Recurrent Chemical Pregnancies, anyone seen a GP?

[Moominmiss]

Hey everyone,

So I’m 37, ttc for 9 months now, about to start 10th cycle.

I had a mc at 9 weeks in January of this year, followed by a chemical in March, and have just experienced another chemical this month. So 3 early losses within the past 6 months.

It would seem getting pregnant isn’t so much of an issue as my body being able to keep hold of it.

I’ve got a telephone appointment with a dr next week but wondering if there are certain tests I need to be trying to push for?

I’m not going to be wanting to go down full on fertility treatment routes like ivf etc. Just wondering what they might suggest doing, or what I can suggest. Baring in mind they may not do anything as I already have children from a previous relationship.

So far my thinking is that it could be an egg quality issue, low progesterone, or perhaps a rubbish lining (I’ve had previous c sections so scar tissue could be a problem). What else could be causing the pregnancy not to stick other than just bad luck?

I want to have my appointment armed with as much knowledge as possible.

Thanks 😊

Sorry you're having difficulties. I don't think chemical pregnancies tend to be counted as a pregnancy loss that triggers investigation- generally they're embryos that contain severe mutations or abnormalities and they're really common- some experts think that up to 70% of all conceptions result in chemical pregnancies. So chemicals don't really indicate anything wrong per se.

www.whattoexpect.com/pregnancy/chemical-pregnancy/

Try baby aspirin. My friend had this until she took that and the next one stuck.

@FourPlasticRings when I had my first chemical a gp I spoke to back then said that chemicals are classed as early losses and if I experienced anymore then I should log them for future reference.
My midwife when I had my mc in January also said to make sure I track any loss no matter how early. They don’t call them chemicals, they just call them early pregnancy losses.
I suppose all I can do is go with the info I have and see if they’re willing to help. I’m also hoping that seeing as I’ve been ttc for nearly 10 cycles and I’m over 35 they might be willing to help as they say once you’ve been ttc for 6 months or more over 35, but will see.

@ajehsnf I’ve heard of women taking baby aspirin but I don’t want to take anything like that unless a dr says as I’ve also read if you don’t have a clotting issue then it can actually be really bad for you and a baby to take it. But that is something I was planning on asking the dr about!

Hi @Moominmiss

Sorry to hear what's been happening. I'm 36 and have had a MC in January at 7 weeks and a CP in April at 5.5 weeks.

I talked to my GP after the last one about what the next steps would be if it happened again and she said she would refer me to the recurrent miscarriage service, but that there are some blood tests she could do in the meantime (eg thyroid function) to speed things along while I waited to be seen. I asked about progesterone and baby aspirin but she said they would be things the recurrent miscarriage service would advise on based on their tests.

She has told me to let her know as soon as I get pregnant again. She also referred me for an ultrasound to check for fibroids or structural issues (all clear) just to have got that out of the way as well, as that would be something the recurrent miscarriage service might check.

So I know it's not the same situation as I'm still trying to get pregnant a third time, but thought it might be useful.

I'm so sorry you're in this situation and would love to know how you get on, as I'm convinced I'll be in the same place if and when I ever get pregnant again!

Fair enough, Moomin, my mistake. Good luck with your onward journey.

@Semele5069 thank you and I’m so sorry to hear you’ve also suffered heartbreaking losses.

It’s positive to hear that your doctor has offered to refer you, this was what my midwife talked about after my first mc. And then after my first cp the doctor talked about 3 or more being classed as recurrent, hence why I’ve now contacted them.

Do you have any children already? The only reason is that I’m worried because i already have had children they may be reluctant to send me for tests and further investigations. I’m hoping the lady I speak to will be understanding. I’m with a new partner but he has no children so would be heartbroken for him if we couldn’t have one.

I will definitely let you know what is said following my appointment. The only thing I have done is start taking ubiquinol to try and improve egg quality.

Please don’t think you’ll end up with another cp like me. I feel like I have other issues such as scar tissue that may be causing problems with implantation being successful.

