Second early miscarriage looking for a specialist - endometriosis or fertility
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cczbunnie83
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HI Everyone,
I'm 31 and have had 2 early miscarriages in the last 2 years, one at 8 weeks another one at 6. I don't have a OB/GYN doc of my preference, only seen a few and never continued the relationship, first because I didn't have insurance and this second time because I miscarried early, so I've had no chance to actually build a trusting relationship. I was diagnosed with endometriosis at 18 and had laparoscopic surgery back then to laser all endo. I was on birth control pills most of the time since then and quit them on April 2012. Then I got pregnant the first time (without even trying!), lost it ,and then discovered i was hypothyroid. Since at that point I had no health insurance I attacked hypothyroid on my own, trying different things and got me to pretty good levels, yet not the levels docs had told me they would like for me since I wanted to conceive. A few months ago my hubs and I decided to try again, thinking it would take us some months to get pregnant, but I did on my second cycle. We had just bought insurance and started shopping for OBGYNs, midwives, etc. However 2 weeks ago I started bleeding and the whole miscarriage thing started happening all over again. At this point I feel like I need to see a specialist... I need to fix my thyroid problem or even find out if that's what's causing the miscarriages, and also an endometriosis specialist to see if that's what's causing it. So the question is who to see first? Do i trust whomever at Physicians and midwives to treat me or refer me? Do i have to see a fertility specialist? and Endometriosis specialist? an endocrinologist? Is there one that would attack my fertility problem from all angles? I would like to see someone that wants to get me healthy in order to conceive. Not someone that will poke me with a thousand drugs to force a pregnancy on my body. I've heard that there are no endometriosis specialist in this area DC/MD/VA but seen highly recommended docs at Duke or doctor Yeung who's now at St Luis. Any input would be so appreciated... I just feel so lost and helpless. If we need to we will travel to see the best of the best. I just can;t continue losing babies... everytime I feel like part of my dies and all I want is to get me healthy and be able to conceive. Thanks! |
Anonymous
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I don't think an OB is the person to go to for thyroid issues. But an OB/GYN would be appropriate for endometriosis.
I'm just a layman, but my understanding is that endometriosis is more an issue with conceiving than with miscarriages. Do you have a GP? The GP would be able to recommend the appropriate specialist for thyroid issues (and I do think it will be an endocrinologist). Meanwhile, set up an appointment with an OB/GYN. Perhaps you could get tested to see if you have that blood clotting issue (which can cause early miscarriages) or progesterone issues. |
Anonymous
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Make an appointment for a consult with Dr. Abbasi at Columbia Fertility. She specializes in recurrent miscarriage. Given your history (which is very similar to my own) I would strongly suspect an immune problem. Unfortunately, there are very few doctors in this area who have expertise in reproductive immunology. It's considered somewhat controversial.
Here's a link with some information that you might find helpful: http://www.preventmiscarriage.com/Reproductive-Immunology/Non-Immune-Causes/Endometriosis.aspx |
Anonymous
| Go to a good ob/gyn. Most specialists do not consider you to have recurrent miscarriages until you have had three in a row. A sympathetic ob might run some of the basic tests for you after two. Good luck, I had two early miscarriages and then two healthy babies. |
Anonymous
| OP, did you have any testing done after your miscarriages? Do you know if there were chromosomal abnormalities? |
Anonymous
| I'd see a reproductive endocronologist. They can look into both issues for you. |
cczbunnie83
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| No, I haven't had any testing done after my miscarriages. Not of myself or the tissue from the miscarriage. This might be TMI, but my father, who's a pathologist in Mexico, asked me to put all the tissue from my miscarriages in pure alcohol for future testing. I never took it anywhere after my first miscarriage, trusting that it had been just a fluke, but after this second one, I just feel this urge to test anything that can be tested and find out why this is happening. |
Anonymous
+1 |
Anonymous
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Yes, see a reproductive endocrinologist (RE). They may refer you to another (non-reproductive) endocrinologist to deal with the thyroid issues, and you'll need a primary OB/GYN at some point as well, but an RE can give you some direction and kind of keep tabs on the various aspects of your health that relate to reproduction. Plus, an RE is more likely to have greater familiarity with endometriosis (and take it more seriously) than *most* OBs.
To reply to something mentioned by the first responder in this thread (just for informational purposes) - endo is believed to impact both getting pregnant (by more than one mechanism) AND the ability to continue a pregnancy. A confirmed endo diagnosis is reason enough to classify a pregnancy as high risk and result in an MFM referral for additional monitoring. |
Anonymous
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Hi OP, I am a fellow endo sister. I strongly recommend DR. Seckin in NYC for surgery should you consider one. endometriosis is a sign for immune problem. I see someone has already given you DR Braverman's website. He is certainly a pioneer in immune treatment of infertility and currying miscarriages. I cycled twice with him last year and he used neupogen, I did not get pregnant. Never gotten pregnant despite my 6 IVFs.
Currently cycling with Dr Abbasi. She is the only RE in the gather Washington area who is open to immune treatment. She did intralipids for this cycle . And she knows about Neupogen. There is currently I study going on with a drug similar to neupogen that you might qualify for. I could not do it because I have previously been on neupogen. |
Anonymous
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I would highly recommend Dr. Sheri Hamersley at Maternal Fetal Medicine Associates of Maryland. http://www.mfmofmd.com/ Her big specialty is working with patients who have experienced recurrent miscarriage. She treated me for immune problems and a blood clotting disorder (none of which I knew that I had until she gave me such thorough testing through lab work). Thanks to her wonderful treatment, I went on to have two healthy children. I would also recommend working with a reproductive endocrinologist who can monitor you very closely during the first trimester. Dr. Siu Wagner is in Rockville, and she is phenomenal. She is in private practice and calls you up personally with the results of your lab work. I can't say enough good things about her. I was very fortunate to work with both of these doctors - and they were also terrific about consulting each other because they respect each other's work highly.
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