Miscarried PGS normal embryo at 6 weeks age 40

[Anonymous]

Hi Everyone,

I miscarried tonight with heavy bleeding filling a pad every hour and passing blood clots. I am with Shady Grove Fertility clinic and will go in the morning to confirm everything has passed. The bleeding has gone to light bleeding now. I had very mild cramps while this happened and it lasted about about 6 to 7 hours.

I have hypothyroid and hashimoto's disease which is/are controlled by thyroid medicine. I was also pre-diabetic but not anymore because I controlled it with low carb diet and exercise. I have family history of diabetes so I am insulin resistant to some degree. I am still overweight but have been maintaining 30 minutes of brisk walking daily. I also have PCOS, take a B-12 shot weekly and a Vitamin D pill weekly on top of prenatal vitamin with folate.

During this FET cycle, I am taking prednisone and a generic for lovenox as part of SGF's implantation protocol that I had requested. I am also on estrace and progesterone in oil (PIO) shots.

I had a 10 week miscarriage earlier this year after getting pregnant from my 3rd IUI cycle. They tested the miscarriage but it was inconclusive so they didn't find out what happened. After this we did 2 IVF freeze all cycles this summer with PGS testing. We got back 6 pgs normal embryos.

This was our 1st FET cycle and our 2nd miscarriage. Since I have autoimmune disorders with hashimoto's, PCOS and hypothryroidism should I look into Columbia fertility clinic with Dr. Abbasi.

SGF has standard protocols and they do not do any additional testing which I feel might be helpful for me. I want to be as aggressive as possible as I am having issues maintaining early pregnancy. I've never gotten pregnant before the fertility treatments due to the PCOS and not ovulating.

My insurance will cover 3 more treatment cycles (IVF freeze all or FETs) and I want to make the best use of it. Also, does anyone know if I can transfer my embryos from Shady Grove to another fertility clinic? Would appreciate any input and advise.

[Anonymous]

I'm very sorry to hear this.

Given your additional issues, SG may be willing to do more testing. If not, I suggest working with Dr. Tortoriello at SIRM in NY to optimize chances. He works with people with many comorbidities included automimmune and other issues.

[Anonymous]

Did they bump up your synthroid dose when you got your positive beta? What's your treated tsh? How closely are they monitoring your thyroid?

[Anonymous]

It's time to leave Shady Grove. They do not know how to handle issues like yours, some of which may point to further immune issues that you should be tested for.

I'd also recommend moving on to Dr. Tortoriello at SIRM. The consult should be covered by insurance and he'll move to additional testing right away. I can also confirm they're willing to take and work with embryos from other clinics. It's great that you have so many more PGS embryos.

Also, I'm so sorry about the PGS normal miscarriage. I've been through one (at Shady Grove as well). It is an incredibly difficult thing to go through, especially emotionally.

[Anonymous]

Anonymous wrote:Did they bump up your synthroid dose when you got your positive beta? What's your treated tsh? How closely are they monitoring your thyroid?

+1 TSH should be checked as soon as you get a positive beta. I am in the 2nd trimester after an IUI at SGF and am grateful to them, but am still a little bothered by the fact that they did not even suggest I get my thyroid levels checked after my first positive beta. I e-mailed my regular OB/GYN on my own a few days after the positive beta after reading online about the importance of keeping TSH below 2.5 in the 1st trimester (some even suggest getting it below that level while TTC). He immediately had my thyroid levels checked and my TSH had shot up to over 5 when I was 5 weeks pregnant, after being below 2.5 several months prior.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Did they bump up your synthroid dose when you got your positive beta? What's your treated tsh? How closely are they monitoring your thyroid?

+1 TSH should be checked as soon as you get a positive beta. I am in the 2nd trimester after an IUI at SGF and am grateful to them, but am still a little bothered by the fact that they did not even suggest I get my thyroid levels checked after my first positive beta. I e-mailed my regular OB/GYN on my own a few days after the positive beta after reading online about the importance of keeping TSH below 2.5 in the 1st trimester (some even suggest getting it below that level while TTC). He immediately had my thyroid levels checked and my TSH had shot up to over 5 when I was 5 weeks pregnant, after being below 2.5 several months prior.

What can be done when your TSH level goes up like that (over 5)?

[Anonymous]

Anonymous wrote:It's time to leave Shady Grove. They do not know how to handle issues like yours, some of which may point to further immune issues that you should be tested for.

I'd also recommend moving on to Dr. Tortoriello at SIRM. The consult should be covered by insurance and he'll move to additional testing right away. I can also confirm they're willing to take and work with embryos from other clinics. It's great that you have so many more PGS embryos.

Also, I'm so sorry about the PGS normal miscarriage. I've been through one (at Shady Grove as well). It is an incredibly difficult thing to go through, especially emotionally.

agree. I'm sorry OP.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did they bump up your synthroid dose when you got your positive beta? What's your treated tsh? How closely are they monitoring your thyroid?