I will keep my fingers crossed for you. But please be kind to yourself. Hugs xx

I had three losses before my DS - as you've said, the NHS doesn't draw a distinction between 'chemical' and other early miscarriages (and the definition of chemical is never very clear anyway - two of mine were at just over 5 weeks and whether or not that's a chemical depends on who you ask).

I had tests at my local hospital, none of which showed any issues, and I also went to the Coventry recurrent miscarriage clinic run by Professor Quenby and had a uterine lining test (also showed no issues) - they prescribed me progesterone, my local hospital said aspirin, I took both and now DS is two. I will never have any idea whether any of it made any difference, though I'm in the very early stages of pregnancy again and taking aspirin; if this one fails I'm going to ask to be prescribed progesterone again).

The referral to my local hospital was pretty automatic after my third loss, though I did have to wait quite a while for both the tests and the results.

It's so hard and upsetting, particularly as the general societal attitude is that you shouldn't get worked up about early losses. The summer after my third was such an awful, awful time for me. Thinking of you and wishing you the absolute best - I hope that you, like me, are fourth time lucky

@Moominmiss your situation is a lot like mine.

I’m 35, TTC #3. Hubby’s first.

I had 4 early pregnancy losses and just in the middle of a mmc.

My doctor refused to refer us until we’d been trying 2 years!

I have only been referred to RMC now as my loss went through EPU. She was more than happy to refer. I have to have lots of bloods, thyroid, FT4, TSH, HbA1C etc and an internal ultrasound but can’t have that until 6 weeks after a negative test.

I’m having a D&C in a couple of days as have retained tissue.

One thing I do think helped get pregnant in the first place was Ubiquinol xx

@Moominmiss thanks for such a kind message when you're having a hard time yourself!

I don't have any children yet but I've never heard of previous children being a barrier to referral for more investigations. I know it is taken into account for funded IVF but I wouldn't have thought for access to a recurrent miscarriage service.

I've just started taking ubiquinol as well! Have you read It Starts with the Egg? I found that and Expecting Better the most helpful sources of information, much more so than the traditional big name books like What to Expect, which I felt glossed over miscarriage very quickly!

Do you know the GP you're going to see? On the practice website the GP I see says her special interest is in maternity and family planning, and she certainly did seem to know more and take more of an interest than another GP I had an appointment with when I was having the second miscarriage. I wonder if you could find out who in your practice specialises or has a special interest in fertility, if you're not happy with the GP you speak to?

Sorry to hear your going through this. I’ve had 3 losses this year also. All losses are counted regardless of how early, don’t call them chemicals just simply an early pregnancy loss. Request an anti-phospoliquid antibody screen blows test- this is a blood clotting disorder that is one of the main causes for early losses and usually aspirin does the trick. Also thyroid function test and other like ESR (inflammation) , coag screen, full blood picture, auto immune screen. My Gp also took my bone profile blood screen, liver function tests, U+E .
But the first few and the most important. I’m back in my tww window and have started low does aspirin of my own accord as I wait my test results. Fingers crossed

Blood test not blows test

@LisaSimpsonsbff thank you for sharing your experiences and I’m so sorry for your losses also. It’s true that the very early losses aren’t given as much thought as later ones, when to the person/couple ttc absolutely any loss is utterly heartbreaking.

So after your tests showed no obvious issues, they were still happy to prescribe you the progesterone and aspirin? Suggesting that taking the aspirin if you might not have needed it, wasn’t likely to cause any problems? If that’s the case it sounds like it’s something I could consider starting to take before having any tests done.

Sending you all the luck and sticky baby dust to you again. Congratulations on your pregnancy, I hope soon I can be where you are again 😊

@LosingtheTTCplot I’m so so sorry to hear you’re currently going through a loss and having to await treatment to manage it fully. I’m semi thankful that when I mc at 9 weeks everything passed naturally and I didn’t need any hospital intervention. I just cocooned myself at home and didn’t see anyone or go out for weeks.

