Wasted appointment and the questions I should've asked

[CarrotWithaTwist]

Hi,

I waited four months (and two hours in the waiting room) to get my first appointment with the fertility specialist.
I came away from the hospital totally deflated having essentially been told that at the age of 38, after ttc for 2 and a half years and having had 2 mc's that we should just carry on doing what we're doing.

I have convinced myself that the mc's are linked to the difficulty ttc, but the Dr dismissed them as 'just bad luck'

I have another appointment in November and would love to be able to ask the right questions.

For my sake and for those others on mn who are just starting this long haul process, what are the things we can ask about?

There's clomide (spell?) for making more eggs but are there drugs to improve sperm mobility or drugs to improve womb lining? or dietary adjustments that both parties can make?

All advice gratefully received.

[Roshbegosh]

I suppose he is saying infertility isn't the issue as you can get pregnant. You need help with maintaining the pregnancy. They don't consider two miscarriages indicates anything wrong, you have to have three for them to take it seriously. Sorry, it is because mc's are commonplace medically speaking. I know that doesn't make sense to anyone ttc.
How far along were you when you lost your pregnancies?

[CarrotWithaTwist]

Hi,

I was approx 10wks the first time. Mc'ing just after the 12wk scan showed an empty sac. Second time I was approx 6-7 wks pg.

Thing is that in my non-Dr mind, the lining is not right and that's why the mc's happened and also why the fertilised eggs are not 'sticking'.

[EeyoreIsh]

Did you get any tests done? It's a while since I had my tests, but I think they were:

• day 1 and 21 bloods (fsh, lh, progesterone)
• sperm tests for your partner. Good clinics well do two tests as they can vary
• you might want to ask for amh, such tells you how many eggs you have left. You may need to pay privately for this (£80ish)

once you have these results back that will help.

You may want to have an internal ultrasound, to check for cysts.

They may also suggest you have a little op to check your tubes and your womb.

It's worth reading up on exactly treats you should be having, and asking for them, otherwise you might spend lots of time waiting.

I wouldn't worry too much about what treatment you need until you get some results back.

Good luck.

[EeyoreIsh]

Sorry for the typos. bloody phone.

[Roshbegosh]

It could be the lining but that would not explain your mc's as the embryos are implanting. Eyeore's tests would not be right for you. The internal ultrasound scan is a good idea but not to check for cysts in your case and your tubes sound fine. Haven't you had a scan already, in the ultrasound dept, not EPU?

[CarrotWithaTwist]

Hi,

I had 'day 2' hormones, 'day 21' hormones, scan to check eggs and various std tests.
I didn't ov on the 21day but have obviously have ov'd (at least twice) and scan showed 'possible PCOS' but not conclusive. Lining looked fine.
OH hasn't done his sperm yet but, as far as I'm aware, it's not like they can do anything if his swimmers aren't swimming any way.

I guess I just keep on going and hope for the best..

[lozster]

that's what I would call being between a rock and a hard place. Not enough miscarriages to be followed up and the pregnancies show that you can conceive so no follow up on the fertility side.

I don't think there is a magic solution. If there was a problem with sperm then ICSI could help. If there was a problem with maintaining the lining progesterone could help but I guess what the dr is saying is that miscarriages can happen due to issues with the egg/embryo quality and two isn't enough to base a pattern on.

I'm a hardened cynic concerning alternative therapies but I did get myself in shape before my last successful ivf cycle. I took DHEA for 3+ months and pre-natal vits, lost a modest half a kilo, stopped drinking alcohol and caffeine and increased my protein in take (I am veggie). I'm not sure if any of these factors were instrumental. If anything they probably 'work' in the same way as alternative therapies by making you feel a bit more in control and by improving your sense of well being.

You could turn this on it's head and look at this in terms of it being a win-win. If you are pregnant before your next appt then great! If not then you should get some help. I do wish you luck - I have a friend in a similar position and it's not a nice place to be.

[Hoophopes]

Hi if you are convinced it is a lining issue then there are tests to check blood flow to the uterus etc but they are only ozone privately. Did the consultant say there was any medical issue or do any tests? If not then perhaps in Nov ask:
For a SA, as you will qualify for fertility treatment if male infertility issues
For a HSG or ultrasound to check for blocked tubes, any fibroids/cysts etc.
For repeat blood tests to see if ovulate... I had NHS tests over 13 months and they did my blood tests 3 times and dh 3 SA's to see if his results improved.

Diet wise yes, healthy bmi's needed. The higher a BMI the higher the risk of miscarriage hence why Ivf treatments requires people to have a BMI under 30. No smoking. Ideally no alcohol. When we were under a fertility clinic we were told no alcohol, no smoking ( didn't so no issue), no caffeine, lots of fruit and veg etc. both of us took good conception supplements.

All the best.

[eurozammo]

The vast majority of mcs happen because there is a chromosomal problem with the embryo, so your dr could be right that your two mcs are just "bad luck". It's really hard to hear that when it takes a while to get pg in the first place though, as time seems to be ticking by.

You can have tests for NK cells and blood clotting disorders privately any time you like, but they NHS won't usually do anything until you have had three consecutive mcs. I did think just to rule it out (hadn't had mcs at that point but was "unexplained").

Lifestyle can play a big part, particularly on sperm health, so cutting down or out caffeine, tobacco, alcohol and eating healthily can help.

[EeyoreIsh]

The amh test can help because low quantity does correlate to low quality (according to my consultant), which might explain the mc if the eggs aren't viable.

OP, you have my sympathies. I had been trying two years when I finally got my bfp, only to mc.

I did make lots of changes before ivf. DH and I took pregnacare, I also took royal jelly and Co enzyme q10. I tried to eat at least 8 portions of fruit and veg a day, cut out caffeine and alcohol, took lots of gentle exercise and selfishly only did things that I enjoyed. It worked for us, we got my current bfp the month I was supposed to start ivf. I had already has a healthy diet, but really ramped it up after my mc. I also had acupuncture.

[Debsndan]

At 38 I'd write off that appointment and get to a private clinic with good results and throw everything at it. Fertility is a game of diminishing returns and waiting for your luck to turn is a huge huge gamble.
The results are all on the HFEA website.

[CarrotWithaTwist]

Thank you all so much for your replies.
Lozster - your comments really helped, I suddenly feel like there might be a chance.
My bmi is 24 and I'm managing to drop a few pounds. I have been reducing caffine but based on all your advise I'll try and cut it out all together, along with alcohol :( I have a healthy diet but there is room for improvement.
I'll ask about progesterone and tests to check blood flow to the uterus and an amh test (if that's different)
I'll also check out the cost of private tests, though money is tight so this might not be an option.
Thank you again all of you. You have given me hope. x