>least</em> bedrest, especially with your second pregnancy!  Did he make any mention of his plan for a future pregnancy?</p>
<p> </p>
<p>It's really disappointing that doctors are out there that deal with patients in your situation, and don't give them a clear understanding of what can or can't be done.  I really think that another opinion here would be invaluable - and I think a MFM or neonatologist would be the person to see. Someone who is an expert in the management of high risk pregnancies.</p>

 

[pedi08]

<p>Thanks, I felt frustrated too. I was followed by high risk this time the whole way, various doctors saw me, all agreed I was not a candidate for a cerclage. Last time, I was referred to high risk once they saw my cervix shorten. I was on bed rest for about a month before I delivered my son, because of the shortening. I was not feeling contractions but they saw them on the machines and gave me meds, which took care of them. With this twin pregnancy, I did not have contractions until the day before I delivered. I went in for a regular scheduled appointment and was admitted over night to be watched and was having contractions (that I did not feel but machines were picking up), I was placed on bed rest that day. They tried various meds/shot, nothing worked. By the next day I was feeling the contractions. I had no dilation until about an hour before delivery with my 1st, with this pregnancy, I dilated within hours of the delivery, the morning of. I am going to be seeing one of the perinatologists to talk more once the pathology report comes in to see if anything was up with the placentas. I have many many questions. </p>