Repeated but not 'recurrent' mc

(28 Posts)
EvenIfYouSeeAPoppy Sat 09-Jun-12 06:24:30

So, my history: 5-week complete mc, ds1 conceived 3 cycles later, 2 mc in consecutive cycles (1 incomplete -> D&C, one blighted ovum discovered by 'chance' -> D&C), ds2 conceived the 2nd cycle we felt brave enough to try after that, FF nearly 5 years, pg by (very happy) accident, should be about 8/9 weeks now, some odd, inconclusive scans this week, first hCG test normal but second showing the levels are not rising anywhere near enough. sad Am 35.

Anyone been through anything like this? Obv I am v v v lucky to get pregnant easily and have two children. But this is affecting me more than I thought it might. I think we were content to accept we'd 'just had bad luck' once we'd had ds2, but I feel like I want some answers now - getting pg has clarified for us that we do want a third child, but now we're left wondering how many more mc there will be.

Am also concerned re the risks of D&C/ERPC (not in the UK). I think the two I had prior to ds2 had a hand in placenta problems I experienced with him. But I am being pushed strongly not to wait - and because my hCG is high, my cervix closed etc., if I did wait it could realistically be a few weeks.

Any thoughts very welcome smile

cosysocks Sat 09-Jun-12 07:58:07

Sorry for your loss. Could you go down medical management route rather than d&c?
I am currently going through this at 8/9 weeks after 3 inconclusive scans but yesterday had conf.
what would your prefered option be?

EvenIfYouSeeAPoppy Sat 09-Jun-12 08:52:47

You too? so sorry sad

My gynaecologist said when I asked her that she's not a fan of medical management. She also painted the risks of waiting and seeing rather dramatically, even saying I could risk losing my womb hmm

I am really rather torn. Of course I could wait and see and need ERPC anyway.

cosysocks Sat 09-Jun-12 13:12:32

I would say go with your instinct.
I chose medical management as d&c just didn't feel right. This feels right for me, whereas it could be not for someone else.
Tbh after waiting ten days it feels like a relief that something is happening. Obviously would have preferred nature to take its course but the waiting was too hard mentally.
Your gyno said you could risk losing your womb???

EvenIfYouSeeAPoppy Sat 09-Jun-12 20:53:25

Yes, she did! shock Obv worst case scenario but it was one of the first things she said.

I really don't know what I'd 'prefer' right now. I think I might be waiting a rather long time if I do wait. Haven't had any bleeding, cramping or anything. If I hadn't had a scan this week I'd still be blissfully unaware.

freelancescientist Sat 09-Jun-12 21:17:16

So so sad for you - I've been where you are.

Re: medical management vs D&C it is not clear cut - but I know that in the UK once I'd had 2 D&Cs the docs were pushing me to have medical management in my 3rd MMC. (I had DS normally after my 2 D&Cs). However it was for me quite painful and more mentally traumatic than the D&Cs but that is just my experience and others have found it better.

I expect your doctor is worried about the risk of infection if you do the 'watch and wait' too long, - as far as I know there is more of a risk from a D&C itself than a medically managed miscarriage.

As for the bad luck and repeated preg loss rather than recurrent miscarriage there is now a theory about some women having a highly receptive uterus - that anything will implant in it - this has made me feel a lot better about my repeated losses (6 pregnancies, 2 babies).....that I hadn't done anything to 'cause' my miscarriages, but my womb gave every embryo a chance!

EvenIfYouSeeAPoppy Sun 10-Jun-12 19:44:23

I'm sorry you've been through it too, FS.

That's interesting re the medical management and the receptive uterus - have always got pg very quickly, within 1-3 cycles (or indeed from miscounting my dates, like this time...). My doctor has said there will be a consultation at the hospital before they book me in for an op, and a friend who has been living here longer than we have has given me the name of the 'best' gynae at the hospital, so it looks like I'll have a chance to ask questions, which I do really feel the need to right now.

What order where your pgs/mcs in, if you don't mind me asking?

Back to doctor tomorrow to get last lot of blood results and scan to confirm. sad

EvenIfYouSeeAPoppy Sun 10-Jun-12 19:45:04

were, sorry <typing fail>

willitbe Sun 10-Jun-12 23:02:54

Hi, sorry you are going through this.

