Hi guys just thought I’d let you know some info I got from the recurrent miscarriage clinic appointment that I went to yesterday, which you may or may not be interested in. It’s a really long message, but I wanted to let you know in case any of it could be any help. If you can’t be bothered to read the whole thing, the take home headlines are: aspirin is definitely recommended and be as informed as possible before you go to an appointment.
So first steps were an ultrasound scan and blood tests (the blood tests were for autoimmune diseases like lupus). As I’m actually pregnant again already he said it wouldn’t be appropriate to do these, which is fair enough. As I’m taking high dose folic acid, I hadn’t started low dose aspirin yet as I wanted to check whether it could interfere with this at all. So I asked about whether I should start the aspirin (75mg) and he was like YES! He got very excited and said this was basically the most important thing, he said low dose aspirin is more or less the only thing that there is clear evidence to back up that it does help with miscarriage (even if no clotting disorders etc have been identified). He said I should absolutely start on it ASAP. So this may be something you guys want to consider- I don’t know if there are any conditions that could contraindicate the use of 75mg aspirin and I didn’t ask if it was best to start it while TTC or only when you get bfp, so you may want to do a bit more digging especially if you have any other conditions, but as I say he was very, very enthusiastic about it.
I asked if there was anything else I could use now that I am pregnant that might help things along- I said ‘like progesterone and thyroxin’ as these are things I’d seen mentioned on various forums and because in my office I sit near the research midwives and one of them mentioned to me that they had just finished a study that gave women who had a history of early bleeding/miscarriage progesterone. He said that thyroxin would probably only be useful if someone had thyroid problems. Re progesterone, he said the results of the study weren’t out yet and previous evidence that it’s helpful is not conclusive BUT he said that when women have IVF, they are routinely given progesterone for the first few weeks to help with implantation and early pregnancy. He said that this in itself would suggest that there are benefits to it, and that they had prescribed it previously in this clinic. He said that if I understood that there wasn’t currently any concrete evidence for its use, but there was also no evidence to contraindicate it, then he would be happy to prescribe it for me, but only because I’d mentioned it myself… So I’ve now got a letter to take to my GP asking them to prescribe progesterone pessaries (for the vag) and heparin injections, both of which need to be taken twice daily until 14 weeks when you start weaning yourself off them. The heparin is a blood thinning agent and also does something else that I’ve forgotten, I’m not exactly sure why this goes hand in hand with the progesterone but apparently it does…
I asked about the NK cells theory. He had heard of it and explained the theory for the benefit of my husband (basically that some women have higher levels of Natural Killer cells in their uterus than other women, which may be killing the embryo basically). He said there definitely could be some truth in it but at the moment this is not looked into/treated on the NHS (which I knew) but he said that one of the private places that does it (Coventry) had emailed him recently to ask if he had any women with recurrent miscarriages that he would like to put forward to be part of their research trial (i.e. you’d get the private treatment for free) I’d read it costs a few thousand pounds, so I was like errrr yes please! But I said I supposed I wouldn’t be eligible now as I was already pregnant and he said he’d find out.
I asked if I could take the normal pregnacare etc while I’m taking the high dose folic acid (as I’d read you couldn’t else you’d be overdosing on folic acid) but he said it was fine.
I asked about the chiropractor and he said he can’t see what good that would do.
I asked about the “unfussy womb/hyperfertility” theory and he said he’d never heard of it and even if it was a thing, he didn’t know what could be done. I mentioned IVF as then you’d only use ‘good’ embryos but he said the rates of miscarriage among IVF are no better than in spontaneous pregnancies so this wouldn’t support the use of IVF in women with “hyperfertility”.
I asked how careful I should be with caffeine as I really do enjoy my tea and he said 2 cups a day should be nothing to worry about.
I asked if the fact I’d had a bad reaction to a mosquito bite a day or 2 before my third miscarriage could have caused it and he said if your inflammatory markers are up this can cause preterm labour but mostly in the second trimester so he didn’t think that would be the cause at 7.5 weeks.
He asked me where I’d learned about all these theories from and I said online forums where women write about their experiences of miscarriage!
So basically I’m going to be on a cocktail of drugs for the next few weeks- high dose folic acid, low does aspirin, progesterone pessaries and heparin injections but on the plus side I will allow myself to have 2 cups of tea!!
He was a registrar not a consultant (but the midwives had said I’d be better off with a reg as they are more enthusiastic and have something to prove unlike a consultant) he was a really nice guy and he patiently answered our long list of questions. My only concern was that he wouldn’t have said anything about the progesterone or the NK cells unless I’d mentioned it, which doesn’t seem fair to people who may be less informed/wouldn’t feel they could mention something they’d read online.
Sorry for the very long message!