Starting over after a miscarriage

[Anonymous]

I just miscarried last week (mmc dx at ~8 weeks, development stopped at 5w5d). We had been trying for 10 months (13 cycles for me, since mine are 23-24 days), and I was on cabergoline for galactorrhea/hyperprolactinemia and, for two cycles, prometrium to address LP spotting (incl. the cycle we conceived). We are TTC #2; DD was conceived with no difficulty when I was 26, I'm 29 now. My OB did day 3 bloodwork a few cycles ago and everything was normal, but AMH was low-normal, and notably low for someone my age (0.81, though my FSH was great at 3.4). While we wait for my HCG levels to drop, we're trying to figure out how to proceed next. I know the clock "starts over" after conception, even though the pregnancy was unsuccessful, but given the history, would you see an RE all the same? We're concerned about the possibility of DOR, including both the possibility that we have less time than we thought and that we might have a harder time with things like qualifying for shared risk if need be (we are OOP, no insurance for anything but diagnostics). Has anyone had this experience with low AMH and normal FSH? Did you conceive on your own or with help? What would you do?

TIA.

[Anonymous]

Hi, OP. I'm so sorry for your loss. Here is my two cents, but only take it FWIW. I don't actually think that 10 months is terribly long, and you were able to get pregnant on your own, so those are good signs. Still, if your insurance covers diagnostics and you're concerned something might be wrong, I would go for it.

My experience was that after trying for a while post-miscarriage and googling too much, I was convinced something was wrong with me. It turned out that nothing was wrong that would prevent me from getting pregnant, so I was able to stop worrying. When I did get pregnant again, I was glad to be seeing an RE rather than an OB because they identified that I had low progesterone and put me on suppositories, which might have prevented another miscarriage.

Diagnostics don't mean that you're committing to any sort of intervention, but you're getting the full picture so that you can make more informed decisions. If there is something off, I feel like an RE is more likely to detect the problem and to have a solution. REs specialize in helping women GET pregnant, and OBs don't necessarily have the same expertise. I have heard friends say that they wished they had just gone to the RE sooner so that they could start working on a plan.