3 MCs, no known cause. What next?

[Churchill20]

Hi There, I'm 35 yo and fit and healthy. Husband is 40 yo and also fit and healthy. we have no children between us. In the last 2 years we have had 3 early missed miscarriages. With the last miscarriage, it took us a year to conceive- so a long wait. All found with no heartbeat at 7 weeks.
I have been referred to the Recurrent Miscarriage Clinic at kings College Hospital and all blood results (clotting issues, APS, thyroid), karyotyping and 3D scan have come back as normal. So nothing they can do.
Has anybody else been in this situation? What did they do?

• is it worth trying to get referred to St Mary's Recurrent miscarriage clinic- do they do other tests?
• should I try taking low dose aspirin with the next pregnancy, even through I don't have a blood issue?
• should I try to get a referral to the Infertility Clinic to try to get pregnant faster (as it took a year last time)

I'm exasperated!!
Thank you!x

[LAURAPAX]

Realise this is an old thread but similar position. How did you get on I hope it all worked out whatever way that looks like xxx

[Getintogear963]

Hi Churchill20
I have just seen this. It’s similar to my situation. Know it’s an old thread. Just wondered if you ever got there with your baby trying? I am now 45 and with a record of 6 losses and a failed IVF between the age of 39-42.
I do hope you had some luck finally. x

[MoominMamaBear]

@Churchill20 I’m so sorry for your losses. I’ve had 3 miscarriages, then DS1, then another miscarriage, then DS2. I went to see Mr. Christopher Steer at the Sloane hospital in Beckenham after the first 3, and it turned out I had anti-thyroid antibodies (I had undiagnosed Hashimoto’s Disease) and high NK cells. Mr. Steer put me on low dose aspirin, progesterone suppositories, and steroids. The 4th miscarriage happened because I couldn’t get a prescription for the drugs I needed in time. I’d definitely go for the NK cell testing to see if that is a reason. Good luck.

[makingmammaries]

I had a MC in my early forties. A previous pregnancy had been successfully supported with progesterone when my hormone levels seemed to be dipping (it was in Switzerland, where you get a blood test and ultrasound every month, more often if you report any problems) and after the MC when I was pregnant again and spotting started I requested and received progesterone - it would have been around 8 or 9 weeks. That baby is now a healthy 6.5 year old.

[Likethebattle]

Is your husband a positive blood type and you negative? Could it be rhesus disease? My friend lost a few pregnancies that way.

[Churchill20]

Hi Everyone, I just wanted to update you and hopefully get some more advice from you please.
Last week I had my 4th missed miscarriage- same old story- went for a 7 week scan and there was no heartbeat. I had a SMM the next day (my 4th 🥺).
It doesn’t get any easier does it? I feel traumatised. It is affecting every corner of my life.
I now need a plan. As I am apparently ‘unexplained’ but this cannot be down to chance. I think I should investigate NK cells and see if this is my problem. It seems that the 2 best people to see are Quenby and Shehata. It looks like Dr S is much more expensive, is he worth the extra fee or does he just charge a higher price for the same thing?
Thank you for reading x

[AnneLovesGilbert]

Hey bertie hope all’s well with you!

OP, bertie and lisa and I were on a ttc after rmc thread which is still going and a huge source of empathetic support. Nearly all the women on there, who had every permutation of loss, got our rainbow babies in the end. Being able to chat to people in the same boat who truly get it helped us all through the toughest of times.

[BishopofBathandWells]

@LisaSimpsonsbff I definitely think stress was a huge contributing factor for me. I can see why a PP felt that her mindset re: having a stable home had a similar impact.

Of the three miscarriages I had, the third one was tested for genetic abnormality and came back normal. I remember it particularly as the (generally lovely) doctor we had put the "conception material" in a specimen jar and left it next to me on the desk. By this point my sense of humour was quite dark, and my DP and I commented that we didn't think much of his paperweight. The poor nurse practically broke her neck running across the room to remove it.

The doctor had suggested heparin as the next port of call. But as I said, I reduced my stress levels considerably - it wasn't a conscious decision, it just fell that way - and my next pregnancy went all the way through. My DD is just over a year old.

[WhatWouldLeighAnneTwohyDo]

Churchill, you've had lots of good medical advice, and what I'm going to say is an approach of last resort, but my story might be interesting even so.