I think you should resist the pressure being put on you, scans and blood tests are not definitive and you need to be ok with any choice you make.

I am surprised they are doing blood tests if you are 8/9 weeks as at that point hcg levels change rate of increase anyway. Once a pregnancy has been seen on scan, beta hcg levels are not helpful in determining the viability of the pregnancy.

Also scans can be unreliable too, especially in women like me who have a retroverted uterus (fairly common thing). It means that in my scans I measure around two weeks behind in dating in early scans. I have had many miscarriages and three successful pregnancies and have learnt not to rely on either hcg or scans to determine if my pregnancy will fail or not. With my second successful pregnancy, I had a scan at 7+3 weeks and they told me that I was measuring at only possibly 5 weeks and to expect a miscarriage. At the 12 week scan I was measuring ahead of dates rather than behind!

I have only had one ERPC as I have been concerned about the risk of ashermans and the scarring.

I regret agreeing to my last m/c being a medical management, it did not help me as it just stopped the bleeding abruptly and did not help with the healing.

Waiting for a m/c to start is hard, but for me it has been the right thing to do, as my body did eventually get on with each of them, and whilst I have had heavy bleeding with two of them, I found it easier mentally.

But everyone has to do what they feel is right for them, please do not let your doctor scare-monger you into an ERPC if you don't feel ready. Also there are risks for having ERPC and medical management and in waiting, all can risk infection and losing the womb, so the doctor is wrong to use this in just one way. The risk for infection from ERPC is just as high and damaging.

If and when you are ready for an ERPC that is the time to do it, and not before you are ready. If you do have an ERPC, then do consider the possibilty of having genetic testing done in order to determine if there was a genetic reason for the m/c, it might help with giving you an answer.

Again, sorry that you are having to go through this, hope you get all the support you need.

EvenIfYouSeeAPoppy Mon 11-Jun-12 07:11:57

Thank you willitbe.

The thing is the pregnancy has not really been seen on the scan - the first one was a sort of indeterminate white mass, the second one showed a sac but with a smaller white mass rather than a baby. She thought she saw an embryo at one point but without a heartbeat.

hCG rise was 35000 to 42000 over 2 days - even allowing for a 4-day doubling time, it's not enough AFAIK.

She is scanning me again later today and we will have another lot of blood results to go by.

With my successful pregnancies I had scans showing the baby at about 6 + 3 each time. This did look very different sad

Doctor has already said she will order genetic testing, plus blood clotting tests for me. I doubt it's the latter, tbh, but it is 5 years since I was last pregnant, so things could have changed. It looks like I'll get any investigation I ask for, which is a help/comfort.

willitbe Mon 11-Jun-12 11:01:35

I am a little hesitent at posting again as part of me wants to just leave it at what I said previously, but I am also just aware that some women like myself have scans that are incorrect. I don't want to give you false hope, but do look at the misdiagnosed miscarriage website Several women having nothing to see on scans with hcg even higher than yours and go onto have normal pregnancies. here

The levels you are talking about - the hcg does not double in the same way for everywomen, and definitely does not continue to double as you get later in pregnancy, levels actually peak at between 8 and 12 weeks, they stay high but do not double throughout pregnancy, and for some women they never have the doubling in 24-72 hours like they are supposed to, but still have healthy pregnancies. My sisiter had a pregnancy where she never had hcg levels even high enough to get a postive pregnancy test, hcg does not have to be high to have a normal pregnancy.

Please go with your instinct on this. If you are not sure about getting an ERPC yet, then wait until you feel more sure. What concerns me is that you are sounding like you are being pressured into an ERPC before you are ready. Perhaps after the further scan today you might help you with answers. I am glad you will be getting tests done, I hope that the tests can give you some answers. Sorry you are going through this turmoil, it is horrible. I will be thinking of you today.

EvenIfYouSeeAPoppy Mon 11-Jun-12 19:41:08

Thankyou, willitbe.

Just wanted to update. After the longest transvaginal scan ever, at the hospital, the gynaecologist located a baby without a heartbeat. There is a massive bleed - the sac is basically full of blood. Cervix is still closed.

As there's no doubt whatsoever on dates, the lack of heartbeat etc indicates the baby has died.

freelancescientist Mon 11-Jun-12 20:56:16

Oh, Poppy, so sad. Thinking of you - it is really the pits.

