When/how did you decide it was time for a RE?
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Anonymous
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This is my first time posting on this forum. I am the OP from the expectant moms forum who posted about recurrent losses (http://www.dcurbanmom.com/jforum/posts/list/754427.page).
Some of the ladies from that thread suggested that I post on this forum for some words of wisdom. When and/or how did you decide that it was time to see a RE instead of your OB? I have had two back to back chemical pregnancies and some of the suggestions in the other post was to go see a RE and get a recurrent loss panel testing done. Would that be the first course of action? I have had two successful pregnancies prior to trying this time around. My last pregnancy was 2 years ago. I am currently 34 (turning 35 soon). Thank you very much for your advice and wisdom. |
Anonymous
| Based on your other post, you've only been trying for 2 months, is that correct? I doubt you need an RE at this point. Although you've had 2 chemical pregnancies in a row, that's not really indicative of anything wrong--as it's fairly common. I wouldn't call an RE until you've been trying for 6+ months and continue to have chemicals. I bet you anything you'll have success within the next 6 months (again this is based on what I read from your other post). Good luck! |
Anonymous
OP here ... thank you for replying. Yes I have only been trying for 2 months so its not the totality of time rather the 2 back to back chemical that had me worried since I have had easy pregnancies in the past. It just surprised me that so many ladies in the other post said I should go to see a RE to get recurrent loss testing done. I hadn't even thought of that! |
Anonymous
| My honest opinion? What do you have to lose by seeking answers sooner rather than later? I don't think it can hurt to have a consult at this point - best case scenario they ease your kind (re something you're understandably worried and stressing about) - or find a problem and then can start taking steps to address it. Worst case scenario, they tell you keep trying and come back in __ months |
Anonymous
| The recurrent loss panel is typically recommended after 3 losses in a row. I do not know however, if there is a minimum number of weeks for the losses to have occurred that the doctor's are looking for before running these tests. |
Anonymous
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At 34/35 you'd be expected to have a higher chance for mc than in your 20s or early 30s, but certainly not to the point where you'd be likely to need an RE assuming all is otherwise normal. MC is far more common than a lot of people think. The testing at an RE is time consuming and annoying. Certain tests have to be done at certain times in your cycle, so scheduling can be a bit tricky if you're busy. Given your age and that it's only been 2 months, I'd wait a little longer before going through the testing b/c it seems highly likely that it'll work out (albeit not at easily as it did for you previously). But if you're anxious and it it will make you feel a lot better to have those results, there's a lot to be said for peace of mind while TTC, so it could be worth it from that perspective. Good luck!
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Anonymous
| If you're feeling frustrated and ready for more answers, book a consultation or two. In my opinion, if you're wondering enough to be posting here, it's worth talking to an RE to get your questions answered. |
Anonymous
| I honestly think if you want to do a consult for peace of mind, great, but lower your expectation that they will tell you anything but it's too early to know with only 2 months of trying and that you have time given your relatively young age. And good luck, all of this is super frustrating even in the early months of trying. |
Anonymous
It shouldn't matter the gestation. Some doctors will discount early losses, but CPs are supposed to count. |
Anonymous
Actually, the most recent committee opinion (2012) of the American Society for Reproductive Medicine define Recurrent Pregnancy Loss defines RPL as two or more failed clinical pregnancies, which means they were verified by ultrasound. In other words, by their definition, chemical pregnancies don't count. Here's a link for the full document: https://www.fertstert.org/article/S0015-0282(12)00701-7/fulltext I became very familiar with this document earlier this year when I was reeling after my losses and was searching for answers. I had 2 chemicals and a m/c at 7 weeks while TTC our first at age 38. My 2nd chemical and the m/c were in back-to-back cycles. We had been working with an RE for awhile by then because we had otherwise only had the first chemical in many months of trying Despite the definition of RPL in the guidelines, my RE counted my CPs as losses and offered me RPL testing. However, she was strictly adherent to the guidelines with regard to what tests she would order. In part this meant that, because I didn't have a personal or family history of blood clots, she didn't run the entire thrombophilia panel to rule out Factor V Leiden, MTHFR, and other inherited thrombophilias (she only tested me for antiphospholipid antibodies). The same RE was also fine with my TSH being >2.5 after my anti-TPO antibody test was negative (there seems to be a lot of contention in the literature over where TSH level should be when TTC). I ended up having additional testing by my hematologist (who I was already seeing for a different issue) and an endocrinologist, and took my results from all 3 doctors to a maternal-fetal medicine specialist to get her opinion because MFMs also treat RPL. OP--I'm sorry for what you've been going through with the CPs. I agree with many other posters who have suggested trying a few more cycles, because the most likely reason for CPs is genetics. If you do decide to see an RE sooner or later, and if you're like me and want tests run to rule basically everything out, then I would recommend going somewhere other than GW's IVF clinic. You could even ask your OB or midwife if they would check your TSH, anti-TPO Ab, and order the RPL panel (both Quest and LabCorp have a whole panel of tests, mainly the whole gamut of clotting factors--you can google it) for you before moving on to an RE. |
Anonymous
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OP here .. thank you for all of your kind replies.
I think we will take this month off and then give it a go the next few months and see where it gets us. If we have another chemical/miscarriage then I might look into getting more extensive testing. The only thing is I am not sure how far we are willing to go for a 3rd child. I don't think we would go through IVF or anything so I am not sure if its worth talking to a RE. I guess time will tell. |
Anonymous
I agree with everyone else. Give yourself until the end of the year and at that point maybe schedule sone testing. Given your previius successful pregnancies you may be dealing with a structural abnormality that recently surfaced (think a fibroid or polyp). This would be seen on an ultrasound of your uterus and would be part of the testing that would be ordered. I would plan to see soneone in January and try your best to relax for now knowing that you have a plan in place for the new year. There are so many options before getting to ivf so try not to focus on that for now. |
Anonymous
Thank you very much for your response. I don't think that I have a polyp or fibroid since I just had an ultrasound with my first chemical to rule out an ectopic pregnancy and the technician and doctor did not mention seeing anything abnormal on the ultrasound. I think thats a good plan though and give myself time until January and then reevaluate. OP here. |
Anonymous
| We went when we'd been trying for 4 years. Shady Grove wanted you to try for a year before they ran panels. If anything, ask you OB to run blood work. Because of your age, egg quality might have decreased since your last pregnancy and these just weren't viable eggs. Don't fret until you get to 6-12 months of TTC. |
Anonymous
Just wanted to add that they want you to try for a year if you're under 35. If 35, it's 6 months. |