Recurring early miscarriage

[Anonymous]

Anonymous wrote:It’s pretty harmless to some doctors will just give it to you if you ask. You can also use an over-the-counter cream, but I’m unsure how effective that is.

NP my OB is against this idea because if genetic issues are the cause of the miscarriage progesterone could prolong the inevitable.

OP has the tissue been tested?

[Anonymous]

Anonymous wrote:21:51 I'm trying to get pregnant at 44, after 2 miscarriages and having my son at 40. Can you say what you think helped you?

Trying with your own eggs?

[Anonymous]

17:03 yes, trying with my own eggs. I had my DS at 40 and two subsequent miscarriages.

[Anonymous]

This is OP. Thanks to all the helpful responses, I appreciate it.

I ended up seeing Dr. Sack after a positive recommendation from a friend. I had previously seen a doctor at shady grove for the first round of tests. She was fine but didnt seem as concerned about digging deeper.

Anyway, I did blood clotting and chromosome karyotyping with Dr. Sacks. and...its normal! Bah.

trying to figure out what my next move is while continuing to try the old fashioned way.

[Anonymous]

Anonymous wrote:This is OP. Thanks to all the helpful responses, I appreciate it.

I ended up seeing Dr. Sack after a positive recommendation from a friend. I had previously seen a doctor at shady grove for the first round of tests. She was fine but didnt seem as concerned about digging deeper.

Anyway, I did blood clotting and chromosome karyotyping with Dr. Sacks. and...its normal! Bah.

trying to figure out what my next move is while continuing to try the old fashioned way.

Did you do an endometrial biopsy to test for endometritis? Unsurprisingly, I'm the OP from the other thread and that was the only thing that came up on my RPL testing. I'm treating it now, so no success story yet, but from what I've read it can contribute to implantation failure and early miscarriages. It's also more common in women that have already had a child, since you can pick up an undetected infection during delivery and not notice it until you start trying for another child. The biopsy hurts like h*ll for a few seconds, but it's a quick procedure then a round or two of antibiotics if it comes up positive.

[Anonymous]

Anonymous wrote:

Anonymous wrote:This is OP. Thanks to all the helpful responses, I appreciate it.

I ended up seeing Dr. Sack after a positive recommendation from a friend. I had previously seen a doctor at shady grove for the first round of tests. She was fine but didnt seem as concerned about digging deeper.

Anyway, I did blood clotting and chromosome karyotyping with Dr. Sacks. and...its normal! Bah.

trying to figure out what my next move is while continuing to try the old fashioned way.

Did you do an endometrial biopsy to test for endometritis? Unsurprisingly, I'm the OP from the other thread and that was the only thing that came up on my RPL testing. I'm treating it now, so no success story yet, but from what I've read it can contribute to implantation failure and early miscarriages. It's also more common in women that have already had a child, since you can pick up an undetected infection during delivery and not notice it until you start trying for another child. The biopsy hurts like h*ll for a few seconds, but it's a quick procedure then a round or two of antibiotics if it comes up positive.

Thanks for this advice. I did not do this test. i did a standard HSG uterus test. I will ask Dr. SAcks!!!!

[Anonymous]

Immediate PP again. Good luck! And also ask about sperm DNA fragmentation while you're there. It's uncommon, and not totally accepted by REs in this area, but research is showing it can cause recurrent losses as well. It's an extra test on top of the standard semen analysis and pretty expensive (I paid $450 including shipping a cooling tank), but another thing to check.

4 miscarriages in 10 months would make me suspicious that there's something more than just age and bad luck going on. Testing for uncommon RPL causes can be a real rabbit hole, but could be the deal breaker for being able to have a second child.

[Anonymous]

Agree about the endometrial biopsy. I too just tested positive for chronic endometritus and being treated prior to next cycle. I know the evidence is mixed but the fact it is so easily treatable and is more common make it a natural place to rule out. I wish I did earlier, but glad I am now. Also secondary fertility after failed IVF. Good luck- sounds like you are asking great questions and wish you the best.

