Recurrent miscarriages. Posting here for traffic.

[Sallyjo27]

I’m currently going though my 4th miscarriage this year. Neither I nor my husband have any children from previous relationships. Miscarriages are shit but especially this time of year. I’ve been tested for blood clotting, thyroid and progesterone all were normal. I had an ultrasound scan after the 3rd miscarriage of my womb, ovaries etc and AMH was tested and results all normal. DH has had a sperm analysis results were all normal. I was given progesterone and aspirin to take this time and it hasn’t worked. My 3rd miscarriage was tested and they couldn’t find a reason for the miscarriage. I don’t know what else to do. I’ve been referred to gynaecology but there’s an 11 month wait so the tests we did have were through a private clinic. I don’t mind paying for the tests as I just want to know what’s wrong, after 4 miscarriages there must be something. I feel like giving up. I should mention I live in South Wales and there are no recurrent miscarriage clinics here. Any suggestions of tests etc would be greatly appreciated x

Forgot to say I’m 28 don’t smoke or drink, probably too overweight but planning on changing that in January.

I'm so sorry. I had the same 7 miscarriages and had a tfmr at 18 weeks in october. Now I am seeing a different consultant who despite all the tests showing nothing wrong has prescribed me with: strong folic acid, steroids, injections to thin blood and progesterone because she said I might as well try it all.
I was a bit miffed as it took so much heartbreak but maybe yiy could ask for a second opinion?

@disconnecteddrifter thank you for your quick reply! I am so so sorry for your losses. I was on 5mg of folic acid anyway because of my bmi. I’ll definitely ask about steroids when I speak to my consultant in the new year. I change clinics if this consultant still thinks there’s nothing wrong after more tests x

Yes I think its wise. As my new consultant said there is limited proof that any of it does anything but trends show it migjt help. After 4 miscarriages I know it's worth trying anything. I hope it works out for you

I'm very sorry to hear this.

Which blood clotting factors have you been tested for? What was the rationale for the aspirin?

Could you ask for a referral to genetics for karyotyping for you and dh? You said nothing was found in the 3rd mc but a balanced translocation is possible. I might be looking into a biopsy for NK cells too IIWY, although their role is debated to say the least.

I've had 6 mc but they were interspersed with 3 live births, so somewhat different situation, and I have to say a definite cause was never pinpointed. I do have multiple clotting factors but have carried to term without heparin and miscarried with. I was on it throughout my final, successful (horrid word) pregnancy, though. A translocation was thought pretty likely given the pattern in my case, but our karyotypes were both typical so that wasn't it either. I think the elusiveness of a definite cause was one of the more difficult things associated with it all, and I can empathise with your bewilderment

@disconnecteddrifter it definitely is! I’m willing to give anything a go!

@AndThenTheDayBecomesTheNight to be honest I’m not 100% sure all I know is it was a thrombophilia screen. The consultant basically said i could take it if I wanted to because it wouldn’t cause any harm.
I will be asking for Karyotyping for both myself and DH. The clinic im with won’t test for NK cells so I might try and find a clinic that will even if it’s just to eliminate that as a cause. I am so sorry for your losses x

I had 3 in quick succession, followed by DD who was an iugr pregnancy & prem but now a happy healthy 16m old.

What was different about my pregnancy with her:

I read about MTHFR and stopped taking anything with folic acid in. I took only l-methyl folate (the bio available form) and vitamins that contained no folic acid.

I had acupuncture before conceiving and through pregnancy. I know its woo and I dont understand it but DD is here so ?

I took 150mg of aspirin a day, not 75mg as I was originally advised. A private consultant told me the latest research indicates 150mg is better.

Nb I had also tests for clotting & thyroid and hormones etc but nothing came up on any for me either. Nothing on scan of uterus and ovaries.

Good luck OP and I'm so sorry for your loss.

I had three miscarriages between my daughter and my son for no apparrent reason when I got to 16/18 weeks I just lost the babies it was heartbreaking I really feel for you.
I changed consultants and he told me next time I was pregnant to see him when I was 10/12 weeks and he would insert a stitch to the neck of the womb because after my daughter had been born he had found the neck of the womb was weak when the expected baby started to put on weight I could not hold it so the stitch was suggested.
Ask your consultant about it when you see him,sending all the luck in the world.

Btw one of my miscarriages I had seen a heartbeat at 8wks, plus a second was tested for genetic problems and came up fine. There was never anything found.

Oh and DD iugr was caused by placenta insufficiency - I still maintain the same underlying problem (whatever it was) caused that AND the miscarriages.

OP, IIWY I would ask (or have a look at the test reports) to see what conditions were covered in the clotting screen.

