What am I supposed to actually do?

[EuroShaggleton]

Hi ladies,

It's my first time on this board.

I'm pretty sure I am about to miscarry. I had a scan at 6+1 last week, following IVF treatment. Everything was smaller than it should have been and there was no heartbeat. Obviously because it is IVF, I am 100% sure of my dates. Since then, my symptoms have been fading and I have some mild cramping, so I am pretty sure the only thing holding back the bleed is the post-IVF drugs. I have another scan this week at which I fully expect to be told that it is all over and to stop the drugs.

The thing is, aside from my IVF clinic, I haven't contacted anyone about my pregnancy (I was planning to after the 6+1 scan) so I don't have a midwife number or anything. I'm just not really sure what I am supposed to do. Do I just let it happen at home (assuming the bleed starts naturally which I am hoping it will, given the cramping) and only call the hospital if it gets too much? Or should I call and EPU or my GP and let them know? I hate hospitals so have no desire to go to one if there is no medical need for me to do so (but obviously will if the bleeding or pain gets out of hand). But if everything is "normal" is there anyone I should tell?

Thanks.

[froggers1]

Hi - so sorry you are going through this. I had a miscarriage at 12 weeks a few yrs ago and first I went to the GP as it happened first thing in the morning but they asked me why I hadn't gone to A and E (I was in NZ)...I went home and then the bleeding got worse and so I went to hospital. I would phone the EPU in the morning unless the bleeding gets really bad..and they will probably ask you to come in for a scan again and take it from there.. xx

[LadyKinbote]

Didn't want to read and run, although I don't necessarily have any answers. Six weeks is a very early scan and it's also not unheard of to have some cramping, but I know that false hope is the last thing you need. I would speak to my GP in your position but only do what you're comfortable with. There's lots of support here if the worst does happen x

[MrsSpencerReid]

I would try epu for some advice, I had an early scan and was told I had prob got my dates wrong, I knew I hadn't cos I'd had a blood preg test which would have been before I'd conceived! If they can't see you I'd try gp and get some painkillers, the worst bit for me was before I passed the baby when I was having, I guess, contractions, if they can't/won't prescribe anything dont leave till you have a number to ring if it all kicks off at a weekend/out of hours, look after yourself

[EuroShaggleton]

Thanks for your responses ladies. I guess when it kicks off I will call a local EPU and see what they say. I think I will find it very difficult to say out loud. My urge is to just hibernate at home until it is all over.

I am coming to terms with the fact that the end is inevitable, but it is horrible - 28 cycles and a helluva a lot of tests, interventions and endless waiting for two and half weeks of happiness from positive test to horrible scan.

I am very sorry that most of the people on this board will have had to go through this. It is pure shit.

[BlackholesAndRevelations]

Euro, I'm so sorry you're going through this. It really, truly, is shit. I understand your wanting to hibernate, so perhaps do so unless you find the pain or bleeding unmanageable.

[LadyKinbote]

What exactly did they say after your scan? When I was in your position they advised a second scan after a few weeks (which sadly wasn't any better) but did they say that because you were certain of your dates there should definitely have been a heartbeat? It helped me to be told in no uncertain terms what was going on so I stopped holding out hope. I'm so sorry you're going through this, my situation was very different to yours. Do you have a partner or friend who could make any necessary phone calls? Be kind to yourself, it's a horrible, horrible situation.

[Northey]

What about asking the ivf clinic for advice? It sadly won't be an unknown situation for them, and they should have a good idea of the people who are best placed to help you in any circumstance. You could give them a ring, or ask them at the scan itself, if things haven't happened before then (and I agree with you that the drugs are probably retarding things a bit).

[TheAccidentalExhibitionist]

Euro I'm so sorry you're going through this and after such a long and hard journey to get here I'm going to give you the advice on the sad assumption that you are miscarrying, if you're not then please ignore.

Practically, you should notify your GP, even if it by telephone. It's not the same in all areas but when I had mine I couldn't self refer to EPU, it needed to come from the GP. EPU will help you make any decisions, the will give you a choice of waiting and seeing, medical management (a tablet) or possibly surgical management (a simple D&C under GA) although they may not prefer this option at 6 weeks. Whatever you chose, they will scan you regularly until your womb is clear.
Essentially what happens next physically is up to your body.
At 6 weeks you will have some cramping and something akin to a heavy period, possibly very heavy for a few hours. Some women don't bleed at all and need intervention (medical management) to get them going.
In terms of practicalities, buy some heavy pads and some painkillers, takes some time off work and get some support from your partner if you can.
We are here when you need support.