[Anonymous]

Anonymous wrote:Immediate PP again. Good luck! And also ask about sperm DNA fragmentation while you're there. It's uncommon, and not totally accepted by REs in this area, but research is showing it can cause recurrent losses as well. It's an extra test on top of the standard semen analysis and pretty expensive (I paid $450 including shipping a cooling tank), but another thing to check.

4 miscarriages in 10 months would make me suspicious that there's something more than just age and bad luck going on. Testing for uncommon RPL causes can be a real rabbit hole, but could be the deal breaker for being able to have a second child.

Thanks! This is op. We are doing dna fragmentation from my husbands blood. Is there one for semen too?

I have asked about testing for endometritis infection but doctor told me that’s more associated with failure to conceive and not miscarriage. We shall see what happens this next cycle and see how to proceed.

Thanks to all for the support and advice

[Anonymous]

Anonymous wrote:

Anonymous wrote:Immediate PP again. Good luck! And also ask about sperm DNA fragmentation while you're there. It's uncommon, and not totally accepted by REs in this area, but research is showing it can cause recurrent losses as well. It's an extra test on top of the standard semen analysis and pretty expensive (I paid $450 including shipping a cooling tank), but another thing to check.

4 miscarriages in 10 months would make me suspicious that there's something more than just age and bad luck going on. Testing for uncommon RPL causes can be a real rabbit hole, but could be the deal breaker for being able to have a second child.

Thanks! This is op. We are doing dna fragmentation from my husbands blood. Is there one for semen too?

I have asked about testing for endometritis infection but doctor told me that’s more associated with failure to conceive and not miscarriage. We shall see what happens this next cycle and see how to proceed.

Thanks to all for the support and advice

DNA fragmentation is an advanced semen analysis. I think you're thinking of karyotyping, which is a DNA blood test. The DNA frag test looks for DNA damage within the sperm - so the sperm can look healthy on the outside, but stress (increased temperatures, lifestyle factors, bad luck) can cause the actual DNA to become damaged and break. The egg can repair a certain amount of sperm DNA damage, but after a certain point it isn't fixable and can cause embryos to die in the lab, or faulty embryos that fail to implant or cause miscarriages (or even genetic defects with live birth).

And there is simply not enough science for your doctor to say endometritis does not cause miscarriage. That's simply wrong and your RE being selective with the available research. My conservative RE agrees that it is not fully established science, but there is sufficient evidence to test and treat after recurring miscarriage. It is a standard part of the recurring pregnancy loss panel of tests at this point, so I'd really push back on your RE about that. The biopsy hurts, but that's up to you to decide if you think the test is worth it (and IMO it is).

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Immediate PP again. Good luck! And also ask about sperm DNA fragmentation while you're there. It's uncommon, and not totally accepted by REs in this area, but research is showing it can cause recurrent losses as well. It's an extra test on top of the standard semen analysis and pretty expensive (I paid $450 including shipping a cooling tank), but another thing to check.

4 miscarriages in 10 months would make me suspicious that there's something more than just age and bad luck going on. Testing for uncommon RPL causes can be a real rabbit hole, but could be the deal breaker for being able to have a second child.

Thanks! This is op. We are doing dna fragmentation from my husbands blood. Is there one for semen too?

I have asked about testing for endometritis infection but doctor told me that’s more associated with failure to conceive and not miscarriage. We shall see what happens this next cycle and see how to proceed.

Thanks to all for the support and advice

DNA fragmentation is an advanced semen analysis. I think you're thinking of karyotyping, which is a DNA blood test. The DNA frag test looks for DNA damage within the sperm - so the sperm can look healthy on the outside, but stress (increased temperatures, lifestyle factors, bad luck) can cause the actual DNA to become damaged and break. The egg can repair a certain amount of sperm DNA damage, but after a certain point it isn't fixable and can cause embryos to die in the lab, or faulty embryos that fail to implant or cause miscarriages (or even genetic defects with live birth).