As I said, the role of NK cells is debated, and they are always present to an extent - my biopsy found them but not at a level considered problematic.

So sorry to read this. I was at the recurrent miscarriage clinic in Liverpool (women’s hospital) but I live there. Third miscarriage was tested and had trisomy 15, so I’ve always presumed something was wrong with the other two as well. Never a heartbeat at the early scans ( had early scans as had years of infertility). Already had one DC and they ruled out a whole list of things but I was still prescribed a higher dose of folic acid and aspirin with fifth pregnancy which produced DC 2. I was never entirely sure why I took those - I think it was just in case ?? After mc 3 the wonderful consultant told me in response to my question whether I had a chance ( then 39) that yes, I did, and that it was likely to be a case of mostly poor eggs but occasionally some good ones. He made it clear that I needed to think hard about whether I could cope carrying on trying - he asked whether I was finding it harder or easier to cope with the mcs - in my case it was getting easier , I was actually getting used to them. Is there any chance you can get referred to a recurrent mc clinic somewhere? It was very well set up in Liverpool ( I’m going back over 10 years now).

Is there anyway for you to find out about genetic abnormalities? E.g harmony test if you are getting to 12 weeks. Big difference between miscarriages caused by genetically abnormal embryos- either because of poor quality eggs/ sperm and miscarriage caused by something else and what helps in in one case won’t make any difference in the other.

I had three before dd, then when I tried again another miscarriage and then got pregnant with dd2. You don't say over what period of time these have happened? With me it was every month I had unprotected sex and 'tried'. I've read that actually recurrent miscarriages can happen to super fertile women. They allow eggs that shouldn't normally implant get further than other women do. This makes some sense to me based on my experiences and how quickly I've got pregnant

I had 5 miscarriages- nothing was found at the tests the recurrent miscarriage clinic did.

You could look at the following tests

• Sperm DNA fragmentation
• NK Cells - treatment is steroids but nigh on impossible to get them to agree to prescribe it due to covid
• Karyotyping

We never got answers so moved onto IVF. My egg quality was shown to be poor which sort of gave us our answer x

Hi all, I’m so sorry for your losses and really appreciate your replies. To answer some of the questions my first miscarriage was a missed miscarriage at 7w4d and we found out at 9 weeks. My second miscarriage was at 4/5 weeks so was very early, the third was a missed miscarriage at 8w1d and we found out just before 9 weeks and my current miscarriage was found at 8weeks and the heartbeat stopped at 6w3d even though we’d seen a strong heartbeat at 6 weeks. All the miscarriages I’ve had have been since February this year. A shit year made even worse by these. Im really thinking of giving up ttc and just accepting that it isn’t going to happen for us. I’m fed up of the heartbreak and the waiting in between scans. Sorry to be so depressing and I really do appreciate all the messages with suggestions for tests etc x

I should add we’ve been lucky in the sense that when we have “tried” I’ve gotten pregnant within a month or two x

Sorry I’ve not read all of the replies so I apologise if I repeat something that’s already been said.

I’ve had three miscarriages. On my third pregnancy I’d taken low dose aspirin as my midwife said it wouldn’t hurt to try but still ended in miscarriage, when I went to the recurrent miscarriage clinic they said they advised against that. All my tests came back as normal and I was told it was “bad luck” and to try again. I’d been researching prof Quenbys protocol so I’d emailed my consultant and asked if we could try what she did (progesterone from positive test until 10(?) weeks and daily dalteparin/fragmin injections from 6w until birth), I’d told him that if he didn’t want to that would be fine but I’d be self referring to her to begin her treatment. He replied and told me that whilst her approach wasn’t proven he would approve it since the fragmin wouldn’t cross the placenta to the baby so there’d be no harm. That protocol resulted in a daughter for me and same again 2 years down the line.

For me I’m not sure if it was the fragmin and progesterone that worked or if it Could possibly have been down to time. I fell pregnant first month trying every time with all the miscarriages, due to the length of the pregnancies and the time awaiting hospital tests by the time I fell pregnant with my daughter I’d been off the pill 12 full months. After being on the pill for 13 years previous to this I sometimes wonder whether I needed the 12 months for it to be out of my system. Or maybe I did have rotten luck. Or maybe the protocol did work?!

I found the recurrent miscarriage board here on mumsnet very helpful, it was there I found out about prof Quenby (she also does/did a womb scratch as part of her clinic which I didn’t do - I just followed the meds) and there was also another doctor Who followed a different protocol who got good results so for knowledge that’s definitely a good place to look. The approach I followed may now be outdated as this was 6 years ago now but I don’t doubt there will be other good info if that’s the case.

I’m really sorry you’re going through this, I hope you’re looking after eachother and being kind to yourselves