Recurrent Miscarriage

[Saraa23]

I had a third miscarriage (in a row and within 10 months) 2 weeks ago. Because we have had 3 in a row this is classed as recurrent miscarriage and affects 1% of couples.

My first happened naturally around 5 weeks.
My second was a heterotopic pregnancy resulting in emergency surgery to have one of my tubes removed at just over 5 weeks and an SMM at just over 10 weeks.
My third happened a couple of weeks ago. I was 9 weeks exactly.

We can get pregnant really easily, but every time I have started to spot around the 5 week mark. Does this mean something? Why can I only get to a certain stage every time?

Because I've had 3 in a row, we are being referred for testing on the NHS. We have been told we will have to wait between 6-8 weeks which is fine. Well it's not. There's so much waiting. I want to know why this has happened now, but understand these things take time and my body needs to get back to normal before the tests can be done.

I'm now researching online, trying to find as much information as possible.

Has any got any success stories they can share with me to help keep me positive?
Has anyone been to any clinics they would recommend?

Thank you,
Sara x

Hi Sara @Saraa23 I'm very sorry for your losses ❤️ it's heartbreaking.

I'm under a recurrent mc clinic having had 2 mmcs this year. I'm also under a fertility clinic as it took us nearly 18 months to conceive the first time, plus I'm 36 now, so my consultant referred us on and we were accepted.

I'm under a Tommy's clinic and managed to get a cancellation appointment (wasn't due to be seen until January!) I had my first appointment last week and had some blood tests and back in the new year for more and follow up.

I've been reading the book Miscarriage, what every woman needs to know but Professor Lesley Regan and its been very helpful. I'd highly recommend it. It helped me prepare for my appointment and the consultant asked me what I thought was happening and what I'd heard of as causes of rmc and he went through everything in detail and really listened to my concerns.

I think my issue is related to sticky blood / blood clots, both my babies stopped growing at 5+ weeks and I mc at 9 weeks so will need to see what the bloods say.

I feel better knowing I'm being investigated so hope you feel the same when you get seen.

We've put ttc on hold until December as I'm also having a hysteroscopy and fibroid removed then as part of my fertility investigations. After my first mc I threw myself into ttc again it's harder this time to not have that focus but trying to focus on me and being as healthy as possible.

Hope you're recovering as well as can be expected, be kind to yourself xx

Hi VenusStarr,

Thank you for taking the time to reply. I’m so sorry to hear about all that you have been through. It’s just so unfair. However, I’m glad that you are being tested so they can get to the bottom of it so you hopefully don’t have to go through it every again (that’s my hope too). I actually read that book and it was great. I took lots of notes and learned a lot. I try to be careful what sites I research on as some things online can be inaccurate so it was reassuring to know everything I was reading was factual.

Can I ask why you think it sticky blood?

We’re also putting it on hold (until next year) until after the NHS tests (initial bloods booked for 21st November), and depending on the outcome of those, may have additional private testing done. In particular uNK cells. I’ve an appointment with my GP next week and I’m going to ask to be referred to Prof Quenby’s clinic and I have all the info for her colleagues clinic for uNK cells testing. I really hope it doesn’t come to that, but it’s good to be prepared and have all the information if it does.

Sara x

@Sarraa hello! I'm so sorry you've gone through that. I had the exact same thing happen to me last year - 3 MC in the space of 12 months. One at 9w (we'd already seen the heartbeat) and the other two at around 5w (the hosp thought the last one may have been ectopic).

The last one came to an end last Christmas and although the HCG took a stupidly long time to leave my system, I was referred to the recurrent miscarriage clinic and in February had all the tests. They look for a few things but the main ones I can remember are:

• whether you have "sticky blood" which means your blood is clotting and not getting to your womb to allow your lining to thicken (this can be sorted easily with a daily aspirin)
• whether you need a higher dose of folic acid (due to higher BMI)
• whether you are producing enough progesterone which is needed to thicken your lining (can be sorted easily by taking extra progesterone at certain times of your cycle)
• whether you ovulate at the right time (they can give you chlomid to fix this if not)
• problems with yours and your partners genetics being compatible - they can look into all sorts of weird and wonderful fancy things for this which I don't quite understand

You can also have a further test where they flush dye through your tubes to check for blockages. I opted for this as well as they thought I may have had an ectopic. They think sometimes even just having this test can flush a tiny blockage if there is one.