And there is simply not enough science for your doctor to say endometritis does not cause miscarriage. That's simply wrong and your RE being selective with the available research. My conservative RE agrees that it is not fully established science, but there is sufficient evidence to test and treat after recurring miscarriage. It is a standard part of the recurring pregnancy loss panel of tests at this point, so I'd really push back on your RE about that. The biopsy hurts, but that's up to you to decide if you think the test is worth it (and IMO it is).

Thank you for clarifying. Yes I did mean karyotyping . Sorry about that! I didn’t know about the semen test. I shall inquire! I’ll revisit the endometritis discussion next time I see my RE. Thanks for the encouragement.

[Anonymous]

Hello everyone

This is OP. Just wanted to share an update. Every test I have taken has come back normal. Very frustrating.

I am waiting to see what happens this cycle ( I can test in a week). Per the doctors instructions I have added Baby Aspirin to my daily vitamin intake ( Prenatal, Vitamin D, Coq-10).

Good luck to everyone who has no answers but keeps trying!

[Anonymous]

Wow, you are me 10 years ago.

I am 40 now and at peace with my 1 DD. However, I spent most of my 30's trying to have a second child and suffering multiple miscarriages (7). I saw multiple specialists and had ALL the tests done--blood panel, uterine biopsy, etc. Doctors kept saying that it must be bad luck and to keep trying with lovenox, asprin, different vitamins, extra progeserone. I even debated doing IVIG transfusions.

That said, at 38 I finally went the IVF route with PGS testing. Only 1 embryo was viable (out of 8) and it didn't take. At that point our fertility doctor recommended donor eggs and my husband and I were so emotionally (and financially) drained, we decided to move on and make peace with our family of 3.

My point is...don't be me. Go straight to a fertility clinic and do IVF. I am trying to live with no regrets, but I wish that I had done that at 33, 35, 36...all those younger years I spent looking for something else wrong with me, when in reality I may just have had shitty eggs, and IVF at a younger age could have been more successful.

I wish you the best!

[Anonymous]

PP my story parallels yours a bit. I just want to give OP different perspectives since she is still trying to decide the course of action she takes and time is of the essence for her.

I'm also 40 now and started TTC about 10 years ago and had multiple losses (8). I went through with immune testing and ended up having four IVIG infusions, humira, intralipids, lovenox, Neupogen after SG tried to tell me to do IVF or possibly donor eggs. After all that, my subsequent 3 pregnancies were all successful (8, 6 and 4 years old now). Not all of those treatments worked the first time around but we learned more with each set of testing and were able to find what worked for me. Each successful pregnancy had some degree of placental issues though which confirms my diagnosis of immune issues. Some cytokines like TNF-a can impact egg quality so I think it's worthwhile to at least have initial testing done there. If you have already been to see Dr. Sacks then it should be less challenging to see Dr. Abbasi about immune testing (assuming they are both still at CFA).

[Anonymous]

Anonymous wrote:Wow, you are me 10 years ago.

I am 40 now and at peace with my 1 DD. However, I spent most of my 30's trying to have a second child and suffering multiple miscarriages (7). I saw multiple specialists and had ALL the tests done--blood panel, uterine biopsy, etc. Doctors kept saying that it must be bad luck and to keep trying with lovenox, asprin, different vitamins, extra progeserone. I even debated doing IVIG transfusions.

That said, at 38 I finally went the IVF route with PGS testing. Only 1 embryo was viable (out of 8) and it didn't take. At that point our fertility doctor recommended donor eggs and my husband and I were so emotionally (and financially) drained, we decided to move on and make peace with our family of 3.

My point is...don't be me. Go straight to a fertility clinic and do IVF. I am trying to live with no regrets, but I wish that I had done that at 33, 35, 36...all those younger years I spent looking for something else wrong with me, when in reality I may just have had shitty eggs, and IVF at a younger age could have been more successful.

I wish you the best!

Thank you! This is OP. The problem here is i already am 39!!!!! So you are so right to say there is no time to waste. I think we are reaching a limit of trying on our own.....IVF is looking more likely.