3rd Miscarriage - Next Steps. Help/advice sorely needed

[J785948]

Writing this message is extremely tough. I have just started the beginning of my third miscarriage at 4 weeks 6 days - I appreciate it is very early so could be termed as a chemical pregnancy.

I had a MMC in May 2020 at 8 weeks after discovering the baby had stopped growing at 6.5 weeks shortly after seeing a heartbeat.

I then had a second MC in November 2020 at 6 weeks.

In Jan of this year I lost a stone in weight to regularise my cycles (which was successful) and had some tests for miscarriages done privately. It was discovered that I have a raised clotting amplitude and was advised to take daily aspirin after my next BFP. The clinic where hopeful that this, along with my weight loss and regularisation of cycles would help us stay pregnant.

Fast forward to last week, I discovered I was again pregnant - started the asprin as prescribed. Had my bloods done last week and they were doubling as expected.

However, today I have started bleeding with cramping and I know this is the start of miscarriage no.3.

We don't know what to do next, does anyone know what our options would be moving forward or is it simply to have another go.

I would be eternally grateful if anyone else who has been through something similar could give me any advice.

Thanks :)

First of all so sorry for all ur losses. I had 2 MCs, one MMC in jan 2019 and another MC in Feb 2020... I understand exactly what u r going through.we've done a number of private tests and all came back ok so far...

I suffer from PCOS but conceived twice without any medication... can I ask if ur cycles are normal and regular? PCOS women are 20% more at risk of a miscarriage... I am now taking metformin along with baby aspirin to see if that would work.. I hope u find the answers !! Sometimes u just have to roll out the dice again.. also strongly recommend a very good prenatal vitamin both for urself and ur partner as it improves egg+ sperm quality ... which might also help...

@lena21 - thank you for replying abs sorry about your losses!

The bleeding hasn't got any worse today nor the cramping but it has started similarly to my 2nd miscarriage. Going to have my bloods done if nothing has changed by Thursday.

So I have never been diagnosed with PCOS but have some of the symptoms. Cycles have never been long but after my 1st miscarriage they went up to 37 days but after loosing a stone in weight, I was able to regulate those again to 28-29 days. So not quite sure!

I think we have accepted we have to just try again. I don't know how long you can keep doing it though with all of these losses. We want to children but I have now accepted that even one would be a miracle.

For some reason I think it's a problem with my eggs. Whilst I don't have really long cycles or diagnosed with PCOS, with my 2nd miscarriage we got pregnant following a second attempt at ovulating and with this pregnancy, I tried to ovulate super super early, and caught the egg when expected at CD 15/16 - so I am worrying that my body trying to ovulate twice is meaning the egg is overly ripe and not of good quality.

It's the lack of a plan on what we do next is what makes it harder

I had 10 MC in total...5 before my first child and 5 before my second child. We had al the investigations. Nothing came up for me but my husband had a lot of weirdly shaped, sluggish sperm, nothing that made pregnancy impossible but definitely in the ICSI would probably be needed category. The consultant put the MC down to oldish eggs (I was very late 30s) and dodgy sperm but was still hopeful that we would get a good pairing in the end when I saw him after 3MC but put our names down to start IVF anyway. We conceived and it stuck before we started it.

I also discovered ( after a month of thrush when sex was too painful so I had to use a Turkey Baster ) that I could only get pregnant when I syringed in the sperm rather than from actual sex. Whether this was because the sluggish swimmers needed to be deposited right by the cervix to get in I don’t know but I got pregnant every time with that method (still had MCs though), never got pregnant once by normal sex. A weird but true story.

@J785948 - u might still be in for a chance if bleeding has stopped. Were u offered a scan to confirm if it's a MC?

@SunshiningBetty - where you recommended IVF to try and get a good chromosomal match? I am presuming that whilst I have a blood clotting problem, if we continue to MC whilst on asprin that will be our next step.

I am sure it is down to my bad quality eggs (despite being only 31). The two early MCs I have had have been as a result of two LH surges (I OPK) where only the second one is successful. So I am concerned my eggs have been over ripe.