My pregnancies etc were:
MMC (ERPC) diagnosed at 8 wks March 2000, MMC again ERPC at 8 wks July 2000, live birth (DS, normal preg, 9lb14oz) Dec 2001, then a break, then early misc (natural loss, about 5-6wks) March 2004, MMC (medical management) 8wks July 2004, live birth DD normal preg 8lb6oz Oct2005.

It seems to me that as well as having a receptive womb it didn't want to let go of my babies even when there was no hope.

Never had ANY trouble concieving - in fact in all the time we were TTC I had only one month where I didn't get a positive preg test. I'm not sure if they'll ever find an answer for us 'receptive' women, but must admit I found it a little bit of a comfort when I heard about this theory.

EvenIfYouSeeAPoppy Mon 11-Jun-12 22:44:52

Such a grim journey, FS (though with joy along the way too); I can well imagine you got that horrible 'here we go with history repeating itself' sinking feeling that I know so well.

Am rather dreading the results of the genetic tests, and almost 'hope' something is found because I'm not sure how I'll cope if it appears this baby died for 'no' reason. But OTOH that might be a better predictor of success in the future.

Doomfinger Mon 11-Jun-12 23:17:49

I waited for two weeks, they booked me in with a scan and everything was normal. I had triplets, on exam one was already being ejected(? not sure what to call it) so the doctor took it out but he could see another still in there (I'd lost one before getting there) and I had a scan to see if he was right. They said it was too early to say if there was a heartbeat or not either way so let me wait it out rather than risk aborting a healthy baby not removing a dead one.

Anyone who has lost more than one baby, however many lives babies should push for testing, this whole thing of "it's one of those things, most of the time we don't know" is absolute twaddle! There are enough reasons for babies to me miscarried even a first time that they can test for out numbering the ones they can't test for that it's just a pack of lies to say they don't know! MN's miscarriage policy says that women should be offered testing for Antiphospholipid (or Hughes) Syndrome. Something like 1 in 8 losses or pregnancy complications are caused by it and a diagnosis could be lifesaving (it's a congenital condition, the diagnosis is biased towards women because pregnancy complications is usually the big factor in diagnosis, but the disease doesn't discriminate) and life changing. I'd urge anyone with a poor obstetric history to get the test.

willitbe Tue 12-Jun-12 22:05:29

Poppy - sorry to hear that your loss has been confirmed. I hope that the hospital will give you all the tests results quickly. With the heamorrage into the sac it would definitely be worth getting all the clotting tests done too. A positive finding on the genetic tests are a kind of double edge sword, great to find something but hard as you can't do anything about it. With the one erpc I had, the genetic tests showed Trisomy 22 and it is probrable that most of my other m/c's had genetic issues due to my age. But it has not stopped me looking at other possible reasons too.

I hope that the next few days are kind to you, and that physically not too hard. Take care of yourself.

EvenIfYouSeeAPoppy Wed 13-Jun-12 08:43:00

Thank you both.

I went in for the ERPC yesterday. Had a final doppler scan beforehand, done by two doctors, just to give me absolute confidence of doing the right thing. Same result - no vital signs, almost no amniotic fluid in the sac sad I'd researched images of subchorionic haematoma previously and it looked nothing at all like those. There didn't seem to be any way for a baby to live in that.
Everyone was very kind, almost maternal, to me. Went home late afternoon. The anaesthetic affected me pretty badly for the rest of the day but am fine now.

The doctor is going to give me the clotting tests and I am wondering whether to have my general fertility looked at - although if I can get pg by simply miscounting a date (I am v v v regular and thought we were on a different cycle day in the heat of the moment - realised the mistake I'd made as soon as my period was late), that in itself is unlikely to be an issue.

Doomfinger Wed 13-Jun-12 11:15:22

I'm like that with dates, I know that at this time on this day I need to visit the toilet (well, except the last 6 years I've been breastfeeding) and got pregnant having sex on day 14, I could pretty much choose to get pregnant. Which is great if you can hold onto a baby!

Clotting tests are some of the tests for Antiphospholipid Syndrome, check if you're going to be tested for it as there's a few things they can look for. Don't let them brush it off because you have children either, it is possible. It's so easy to treat in pregnancy (a Jr Aspirin a day) that it's worth ruling in or out.

