Your advice: Is it worth seeing a fertility specialist?

[Anonymous]

OP, have you had blood clotting disorder testing done close to a miscarriage or in the beginning of pregnancy? My general, non-pregnant tests are fine, with the exception of one MTHFR mutation (generally seen as no big deal) but when I am pregnant the variable numbers for clotting disorders go through the roof. I mad a m/c that lead me to find this out and I will absolutely go on Lovenox if I am fortunate enough to get pregnant again.

[Anonymous]

My sister had RPL (3 first trimester losses before her first DC and one second trimester loss before her second DC). Obviously, from the above, she was ultimately able to carry to term. I don't think they found anything specific in any of her BW/testing, but she did take baby aspirin during her two successful pregnancies (of course there's no real way of knowing if that's just a coincidence since I think she also took it during the pregnancy that miscarried in the second trimester). The aspirin supposedly prevents clotting, BTW, which some think leads to miscarriage.

I think she had a doc willing to supervise that regimen, but many are not. It's frustrating because there is very little data on autoimmune issues and RPL, but given how much IF is unexplained it seems weird that so many in the medical community aren't willing to even consider that it may be a factor so more studies can be done. My mom also suffered from a few late term miscarriages and has arthritis which is an autoimmune disorder. I personally haven't looked into autoimmune issues, though I do have a chronic ai disease (IBD/UC which hasn't been linked to IF). I'm starting to think I should, though.

[Anonymous]

Anonymous wrote:OP, have you had blood clotting disorder testing done close to a miscarriage or in the beginning of pregnancy? My general, non-pregnant tests are fine, with the exception of one MTHFR mutation (generally seen as no big deal) but when I am pregnant the variable numbers for clotting disorders go through the roof. I mad a m/c that lead me to find this out and I will absolutely go on Lovenox if I am fortunate enough to get pregnant again.

Can you recommend a doc who does this testing in the DC area?

[Anonymous]

Hi, I saw Dr. Hammersly in Rockville. She specializes in this and other high risk pregnancy issues, but she can work directly with your RE or OB so she can act as a consultant if you already have another doctor you like. If I am remembering correctly she has had personal and family health issues/miscarriages that lead her to pursue this field so she gets it.

http://www.mfmofmd.com/

[Anonymous]

^ sorry that last post was from 23:58

[Anonymous]

I would almost 100% guarantee that you have an immune problem. Agree with the advice to see Dr. Abbasi or an out of town specialist in reproductive immunology. Do it before you TTC again and don't wait any longer.

[Anonymous]

Two cents on Dr. Abbasi...I have clotting disorders and first was a patient of Dr. Abbasi's for a year when I first had trouble conceiving. I had no idea that I had them then, but she never even suggested testing for it. She is rough to deal with and I found her not open to my feelings/suggestions on why I was unable to get pregnant. I think a doc like Hamersly would be the way to go especially given that OP has no trouble actually getting pregnant.

[Anonymous]

Sorry, 18:17 again. Hamersly also does nothing but clotting disorders and high risk pregnancies, where Abbasi may test for it, it is definitely not what she specializes in.

[Anonymous]

Dr. Abbasi refers her patients who test positive for clotting disorders to a hematologist.

[Anonymous]

Anonymous wrote:This is the OP -- thanks so much for the input and good wishes, everyone.

13:41, yep, we had karyotype testing -- all normal.

We've read a lot about autoimmune issues. Clearly there are those who feel very strongly that it is a real and treatable condition, and others (including one nationally renowned specialist in RPL who I had a phone consult with) who feel that the evidence just isn't there yet. I know there are multiple threads about this on DCUM, and I'd rather not re-open that dialogue again here. I'm not yet sure where I stand on it -- I've heard powerful arguments both ways.

What I think we may do is see Dr. Abbasi instead of Dr. Frankfurter -- that way, we can discuss the more "traditional" RE strategies (which we would've covered with Frankfurter anyway) and we can also talk about the autoimmune stuff with someone we know won't dismiss it out of hand.

Any other advice/experience/ideas welcome! Thanks again.

OP, do yourself a favor and fast before your initial consultation with Dr. Abbasi. When I made my recent appointment they didn't ask me to, but I went ahead and did it anyway. They were then able to draw blood and get the testing moving forward that day, as opposed to having to come back another day for the blood work.

[Anonymous]

Anonymous wrote:My heart aches for you, OP. My DH and I also got pregnant easily and have two children from previous uneventful, normal pregnancies, but still had 3 losses in the last year at age 41-42 (DH is 38). All losses were between 9-12 weeks. The last two were trisomy related but the first came back no issues/female (though my OB wasn't completely convinced this was accurate b/c the practice lacked confidence in the lab they used at the time and subsequently switched).

It was recommended that we try IVF with PGD. Fortunately my insurance covered it though I paid out of pocket for some of the meds (my long stim cycle required meds that exceeded my insurance cap). We went with Dr. Osbourne at Shady Grove and agreed to give it ONE shot and then move on.

Prior to cycling, my DH and I went through a full array of tests, including genetic, but everything came back normal. Long story short, the PGD testing at 3 days revealed that out of 9 embryos, only 2 were genetically "normal." We put back those 2 and have 2 beautiful beans at 7 weeks with heartbeats. We are obviously not out of the woods yet, but for me, the PGD results were enough to justify our going the IVF/PGD route. While we surely could have gotten pregnant again on our own, the odds clearly were not in our favor.

Best of luck to you.

This is such an inspiring story. Congratulations!! We're in almost the same boat, although we've had 5 losses in a couple of years. Three of our losses were early, but two were toward the end of the first trimester. We've also been recommended to try IVF with PGD, but it's been a hard step to take. We were told that the odds were very low, but your story is motivational. I hope you have a healthy and happy pregnancy!