I have heard a lot of people using a syringe to become pregnant. We have been able to conceive naturally each time luckily.

@lena21 - I wouldn't say it has stopped but it is not full on blood but comparable to my last MC. I have been referred to my EPU (mainly coz I want a NHS referral to have a second opinion about what we do next) so will have a blood test on Thursday if I have not properly miscarried by then.

Thank you again for all of your replies xx

Hey @J785948 so sorry for your losses it’s such a hard thing too deal with. I have also suffered 3 MC 1 MMC and 2 very early/chemical. I have just had my first phone appointment with nhs gyno we went through everything in full detail and she said I have 70-80% chance of having a full term healthy pregnancy and it all sounds like very bad luck I had baseline bloods done with gp which checks egg quality blood cells thyroid and a few others all came back fine and now waiting too have my blood test for APS. Just too rule it out. That’s all she said nhs can test for but she said in the meantime too carry on trying and when I get the BFP too take 75mg baby asprin daily. Good luck with everything xxxx

@LaurenGa sorry for your losses also! It's horrible isn't it.

After my spotting, we have spoke to our EPU who wanted me in for a blood test to check my hormone levels. It has gone up from 345 on Friday 23rd to 1200 today (28/04) but a 68 hour doubling time rather than the 48 (which it was initially) so I am not holding out for much hope. They want me in for a scan tomorrow to rule out an ectopic. The spotting has stopped however.

Sounds like the tests you are having done are similar to what we have done. If this does end in a miscarriage (which I am expecting) we will speak to our NHS gyno also for some further advice.

Whilst horrible to go through, I think on your 4th pregnancy the EPU monitor you following on from your BFP with blood draws and early scans.

Best of luck to you! Xx

@J785948 yes I believe they do she also said when I get the BFP too contact epu for more monitoring etc. Good luck with everything xx

Hi @J785948 I’m so sorry for your previous losses. I have just had my third miscarriage confirmed this week (2 missed miscarriages and 1 chemical) and it’s so tough isn’t it.

I’ve emailed my doctor asking to be referred for tests but I’m not really sure who does them or what they will do. I’m also 31 and always invisioned having 2 children, but right now it feels like a miracle to be able to have one xx

Hey @MsK89 I swear you have written exactly how I feel. Also 31 and would like two children but coming to terms that having one seems to be impossible at the moment.

How are you doing? Although I know it is hard to know what to say in this situation but I know exactly how you feel so hopefully that can give you some comfort.

I am unfortunately still in limbo. After a beta draw of 1300 yesterday at 22 DPO my scan today came up showing something but not a full on sac. I have no hope at all, I know that my hormone levels should be higher than 1300 at 22 DPO but I find it so hard that the EPU still hold out for hope that there is still a chance. I would rather have someone say to me it is not looking good and then I can start the grieving process and begin to move on.

What may help you is I asked a bit more at the EPU about the next steps in terms of speaking to their recurrent miscarriage clinic. Whilst we have had the tests done privately (which found a blood clotting problem) I still want to be referred to the NHS as our private consultant is extremely busy and I suspect that the NHS equivalent has more time and may be able to ask our next questions about what our next options are seeing as we have already had the tests done and are still not having success despite the aspirin which I had been advised to take.

I am not sure if you have already been referred to your EPU but my EPU will refer me to their gyno who specialises RM, they send you a letter with the first consultation appointment to be made 6 weeks after 3rd miscarriage (this is to ensure all hormones have left your body). They will then do the standard blood clotting tests, thyroid function and potential karyotyping (this is the only test that we have had not done privately). Whilst the tests are being done you cannot be pregnant as some of the tests require two blood samples to be compared, taken 4 weeks apart in the non pregnancy state. Once you have done the tests you can start trying again. At my EPU they will scan me by-weekly in my next pregnancy and will monitor me from the offset rather than having to have a bleed to be able to even speak to the EPU. I presume the same would be for you.

Anyways, I am sorry you are also going through this horrible horrible time. I hope the above helps you somewhat. Always here to chat should you wish xx

So sorry for your losses.

