what can i ask for?

[picklebum2011]

Hi I have posted on here before and always been comforted. My history in a nut shell, two missed miscarriages Feb 09 and June 09 heartbeat seen once during June pregnancy, sonographer said it was slow though. The first time I don't know as thought all was great until brown bleeding at nine and a half weeks. The next was my lucky one, we had our gorgeous daughter in July 2010. We then tried again fell first time again only for it to end in a missed miscarriage June this year. During thus pregnancy we saw heartbeat twice, St six weeks and at seven and a half weeks. The next scan at just before ten weeks showed baby had died around nine weeks. I just want to know why? How can an apparently healthy baby just die with no rreasdon? We were ref for testing and saw someone who did a blood test not really sure what for and a scan, all was normal but she said I should take aspirin should I fall again but only after a heart beat detected. I'm unsure of this as I thought you only took aspirin in pregnancy if you had been diagnosed with a blood clotting disorder. If my tests didn't show this then I'm not sure what the reasoning is. We were supposed to be trying again but we've lost our nerve, too scared at the moment of going through the hell again, you never get over any loss as it is! I just feel so hopeless, I long for a second child, just one more.. It is nearly my due date and I had so hoped to be pregnant again. My husband has arranged for us to go back to see specialist and this time I want to be ready with a list of questions etc. So please please can anyone help? What can I ask? Which tests can I ask for? This next pregnancy (should I be lucky enough to fall again) has to be our last go as I can't keep going through this, so I want to given it every chance. If anyone knows of any private testing anything, help, suggestions anything. Thank you so much.

HI Pickle. The first thing I'd be asking is what was tested already, sounds like the explanation you were given was inadequate to say the least! There is a pretty standard recurrent miscarriage work up, though normally you have to have had three consecutive miscarriages to trigger that process. I'm not clear whether you went private to see someone in the first place or whether GP referred you?
I paid for a private appointment after my third miscarriage (wasn't 3 in a row so didn't qualify on NHS) then my GP performed a lot of the tests the specialist recommended.
Standard work up would include - a scan for you to check your lining, ovaries and for any anatomical abnormalities (uterine septum, fibroids etc), blood tests for you both for karyotyping (checks for genetic abnormalities you could be passing on to a baby) whole raft of blood tests for you for clotting disorders/ sticky blood / thyroid / diabetes, cycle day 2 hormone levels (FSH/LH) and potentially day 21 progesterone. If you're an old bag like me, Antimullerian hormone test to check ovarian reserve.
I had nothing found on that lot and then had another miscarriage, which was tested as genetically perfect. I then went to see Professor Quenby at the implantation clinic in Coventry and had uterine biopsy which showed I had high levels of NK cells. I have been treated with steroids, clexane and progesterone and am 13 weeks pregnant (with everything crossed).
All my failed pregnancies ended between 8-10 weeks, several times after we had seen a heartbeat. I often had slow heartbeat/faltering growth, which is typical of implantation failure. I think that pregnancy loss due to chromosome abnormalities typically gives an earlier loss, which is why your chances of MC after seeing a heartbeat are normally quite low.
Prof Q (and St Mary's which is the national centre of excellence) both advise against taking aspirin unless you have a diagnosed clotting disorder, in which case you almost certainly need heparin anyway.
I recommend Prof Regans book "Miscarriage - what every woman needs to know" and "Coming to term" by Jon Cohen. I also have a copy of "Is your body baby friendly?" which is about autoimmune causes of miscarriage, but it's not an easy read. I'd be happy to pass on my copies if you PM me your address. There's also a very interesting Horizon documentary about RMC testing at St Mary's. Make sure you have the tissues handy though!
Come and join the RMC thread on this board as well, it helps to have company.

Thanks so much baking for such as thoughtful response. I don't think I was in the right frame of mind to take in what I was tested for as it was so early after our loss. I just remember her saying you'll be fine next time and other unhelpful things, though I'm sure she meant well.
I watched the documentary was brilliant and yes definitely needed the tissues. I have prof regans book but never felt ready to read, I am now. Feel all fired up now. Next appointment 9th jan fingers crossed we can then move forwards. Thank you again.

Thanks so much baking for such as thoughtful response. I don't think I was in the right frame of mind to take in what I was tested for as it was so early after our loss. I just remember her saying you'll be fine next time and other unhelpful things, though I'm sure she meant well.
I watched the documentary was brilliant and yes definitely needed the tissues. I have prof regans book but never felt ready to read, I am now. Feel all fired up now. Next appointment 9th jan fingers crossed we can then move forwards. Thank you again.