EvenIfYouSeeAPoppy Thu 14-Jun-12 08:25:12

Thanks doomfinger. Fortunately my doctor seems to be extremely thorough and is as keen to find out what's going on as I am. Am going for post-ERPC check-up (scan to check womb lining, I presume, and hCG test) tomorrow, and will ask lots of questions then.

I'm barely bleeding at all. It makes me think they must have been very thorough and worries me a bit re damage to my endometrium. I suppose they might have been concerned I might haemorrhage.

Doomfinger Fri 15-Jun-12 01:41:56

I'm glad you have a good doctor smile I was fortunate that I did, it was quite obvious from the circumstances that something was wrong with me so they bombarded me with all the tests - they induced a TIA taking so much blood from me! I know too many people who have to fight for testing, especially if they have living children, it could have been a totally different story for me. I hope you come up with some answers, in a way a diagnosis is better than nothing wrong because you know you can do something, but I don't want to wish anything onto you.

EvenIfYouSeeAPoppy Fri 15-Jun-12 13:44:23

It's hard, isn't it? Results are a double-edged sword, I think.

I had the first lot back at the gynae today - no infections, no inflammation. I had been worried about listeriosis because of having eaten grilled goat's cheese at the very beginning of the pregnancy (you forget the guidelines when you haven't been pg for 5 years) and am very relieved it wasn't that. Now to wait for the genetics. Plus have been promised a referral to a clotting specialist.

There is still blood in my uterus and I am barely bleeding, much lighter than a normal period, so have been injected with something to cause contractions and help expel it sad although it doesn't seem to be working yet.

jellybeans Fri 15-Jun-12 13:55:41

Hi I am very sorry for your losses sad I have had 8 pregnancies; 4 full term normal and 4 losses; 2 first trimester and 2 after 20 weeks. They were in between my healthy pregnancies not reccurrant (although had 2 in a row). One was for genetic problems. I was diagnosed with clotting issues, incompetent cervix (I have a history of D&Cs and traumatic births) infection in 1 loss-probably from the IC. With treatment (injections, cervical stitch) we completed our family and have 5 DC (one preg was twins). I was given a 50% + risk of late loss at one point. So if they find a reason and treat it there is lots of hope, wish you lots of luck.

katesav87 Fri 15-Jun-12 16:21:27

hi im sorry hope u dont mind me joining this thread. I am sorry to here of your loss. I to am going through my 3rd miscarriage. 1st one was a missed miscarriage then i went on to have my daugther who is 4 and then have had 2 miscarriages in a row. Im so confused and upset at the fact i feel i may never be able to carry another baby and am not sure if they will do any tests. I had a scan on wednesday and they could only see a tiny sac so they thought it may be to early to see baby but i started bleeding yesterday so went to the docs and my cervix was closed. Had my second HCG bloods this morning and called for results this afternoon and levels have dropped in 2 days which leads them to a miscarriage but they have asked me to do a pregnancy test on monday to see what comes up. I have had D&C with me 2 previous MC and now just sort of want it over but dont know how to go about this and who to ask for tests as really would like another baby. I have PCOS so my periods are everywhere but when i had scan on wednesday they said my ovaries were fine so am a little confused.

EvenIfYouSeeAPoppy Fri 15-Jun-12 18:18:23

oh jellybeans, what a rollercoaster you've been through! I've a friend who had two post-20-week losses and then 2 children with cervical stitches. I'm so glad it worked out for you too.

So sorry, kate sad If you are, sadly, miscarrying again, you should be able to push for tests. Good luck. Hang in there - even after 3 miscarriages the odds are in your favour, IIRC. Have you got Lesley Regan's book? I can no longer locate my copy - never imagined needing it again, tbh sad - but I remember it was very good and helpful.

katesav87 Fri 15-Jun-12 20:23:04

No I haven't I think I will buy it tho. Could really do with some ideas. I think my body was not ready to carry a child as I am going through extreme attacks of gallbladder pain and am waiting to have it out so I was very shocked I was pregnant but I knew I could cope with the pain if it ment having another child. Now I will have the operation and hopefully start trying when I have had it out but I am terrified. I think I'm never going to get over that fear. I just have to hope for the best.

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