I had 3 mc before my little girl who is 3 months old. My 3rd MC was just before the first lockdown. I was booked in to the recurrent miscarriage clinic but the appointment got cancelled and I got pregnant again while trying to work out what to do. Are you taking 150 mg aspirin rather than 75 mg? I had a mc with 75 mg but a successful pregnancy with 150 mg (although I don't know for sure that was what made the difference I think it is likely). I spoke to a consultant after my 20 week scan (as I was still taking aspirin and the midwife didn't know if it was OK when I wasn't officially diagnosed) who said the gp could have prescribed progesterone up to 12 weeks which has been shown to help so that might be something to ask for. I know some people also get heparin which is a stronger blood thinner that needs to be injected.

On my 4th pregnancy, possibly because of Covid, I did get an extra early scan which ended up being at 9 weeks but nothing else. Tbh, I was OK with that as I knew that it was basically just a case of riding through the anxiety of the first few weeks.

I was referred to RPL clinic after 3 losses and had a 4th while on the waiting list. No cause was found but the consultant said I have low vit D levels and prescribed me a loading dose - he said it has a protective effect against miscarriage. Also put me on cyclogest until 16 weeks and gave me scans at 6,8 and 10 weeks with my next pregnancy, I'm now 27 weeks with a healthy baby. So there are things they can try even if no cause is found.

Hey @J785948 thanks for asking. I’m doing ok thanks, but I know the grief comes in waves so there will be sad days ahead. How are you?

I am under EPU already, I was also under gynaecology for a few months but they signed me off in January.

So sorry that you are stuck in limbo. Miracles do happen though, so for now hang on as there may be some hope 🤞🏼

Thanks for your detailed message about the testing, that’s so useful to know what they can do. I really hope the NHS wait isn’t too long, or I will look to go private too

@Sprite999 - Congratulations on your 3 month old!! I have already had the RMC tests done and am already on 150g of aspirin as I have a blood clotting problem. Still taking it daily despite having no hope for this pregnancy but I was advised that the aspirin won't save a poor chromosomal match.

Tbh, I am very split minded on whether more scans and blood tests reassure you or don't - after everything we have been through I think I will just always be on edge with every pregnancy.

@GreenSlide That is fab news about this successful pregnancy. How did they find out you had low vit d levels? We have had the majority of the tests done already but we will literally try anything!

@MsK89 I am ok thanks. I suppose, the same as you - there will be good days and there will be bad days. Me and my husband had a day out together yesterday which was nice. The limbo is indeed the worst, I haven't had any more bleeding since Wednesday and one minute I am hopeful and the next minute I have none. I think the teeny tiny thing that they thought was the gestational sac compared with the not doubling HCG every 48 hours is not a good sign - but no sign of imminent miscarriage yet.

What did the gynaecologist do with you last time? Perhaps your NHS has the RM tests done by another part of the hospital. I would ask your EPU on how you get the ball moving with the tests, I think it would be pointless to then have to go back to your GP to get a referral.

If you do decide to go private - we have gone with Professor Regan at Imperial in London. She has been good throughout (and her assistant has been fantastic at replying to my stressed emails) - and we are intending to have a call to discuss what our next options are if this is indeed a failed pregnancy.

Xx

Hi ladies, similar boat to you all here. Had 2 mc both at 10 weeks last year and just had a cp last week. I called the drs to asked to be referred so just waiting to hear back but have been trying to Google what they do, so thank you for explaining. I hate to think others are going through the same pain but it is so reassuring to know I'm not alone. X

@keepingthehope Sorry for your losses. Not a lot I can say really, but like you say, it is possible to take comfort that there are others in the same position. I find it hard to believe that only 1% of women deal with recurrent miscarriage.