I do wonder if because only my mc went through the EPU, and not either of my cp, whether they will refer me. After my first chemical I did try to ask for bloods etc, just so there was some official record of it, but the doctor said she’d spoken with the EPU who had agreed there was no need. So I guess only time will tell now with that.

I’m glad you’ve mentioned the ubiquinol though, I know it will take a while to build up in my system, but if that’s what will work for me then I’d be happy to wait a little longer for better quality eggs.

It sounds like at least they’re offering you the right sort of tests and are looking into things further for you, which can only be a good thing and will hopefully rule out any concerns.

I hope you look after yourself following your d&c, and I hope you go on to get your sticky bfp as soon as possible. Good luck with all your tests etc too.

@Semele5069 I’m hoping you’re right, and that the simple tests won’t be refused based on the fact I already have children. I’m not looking to go down the route of fertility treatment etc, so if it’s discovered that I cannot do this naturally then we will accept that. I would however hope they’d help with prescribing progesterone if it’s shown that that is an issue though. So fingers crossed.

I’ve not read any of the fertility, ttc books. Maybe I should though as I’ve heard lots of ladies on here talk about those books.

I do know which doctor I’m seeing, I specifically requested an appointment with her, hence having to wait until next week as she’s pretty popular. I believe she is the ‘women’s problems’ person to see. I think she specialises in gynaecology and family planning so I’m hoping she will be helpful. If she’s not then I’m not sure who else there would be willing to help so I’m sort of pinning all my hopes on her being understanding. I’ve seen her before for non pregnancy or fertility related issues and she’s always been very good and very thorough so I’m keeping fingers crossed!

@2020wish I’m sorry to hear you’ve also experienced the heartbreak of not one, but several losses.

I think I’m definitely going to ask about the blood clotting issue and thyroid function.
I just really hope the doctor is clued up on all of this. It sounds like your gp has been really helpful in sorting all those tests for you. I hope I can say the same about mine after next week!

Can I ask with the aspirin what is classed as a low dose? And do you take it every day of your cycle? Or just certain times, ie up to ovulation, or following it etc?

Thank you all again so much 😊

I had this too and it was my thyroid. TSH measured 4.5. It should measure 2 but ideally closer to 1. I was prescribed levothyroxine and as soon as it started working I fell pregnant. Good luck!

@Mooninmiss tbh I had to push my doctors a bit after the 3rd. And then for blood clotting test I had to make them aware I wanted it done and they agreed they would as it is a standard test once you get referred to the recurrent miscarriage clinic. So just be a bit pushy.

Low dose aspirin dosage I believe depends on where you are based. US is 81mg per day after ovulation until about 37 weeks. The uk was originally 75mg but I hear that the guidelines have increased it to 150mg per day for recurrent miscarriage

@Livingmagicallyagain that’s interesting. Did you have any symptoms of a thyroid issue before having the tests done? Or were they just done as standard and then the results came as a surprise?

@2020wish that’s what I worry about, having to push for tests etc. How do you even go about pushing for things? Like if I talk to the doctor and explain I feel something isn’t right do I have to literally come out and ask for certain tests to be carried out? Do I even have the right to ask for tests to be carried out? If they say no then what? Is it literally game over? Other than going privately?

Hmm, I might try to do some research into the aspirin thing then.

Thank you both!