I had an accidental pregnancy in my 20s. I was in very precarious housing and even though I was devastated by the idea of a termination I felt like I had no option. Fortunately, before it came to that, I had an early MC.

Years later, in more stable circumstances, I conceived and gave birth to DC1. After that 3 early MCs. Then DC2. Then 5 more early MCs. Then DC3. I tried for DC4 but had 3 more MCs and was in my 40s by then so I gave up TTC. In between DC2 and 3, we had all the testing and nothing showed up.

What's interesting, though, is that the 3 cycles in which I conceived a viable pregnancy correspond with the 3 occasions in my life when I've signed a contract on a house. I think I was so appalled at the idea of having a baby when I was borderline homeless all those years ago that that first MC was psychologically induced and that my body continued responding inappropriately to that anxiety except for the few times when my domestic security was literally right in front of me.

I know you will obviously want to look at physical causes first, and quite right too, but it might be useful also to consider the possibility of psychological factors in your history. The mind has a really powerful effect on the body imo.

I wish you luck.

[BertieBotts]

Anne and Lisa

It might be worth asking if you and DH can be karyotyped directly if they have not done this, as genetic issues may not necessarily show up in all miscarriages if for example you had one which had miscarried anyway. But it's quite a low chance, as chances are if one of you had a genetic issue it would be the cause of most of your miscarriages. You'd have a stronger case for this if one of you has family history of miscarriage, birth defects, stillbirth or infertility. Interestingly DH's was picked up by amniocentesis before he was born as his parents were older with high risk for Down's Syndrome.

[Lauriestory]

I was in a similar situation - 3 missed miscarriages, all around 8/9 weeks.

I then had two successful pregnancies in a row to have my children - in those pregnancies I took an aspirin every day from BFP and used progesterone pessaries every day from BFP (these things on the advice of the recurrent miscarriage clinic).

Testing was done on tissue from the baby after my third miscarriage and they found no genetic issues or obvious reason why.

Wishing you lots of luck in the future. I didn’t believe I would ever have children, I genuinely didn’t. Don’t lose faith, they can do so much these days. Fingers crossed for you.

[AnneLovesGilbert]

I’m so sorry for your losses

I had 5 mcs and all my tests through the RMC came back negative but my consultant has his own regime and was happy to throw increasing numbers of things at me till it worked and my sixth pregnancy is now my DD. With this one I had aspirin, 2 fragmin injections a day, steroids, progesterone suppositories and a dose of antibiotics from bfp. Can’t remember why the ABs and I’d had everything but the steroids in previous pregnancies which then failed. I did ask as it this last one progressed what he thought it was that was making the difference and he said honestly we’ll never know. But his theory is that people with recurrent losses possibly have a blood issue but that current testing can’t pick it up and he’s had huge success with blood thinning injections even where’s there’s no diagnosis of sticky blood. I’m pretty sure if we’d lived anywhere else I wouldn’t have been put on all those things but after so many mcs I was happy he was happy to take the kitchen sink approach and throw everything at it.

It’s absolutely true as others have said that there’s no reason why your next pregnancy will end badly and every reason it was the shitty “bad luck” but I well understand how the prospect of just keeping going hoping things will be better next time when there seems to be nothing to fix is terrifying. We had some very dark days and testing on my two mmc ones showed perfect babies so I knew it was me and that was a particular kind of awful.

[WeepingWillowWeepingWino]

Hi, yes, they did (including an x-ray of my womb which was a special treat). None of which came back with anything really so I was given progesterone to take for the first 3 months - and I was successful (DD now 9!) but not with 2 subsequent pregnancies (I couldn't afford to go back again).

I really can't remember much about it now!

[Churchill20]

WOW!! I'm blown away by all your message of support and advice! Thank you so much- I hadn't expected this and so quickly too :) What a community.

NewAccount270219 & Mamabear12 thank you I will look into NK cells.

LittleAndOften & NoIDontWatchLoveIsland - I was having fertility acupuncture at Zita West but stopped when I miscarried. Not sure whether to start it again as it is very expensive.

WeepingWillowWeepingWino - interesting- did St Marys offer any different testing to Kings?

CheeseIsEverything & LisaSimpsonsbff- ive been tested for genetic abnormalities- they did karyotyping on the products of conception and the result was normal.