+1 TSH should be checked as soon as you get a positive beta. I am in the 2nd trimester after an IUI at SGF and am grateful to them, but am still a little bothered by the fact that they did not even suggest I get my thyroid levels checked after my first positive beta. I e-mailed my regular OB/GYN on my own a few days after the positive beta after reading online about the importance of keeping TSH below 2.5 in the 1st trimester (some even suggest getting it below that level while TTC). He immediately had my thyroid levels checked and my TSH had shot up to over 5 when I was 5 weeks pregnant, after being below 2.5 several months prior.

What can be done when your TSH level goes up like that (over 5)?

You increase your synthroid dose. My endocrinologist tested me monthly, starting when I first discovered I was pregnant. My dose went up 3 or 4 times - I think it stabilized somewhere late in the second trimester. Most Hashi patients are told to take an extra pill a week once they get a positive pregnancy test. Or at least, Hashi patients with doctors who are paying attention.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did they bump up your synthroid dose when you got your positive beta? What's your treated tsh? How closely are they monitoring your thyroid?

+1 TSH should be checked as soon as you get a positive beta. I am in the 2nd trimester after an IUI at SGF and am grateful to them, but am still a little bothered by the fact that they did not even suggest I get my thyroid levels checked after my first positive beta. I e-mailed my regular OB/GYN on my own a few days after the positive beta after reading online about the importance of keeping TSH below 2.5 in the 1st trimester (some even suggest getting it below that level while TTC). He immediately had my thyroid levels checked and my TSH had shot up to over 5 when I was 5 weeks pregnant, after being below 2.5 several months prior.

What can be done when your TSH level goes up like that (over 5)?

You increase your synthroid dose. My endocrinologist tested me monthly, starting when I first discovered I was pregnant. My dose went up 3 or 4 times - I think it stabilized somewhere late in the second trimester. Most Hashi patients are told to take an extra pill a week once they get a positive pregnancy test. Or at least, Hashi patients with doctors who are paying attention.

NP. I'd consider moving to someone who deals with immune issues, and I'd also seek out the care of Dr. Hammersly for when you get pregnant again. She deals with high risk patients, some of whom have immune issues.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did they bump up your synthroid dose when you got your positive beta? What's your treated tsh? How closely are they monitoring your thyroid?

+1 TSH should be checked as soon as you get a positive beta. I am in the 2nd trimester after an IUI at SGF and am grateful to them, but am still a little bothered by the fact that they did not even suggest I get my thyroid levels checked after my first positive beta. I e-mailed my regular OB/GYN on my own a few days after the positive beta after reading online about the importance of keeping TSH below 2.5 in the 1st trimester (some even suggest getting it below that level while TTC). He immediately had my thyroid levels checked and my TSH had shot up to over 5 when I was 5 weeks pregnant, after being below 2.5 several months prior.

What can be done when your TSH level goes up like that (over 5)?

You increase your synthroid dose. My endocrinologist tested me monthly, starting when I first discovered I was pregnant. My dose went up 3 or 4 times - I think it stabilized somewhere late in the second trimester. Most Hashi patients are told to take an extra pill a week once they get a positive pregnancy test. Or at least, Hashi patients with doctors who are paying attention.

^ just to clarify, I'm the first quoted pp, not the second one. Funnily enough, I was seeing Dr Tortoriello and prepping for an IVF with him when I got pregnant the first time. He actually bumped up my synthroid the month before, at my urging, as it was a smidge over 2.5. He did not think it was a problem at that level, but was open to accommodating me when I requested that we try to get it lower before I did the next ivf cycle. And boom, I got pregnant on my own instead.

[Anonymous]

Sorry OP. I would not go to Dr. Abbasi- I went to her and Shady Grove. I found Abbasi and that clinic to be very flaky. People go to her because she believes in immunology issues and SGF doesn't really address those issues. But it's not worth dealing with the disorganization of the clinic- losing papers etc

[Anonymous]

OP, who did you get at SGF to prescribe prednisone and lovenox? I was told it's a complete no go zone for them.

[Anonymous]

I didn’t have same issues as OP but I took both prednisone and lovenox with SGF. They recommended it I didn’t even bring it up.

[Anonymous]

Anonymous wrote:I didn’t have same issues as OP but I took both prednisone and lovenox with SGF. They recommended it I didn’t even bring it up.

That's great, but it really doesn't help me unless I know which doctor was forthcoming with these treatments. That's why I asked the same question from the OP.

[Anonymous]

I'm a new poster but SGF (Dr. Widra) let me take prednisone. I had 2 failed xfers with PGS normal embryos (after many other failures too) and I'm so sorry for what you're going through. My third and final embryo is 3 years old now. Have you brought up metformin? I was on this as well to help with my PCOS and since you mentioned being pre-diabetic at one time, it's worth a conversation.