[EuroShaggleton]

Lady they said the sac was about half the size it should be at that stage, and there was no foetal pole or heartbeat. They are rescanning me on Thursday and in the meantime I have been told to continue with my post-IVF drugs, but in the past few days all of my pg symptoms have been disappearing and I have been cramping, so I'm only really bothering to go to the scan to get confirmation that I should stop the drugs.

Norfy that's good advice to ask at the clinic. I will probably do that.

Accidental thanks for the practical advice. With medical management, is there a 3 month waiting time to ttc again? I seem to remember reading that somewhere. I would be very reluctant to go down the ERPC route as I remember my own mum being horrendously ill with an infection after one when I was a child. She almost died and it really scared me. I am hoping that once I stop the drugs it will just happen, as I am already cramping.

I really appreciate the support and advice - thanks ladies.

[TheAccidentalExhibitionist]

Euro ERPCs are generally safer nowadays. I say that cautiously because I've had infections and a perforated uterus from ERPCs although I've had several. No three month wait until TTC as far as I'm aware unless the advice has changed very recently.

The important thing is that you do whatever feels comfortable for you. It does sound like the MC will start naturally once you stop the drugs. They will probably want to can you regularly or until your womb looks clear.

I'm so sorry you're having to go through this, it's utter shit isn't it?

[EuroShaggleton]

Thanks Accidental. You are probably right. I'm finding that my mum's experience is really affecting me. I can remember going to the hospital with her and my dad for a scan when she got bad news. And then her being very, very ill. I've still never been to a pregnancy scan that brought good news!

Maybe it depends on what drugs they use for medical management. I think one is toxic to the foetus for 3 months but maybe there are other drug options available.

[delilahbelle]

Euro it totally sucks to be on this board, but I hope you get through it.

If your second scan isn't positive and you do have to stop the drugs, hopefully the bleeding should just be like a very heavy period. Get in a variety of painkillers and hot water bottles etc. I had a LOT of cramping and clots etc with previous very early miscarriages after IVF, in total bleeding for about 10 days. Test after the bleeding has stopped, and if negative you don't need further treatment.
I would let your GP know, just in case you need a referral to the EPU, and also ask for your iron levels to be checked.

Still keeping my fingers crossed for you on Thursday though.

[EuroShaggleton]

Thanks delilah. 10 days doesn't sound too horrific.

[LadyKinbote]

Just to add that I had an ERPC which went absolutely fine (with the nicest anaesthetist in the world!). Keep us posted and look after yourself x

[teaandchocolate]

I'm so sorry you're going through this. Especially after IVF it must be absolutely heartbreaking. I just wanted to add my experiences in the hope that it puts your mind at rest. I've had one natural mc at 7.5 weeks which was just like a period and not particularly painful or heavy. I realise I may have been 'lucky' but it wasn't that bad physically. I've also had 2 erpcs for missed mc at 12 and 9.5 weeks. Both were absolutely fine and I had no problems during or after. I've since had a detailed saline 3D scan and no scarring/adhesions were found from the ops. So try not to worry about that side if things if you can. I really hope you are wrong though and that everything is ok. Fwiw I also have a dd who was the result of my second pregnancy so it seems it is possible to have mc & still have babies without doing anything differently. Although I appreciate you had IVF so it is different. But please don't lose hope.

[EvenIfYouSeeAPoppy]

Oh, Euro What a difficult thing to go through.

I can reassure you on the ERPC front if it's any help. I've had three (four mcs in all). They were all fine, not nice to go through obv, but over quickly, uncomplicated, no infection or pain.

I will hope you don't need this reassurance, but understand very, very well the reluctance to build up hope.

[EvenIfYouSeeAPoppy]

Oh, and after ERPCs 1 and 2 (which were in consecutive cycles - i got pg again straight away after the first - the ERPC definitely didn't cause that other mc) I conceived again a few months down the line and had dc2 that time.

[EuroShaggleton]

Thanks ladies. That does reassure me a bit about the ERPC.