2nd consecutive miscarriage. Now what?

[Anonymous]

I just had a D&C for a 4.5 week miscarriage that my body was having trouble completing. I also had a D&C in November for a 6.5 week MMC. No living children and am 28. Do you think it's time to start testing? Which should I ask for? I just have such a hard time believing its bad luck and the thought of going through this again is daunting...

[Anonymous]

Unfortunately, it's difficult to get any doctor to go through with testing before you've had 3 miscarriages. Do you have any risk factors for recurrent miscarriage like endometriosis or auto-immune problems?

[Anonymous]

I'm very sorry, OP. Are you the poster from the Jobs board? Whether or not you are, I'm very sorry you're going through this.

I had back to back miscarriages - several of them - starting at age 40. Despite the fact that my numbers were good (good egg reserve, no hormonal problems), it was clear in my case that I had age-related decline in egg quality.

If I were you, given your young age, I would give natural TTC a break for a few months. Get yourself to an RE stat. I would ask about getting the basic tests to see what your hormonal situation is, and see about getting you and your husband karyotyped.

An IVF cycle with genetic testing of the embryos may be a good idea, as then you will know that you are only transferring genetically normal embryos. It could be that I'm just thinking about your issue from the perspective of the problems usually faced by someone who is AMA, which you are not.

Best of luck, OP. Multiple miscarriages are rough.

[Anonymous]

I had 8 miscarriages (also starting in my 20s) and got testing after my 3rd, had my 4th miscarriage waiting on those results. I kept trying while talking my OB into doing testing.

Also pay attention to family history that could indicate a blood clotting disorder (stroke, heart attack), plus as the PP mentioned auto-immune conditions. If you have a family history of those things it might be worth looking at consulting with someone who has more experience dealing with those things.

I eventually found success (twice) with Dr. Braverman. Not everyone needs to see him but it is important to work with someone who doesn't take 2 miscarriages lightly, especially in your 20s.

[Anonymous]

Absolutely, you deserve to have testing done BEFORE trying to conceive again. I'm very sorry about your two miscarriages. I also had back to back miscarriages. All prospective parents need to know that if a patient is a strong advocate for herself, testing can even be done after ONE miscarriage. (Doctors typically won't offer it, but you are entitled to request it.) I was tested for blood clotting disorders after my very first miscarriage and tested positive for one of the blood clotting disorders. So I was put on blood thinners for my next pregnancy. However, I had another miscarriage. THEN I was tested for immune issues and turned out to have overly active natural killer cells. So for my third pregnancy I was on blood thinners and an immune suppressant (prednisone) - so I was FINALLY able to carry a pregnancy to term. I've had two healthy pregnancies - and that might not have come to pass if I hadn't insisted on comprehensive testing. I would suggest that you see a maternal fetal medicine specialist and a reproductive endocrinologist. My thoughts and prayers will be with you, OP!

[Anonymous]

Thank you for all of your advice. I have a follow up appointment on Monday and will ask for this sort of testing then.

And I am the same poster from the jobs board. My job situation is a wreck now, sadly. I'm afraid to even tell my boss about the appointment on Monday.

[Anonymous]

OP--just as an FYI, there are very few doctors in this area who do real immune testing for recurrent miscarriage. For whatever reason, the vast majority don't believe in the concept of elevated natural killer cells impacting a pregnancy. Just about any doctor can do karotyping for you and test for the major clotting disorders but if you want comprehensive immune testing, you will need to go out of town, or see Dr. Abbasi at Columbia Fertility. Good luck.

[cczbunnie83]

Hi OP. I just had my 2nd miscarriage too on March 5th. Dr. Abbasi was highly recommended to me in this forum, more so since I suffered from mild endometriosis and hypothyroidism...I had my first app yesterday. I came in to the app so worried and sad and left happy and hopeful. A week ago I had gone to Physicians and Midwives and was pretty much told to get pregnant again and "hope" not to miscarry. Since at that point I had already made my app with Dr Abbasi I didnt even bother fighting my case with the OB. She actually said endometriosis would only affect my ability to conceive and not my ability to keep them. Since I seem to have zero problem getting pregnant the doctor there just said to try again. I was pretty mad at that... who would want to go blindly into another miscarriage without any testing done before?

Good luck to you!

Dr. Abbasi was wonderful and talked to me very straight forward about her plan to find out what's causing my miscarriages.