You normally get the results back around 1-2 months later and your consultant will then make a plan with you. Even if the tests come back all normal they may give you some of the above medication anyway which won't harm and might help.

If it helps you to know, although the sticky blood test came back fine, I've been told that once I get pregnant to take a daily aspirin just in case. I was also put on higher dose of folic acid from February and was given progesterone pessaries to take for the last week of my cycle as they found I don't produce enough. This ensures your lining is nice and thick! Once pregnant I was told to then continue taking the progesterone for the first 12 weeks and obviously start the aspirin.

I'm telling you all of this because I tried again for the first time since December recently and I've become pregnant again. So far so good and I don't know which of the three things is helping or whether it's a mix of all 3, but don't lose hope. They can do so much to correct little things which make a big difference.

There was a study on the effects of progesterone in early pregnancy recently and they found its especially effective for women who have had 3+ miscarriages so I think that's what might be helping me.

It's still early days for me but it feels right this time and I just wanted you to know that you will get there in the end, I know it's such a difficult thing to go through x

@Sarraa one thing I forgot to say in the short novel I wrote above was that if you're consistently miscarrying at 5 weeks that would suggest you also don't produce enough progesterone so your lining isn't thick enough to allow everything to implant properly. I'd definitely ask your consultant about this if they don't offer you the test or medication.

@Saraa23 also (and I'll shut up now!) I think you're definitely doing the right thing holding off until you've had your test results. It's so hard not to just get back on with it but you'd kick yourself if it was something really easily fixed and you had the same problem again between now and then x

@siaa Thank you so much for your reply. It’s really really helpful and I really appreciate you taking your time to pull it all together. Sorry to hear about your losses, but congratulations on your pregnancy 😊 It’s lovely news! How far along are you?

I read about progesterone on the Tommy’s website (their PRISM trial). When I was in getting a scan at 6.5 weeks I practically had to beg for them to prescribe it to me. They agreed in the end and the spotting improved within a couple of days. I can’t help but wonder had I taken it at the very beginning if I would be in this situation. They checked my progesterone levels when I was around 6 weeks and they were at 29. The cut off before they intervene is 25 they said, but I think it must have been lower than 25 when I first fell pregnant? I’m not sure how it works though. Sorry if this is too much info, but I’ve been giving progesterone a lot of thought lately. I know that it’s needed to make sure our linings are nice and thick. Before I got the contraceptive coil (about 5 years ago) I was on the pill and used to pass clots with my period which was heavy. When the coil was in, and even now it’s been removed (a year ago) I’m not passing clots and my periods are pretty light, which makes me think there is maybe some sort of hormonal issue going on i.e. progesterone. I’m concerned they won’t prescribe it to me but I’ll cross that bridge when I come to it. My biggest fear though is we are genetically incompatible. I know there are things they can do for most genetic issues (i.e. genetic screening/IVF) but what if it can’t be fixed. I’m filled with so much fear and anxiety. Hopefully that won’t be the case though and our test is in 20 days 😊

Sara x

@Sarraa not too far, I'm having my first scan next week but I don't normally have such a strong pregnancy test so early on like I did this time (on 8dpo) which suggests it implanted quickly and very well. Normally I just get a faint positive at like 16dpo. The hospital are doing me an early reassurance scan, I'll be around 6w then so fingers crossed but I just feel much more confident this time round.

Yeah from what my consultant said you need the progesterone every day a week after ovulation (day 21) because at this point the embryo needs to implant so you wouldn't want to wait any longer! I actually started it 3 days after I got a positive ovulation test to start packing it in a bit early just in case it helped!!

I wouldn't worry about the genetic one for now because it sounds very uncommon and I know someone who did have that issue and now has a daughter and another one on the way, both conceived using IVF so they can still help you!

Best thing you can do is to take care of yourself and make sure you fully recover mentally and physically before you try again x

@siaa That all sounds very positive and you're getting all the right signs with the strong pregnancy test :) How exciting. Keeping my fingers and toes crossed for you (although it sounds like you definitely don't need it).

Thanks again for your messages. They've really helped.

Sara x

@Sarraa thank you, and no problem any time! 😊 good luck with everything x

@siaa you too :) xx