Caucasianchalkcircles- the 3d scan ruled out PCOS

juneau I think my weight is fine- BMI of 22

Thank you everyone!!
I'm going to look at Coeliac disease, anti thyroid antibodies, NK cells and see what happens. I might even see if I can try Clomid to try to get pregnant faster- i have irregular periods, which doesn't help.

Thank you for all of your support! xx

[NoHolidaysforyou]

I would definitely take low dose aspirin in your position. I would take it now before I even conceive because it's about thinning your blood so that a pregnancy can happen/survive.

Other things I would do:

1. Do not take any NSAIDs anymore, so no nurofen or ibuprofen. Conception depends on inflammation. NSAIDs are non-steroidal anti inflammatory drugs. Basically the ovary becomes inflamed in order to release an egg and if you take NSAIDs this could be stopped or could jeopardize your pregnancy.
2. I would start pursuing fertility clinics (UK or abroad). They usually want 2 years of trying and you have had 3 miscarriages in 2 years. You also don't want to waste time because the success rates for women over 36 are very different to those who are under. Its just an unfortunate thing that egg count could already be very low or you could be producing eggs with chromosomal issues which gets more likely with age.

[CheeseIsEverything]

You're right BertieBotts, I missed that in the OP apologies OP!

[BertieBotts]

The test for balanced translocation is karyotyping, which the OP has already had. Otherwise I'd suggest that too as DH has one and it's the cause of 3-5% of recurrent miscarriage cases apparently.

[NoIDontWatchLoveIsland]

Ps if it took you a while to get preg at all, get your egg quality/reserves checked. If they aren't great (not that rare at 35, sorry) you may get on better with IVF.

[NoIDontWatchLoveIsland]

Hugs. I have been there. All i can say is keep trying - after 3 mcs last yr (pre 12wk), I'm now pregnant & nearly half way & crossing everything.

The only differences:
I'm taking low dose aspirin (altho I was for mc number 3).
I'm not taking any supplement containing folic acid, I'm taking a 1000mcg dose methylfolate instead. Google MTHFR gene.
I'm having accupuncture.
I've had very regular checks and scans since 6wks (part of Lesley Regans approach is regular monitoring).

[Biffsboys]

I had 4 mc - during my 5th pregnancy I took half an aspirin and injected heparin every day . It was just as a trial as tests came back with no reason . I had a baby boy at the end of that one x

[Caucasianchalkcircles]

Sorry to hear of your losses Churchill. It really is shit isn’t it. I had 2 miscarriages, 1 conceived naturally, the other with clomid, then a live birth with ivf then a further miscarriage.
It took me 7 years to have healthy ds1 with all this. Had another ds2 again with ivf following 3rd miscarriage supported with progesterone and s/c heparin.
Not read the whole thread but I have 1 polycystic ovary according to scan (other seemingly normal). I was having regular periods but this scan showed I was ovulating early on in cycle at day 10 so hormonally a bit up the shoot. I’m presuming you’ve had bloods and us to exclude pcos.
This can seriously impact on the womb lining and so prevent healthy implantation.

[CheeseIsEverything]

In my local area they will do this only if testing on the products of miscarriage show it might be an issue

Ahh, I didn't have to do this but then my mother had similar problems so perhaps they took this as evidence enough in my case to refer without the need. I still think (despite how awful the above sounds) it may be worth OP looking into if all else fails. If it is anything like this, there is lots of specific support available which I found completely invaluable.

Really glad to hear you never had to do this in the end Lisa

[juneau]

Similarly, if you are underweight, it's worth gaining so that you're a healthy weight for your height. I'm not making any assumptions btw about your health or lifestyle!

[juneau]

How is your weight and your general lifestyle OP? The poster above who overhauled her health is right - if you're overweight, stressed, tired or drinking/smoking/taking drugs then you should address all of those factors and so should your DP. Being a healthy weight and getting rid of toxins from your system can really help. I know lots of people get pregnant who are overweight or who do drink or whatever, but if you're struggling this is something that is within your power to change. Join WW or something if you need help/support.

[LisaSimpsonsbff]

I don't think this is something that is routinely offered, I had to ask as I knew there was talk of it being in my family so maybe see if this is something they can refer you for?

In my local area they will do this only if testing on the products of miscarriage show it might be an issue - I had a fairly horrible conversation about keeping MC no 4 in a tupperware to go for testing, and the logistics of this. I was very lucky that there was no MC no 4, but it was an option.