Sending love xx

@J785948 how strange I googled that last night and found out only 1% have 3 miscarriages and then just seen you posted it here to! I feel like a very unlucky stat at the moment, but I’m shocked it’s not higher

The gynaecologist diagnosed me with a septate uterus, however it’s to small to consider operating on apparently, but it does increase my chance of miscarriage unfortunately. I’m going back to EPU on weds next week to start medical management as nothings happened by itself so I’m going to ask then about a referral for tests and also if they can do any genetic testing on the tissue

Keep the faith, it will happen for us one day xx

I'm so sorry you are going through this. It's awful and such a horrible feeling. I have had 4 miscarriages, 3 in a row- May 2020, august 2020 and January 2021. The august one was hard as my best friend was due two weeks before me and her pregnancy is going well.

I started taking baby aspirin and avoided any prenatal vitamins just taking folic acid from January 2021 and I'm currently 13 weeks pregnant. I was referred to recurrent miscarriage clinic but haven't had the appointment due to falling pregnant again.

I would speak to your gp about a referral if you haven't already. Good luck

@krj2688 Congratulations on your pregnancy! After 4 MC, did your EPU monitor you a bit more with this pregnancy?

I am still in limbo, haven't had any spotting in the last 5 days so as each day goes on that teeny tiny bit of hope grows. It just means I will have to go through the heartache again this week.

Is there any particular reason why you stopped prenatal vitamins and only had folic acid?

Thank you for messaging! Xx

@J785948

I was monitored by epu, they did an early scan at 6 weeks where I saw the heartbeat (was very emotional). I stopped the prenatal vitamins as 3 out of the 4 times I miscarried I was taking these. I eat well so wondered if it was a vitamin overload.

Miscarriages are miscarriages, no matter how early it is, it's heartbreaking. My first was at 7.5 weeks after seeing the heartbeat the day before, my second at 5 weeks, 3rd was awful as I fell down the stairs and lost baby at 6 weeks in july but didn't find out until 10.5 weeks that baby had died, I ended up having the tablets to encourage it along but some bits were still hanging around. My 4th was on New Years this year and was at 6 weeks. Each loss is awful! I had friends that ended up just telling me to get counselling but proceeded to tell me about their own pregnancy. It was very difficult. I did have some counselling which helped. X

@krj2688 thanks for telling me your story. My 1st miscarriage was at 8.5 weeks after seeing a HB at 6.5 weeks with the embryo dying shortly after. 2nd MC was at 6 weeks but I started spotting at 5.5 weeks. This MC is looking at around 6.5 weeks.

I agree every one is heartbreaking in its own way and whilst each time I seem to deal with it better, the fear of us never being able to have our own child grows with each one.

Your story gives me some hope so thank you for that.

I agree, friends and family don't always say the right thing and that makes it harder. Xx

Hey @J785948 is there any update? I hope you are ok xx

@MsK89 - Thanks for message. Still in limbo unfortunately. I think we last spoke after my first scan 29/04 which was inconclusive. No sign of MC (although still a bit of spotting) so and bloods done 05/05 and they had gone up to 5,400 (up from 1,300 exactly 7 days prior). EPU were not very hopeful but couldn't confirm unviable pregnancy and give me any pills so I am scheduled to go for another scan on Wednesday. Have had a bit of cramping but still nothing major.

Pregnancy symptoms still ongoing - really tired all of the time and the odd bout of dizziness.

I really didn't think it would drag on for as long as it has. I know deep down there is no hope but the longer I go without miscarrying a teeny tiny part of me has some hope. So it means you end up going through the emotional rollercoaster again.

How are you getting on? Have you had any further progress getting the NHS to start looking into tests? How did your appointment on Wednesday go?

X

@J785948 oh my gosh I’m sorry you are still in limbo. The waiting around from EPU is 100 times worse than the TWW. I feel for you. Hope you get some clarity next week

I had my first tablet on weds and then the main lot of tablets yesterday for medical management. I’m concerned they haven’t worked though, as I haven’t passed much yet. When I had medical management last year, I passed a lot more blood/clots and I was in a lot more pain. Dreading doing a test next week and it saying positive still 🙈

I have been booked a phone appointment with someone else from gynaecology for June, EPU told me they think theres another department within gynaecology who deal with recurrent miscarriage, so hopefully it’s been booked with the them. Last time I was with gynaecology it was to do with my uterus but she said she couldn’t help with miscarriage and discharged me!