If you are in the uk then yes you have every right. You need to tell them you have had 3 recurring pregnancy loses and you want referred to the recurrent miscarriage clinic (not a fertility clinic as you have no issue falling pregnant ) and you want the blood tests done through your GP while you wait on your referral. Because you have had 3 losses in a row you are entitled and fit the guidelines . If your doctor tries to fob you off with them being chemical pregnancies then tell them the current guidelines and Tommy’s recurrent miscarriage association advises that they are seen as losses. You can search Tommy’s on google(I believe they are the top RM charity in midland uk) You shouldn’t have a problem having the tests done. Guidelines also state that to get tested for the anti phospoliqid blood tests you need to have 3 recurrent loses which you have. Plus because you are over 35 then that is also a factor for your doctor to have you referred. This has all been nerve wrecking for me also so I feel your anxiety when pushing a doctor but you shouldn’t have a problem getting the care you need x

On the aspirin thing - they did prescribe it to me even though I didn't have any signs of a blood clotting problem (and I don't think that's uncommon) obviously they had seen my test results, my general history and health so I guess could also make a judgement on whether there was any reason aspirin would be a bad idea for me, so I don't feel comfortable telling you it's definitely fine because they gave it to me if that makes sense? I am taking it of my own accord in this pregnancy (the direction I was given was to start taking it from a positive pregnancy test) but I guess I feel a bit more confident doing that because I have previously been told to take it, albeit three years ago.

@2020wish That's interesting about the dosage guidance for aspirin increasing. I had a search for the 75mg ones and couldn't find them anywhere!

Do you just start it when pregnant and keep going till the first trimester now over?

Oh @LisaSimpsonsbff you've just answered the question I posted at the same time! What dose were you advised?

I was told to take 75mg and that's what I'm taking this time - but maybe this has changed in three years?

It's behind the counter, normally, and they won't sell it to you if you tell them you're pregnant - I had a letter from the consultant that I showed them so they would. This time I just sent DH to get it and no one asked him any questions (again, I am not recommending this)

@semele5069 like you I can’t advise fully myself as I’m taking it on my own accord until I get seen at the RMC clinic. But other ladies that have had it prescribed in the uk this year have told me it’s now 150mg per day and I’m getting a mix of info on starting is after ovulation or on day of pregnancy test. I don’t see any harm many starting it a few days before a possible pregnancy test but I can’t comment further. My doctor is aware I’m taking it and advised she does know it’s known to work and is a treatment but that she can’t prescribe it herself until my bloods come back

@LisaSimpsonsbff I know it was 75mg. I can’t 100% advise 150mg but that’s just what I’ve been told on this forum plus a uk Facebook one by ladies being prescribed it at present x

@2020wish thank you, all that information is really helpful. I feel like If I can have my appointment armed with As much knowledge as possible then I stand the best chance of being taken seriously.

How can you find out where your nearest recurrent miscarriage clinic is? I will make sure to ask to be referred and for tests in the wait time.

@LisaSimpsonsbff so what is the normal aspirin you can just walk in and buy? Some I’ve seen in tescos are like 300mg tablets, which would be too difficult to try and split down to 75mg. So from what you’ve said you can buy 75mg tablets but they don’t like giving them out? If I asked for them I’m assuming they’re likely to ask why I want those specifically? And I guess if I said it was because I’m trying to get pregnant they wouldn’t give them. I could try saying they’re for my dad who I shop for.

I know you aren’t going to advise to take them or not, and I understand and appreciate that. I will most likely wait to speak with my doctor next week before making a decision but it’s so good to feel I know more now than I did.

If I am going to take it I guess I need to decide at what point do I start. Do I take it only once I know I’ve ovulated, or throughout my whole cycle. It helps blood flow to the uterus in theory making for a better lining, so that would suggest you need to be taking it in advance of ovulating so that the lining is ready and waiting for an egg?

I would ask your doctor to refer you and then ask them where is it based just for your own information. As far as the aspirin goes I still believe you can purchase the 75mg in the likes of boots or Superdrug. But yes if you are going to a chemist if they ask what it’s for just say for your dad. I doubt this will ask tho unless you look obviously pregnant. I wouldn’t take it throughout your cycle, maybe just a few days after ovulation or around the time you would expect an early positive test. Then stop taking it if your tests are definitely negative when AF is due

Btw I got my antiphospolipid blood tests done today! Just back after requesting it yesterday so I’ll get my results on monday. I’ve started taking aspirin today tho