Recurrent miscarriage investigations

[Maurice76]

Hi all, I’m hoping you guys have some experience in this department, because I’m feeling seriously low right now 😕

We started TTC this time last year, got pregnant straight away, but at 9 weeks I was rushed into hospital with a corneal ectopic. Right tube removed entirely and a fair few stitches in uterus. Had to wait until Sept to try again. Again got pregnant immediately, but lost it at about 5/6 weeks. Tried again, fell pregnant again, but lost again at 5/6 weeks.

I’ve always been super healthy, don’t smoke, don’t drink that often and have never been overweight. But I am 36.

Now that I’ve had 3 losses, my GP said she’ll refer me for scans and blood tests, but because of the COVID backlog and Christmas etc, I’m not likely to be seen until late Jan/early February. I’ve booked to see a private consultant on Thursday instead now, as I just need to get the ball rolling.

Had anyone got any positive stories about a pregnancy going full term after losses like mine? Any experiences of investigations into losses?

Everything I read and consultants I’ve spoken to say that it’s really rare to have (a) a corneal ectopic, and (b) three miscarriages in a year.

I think I just need reassurance that it’s all going to be OK... I’m trying to be upbeat because I’m lucky enough to be seeing my family for the first time in two years this week, but inside I’m breaking.

I'm similar to you OP but the other way around. I had 2 early losses and then an ectopic which required the tube removing all in the space of 12 months. We had all the tests in the recurrant miscarriage clinic but they didn't show anything up and I'm still non the wiser I'm afraid.

@Ilookedatthesea thanks so much for replying. Sorry to hear you’ve had a tough time too. Did they tell you to just keep trying?

Yes so far. We've tried again for almost a year and then been referred to fertility. Just waiting for the results of those tests now.

@Maurice76 my good news story was born last year and is sleeping upstairs in his cot

I was the same as you, I'd had 3 miscarriages, one had been ectopic. Had allllllllll the tests and my tubes flushed and then was given about 4/5 medications to take so that next time it happened it would stick. And it did! The very next time I got pregnant. I don't know which of the meds worked but something did.

Started the whole process again in October and am now 17dpo and pregnant again so I've got my fingers crossed the cocktail of meds works for me for our second baby.

It will happen for you, it can be something so simple which just a little bit of medication fixes x

@Maurice76 also yes it is really rare to have 3 mc, think the chances are like 0.1% and I'm so sorry it's happened to you as well. Try not to lose hope. Happy to answer any questions about the investigations / meds if you have any x

We were referred to the recurrent miscarriage clinic after our 3rd, but fell pregnant again quickly and I'm now 16 weeks. I was put on progesterone and aspirin by the EPAU at 6 weeks once they confirmed a heartbeat. I honestly don't know if it was that or just luck this time, but don't lose hope x

Op I’m very sorry for what you’ve been through. My rainbow was born last week after a harrowing year including 1 chemical and three mmc at 9 weeks and 2 rounds of ivf.
I would definitely stick with private due to the speed.
Your GP should do a full blood check to see if you have issues with iron, vitamin d , thyroid etc
The next set of tests privately would be around any clotting or gene issues e.g one prevents you absorbing folic acid and can cause mc.
You could then look at your womb to check the structure and any issues there e.g hystereoscopy or other checks
Your dh should also have his sperm checked for any abnormalities
Finally, try dr Shehata or dr Gorgy ( I went with Gorgy) for immune testing.
This was my issue, my body was attacking embryos as a foreign object, I took a lot of immune suppressants and this pg was successful.
Pm me if you need any help or further support. It is a dark, hopeless journey sometimes and feels so unfair but good things can happen

3 years

@Ilookedatthesea Fingers crossed that you get some answers.

@siaa Thank you for sharing -congratulations 🙂 really glad you found what worked for you and have everything crossed it works again! Makes me feel better to know that there are people out there that have successfully gone full term despite the challenges.

@AwkwardPaws27 thank you - and congratulations! hope yours carries on professing nicely! I asked the GP about progesterone and aspirin but she wouldn’t comment. X

@Sleephappy thank you so much for the advice and congratulations 🙂 Will be asking the Dr on Thursday allllll the questions! My GP was pretty useless on the phone today and actually made me feel worse. Hopefully the private Dr is more helpful.

No success story (yet) but in a similar position.
12 months of ttc, 3 pg with 1 mmc discovered at 13 weeks - I then haemorrhaged spectacularly at home requiring ERPC and a blood transfusion.

The consultant at the hospital said she referred us to the miscarriage clinic and baby was sent off for genetic testing (as we'd seen a hb at 7 weeks). No results yet and this all happened in October so not sure how long we should wait before chasing!

We're in Hampshire so not sure what the wait "should" be

I had 3 miscarriages back to back (no periods in between!) referred to Dr Shehata at Epsom hospital. Was put on baby aspirin, progesterone and steroids. I’ve since had 2 boys (with one more miscarriage in between). I’ve since discovered loads of people I know have had children after recurrent miscarriage. It’s much more common than people realise. It’s just not talked about .

Hi @Maurice76 firstly I am so so sorry for your losses. I know how heartbreaking they are.
I had 4 recurrent losses in 2020. After a long waiting list on the nhs like yourself I went private. This November I had my rainbow baby. The first every pregnancy that went full term. I had loads of tests and my husbands sperm was tested no cause was ever found. My consultant prescribed progesterone and 75mg aspirin on my 4th pregnancy it didn’t work. Then for the 5th pregnancy I had clexane injections, double dose progesterone and 150mg of aspirin prescribed. I also took natural folate rather than folic acid. I’ve had acupuncture and I took antibiotics that I’d read was being used in a trial in Warwick hospital to prevent recurrent miscarriages due to inflammation in the lining of the womb. I bought the antibiotics off Superdrug dr online xx

So sorry for your losses I had 3 MC (one at 6 weeks then 2 MMC at 7/8 weeks) in 2019. I was booked in to the recurrent miscarriage clinic but then Covid hit and it was cancelled. We didn't know whether to stop TTC (but my age wasn't in our favour!) but while we were deciding I got pregnant again. I straight away took 150 mg aspirin per day at night and this time it all worked out and DD is now 11 months. I definitely think aspirin is worth a go as some people (eg doing IVF or overweight or pregnant with twins) are advised to take it anyway. I believe even if the blood clotting comes back normal during RMC tests, it can still be an issue just while you are pregnant. I really believe it was what made the difference with my DD's pregnancy.

Hi OP, so sorry for your losses. I had three miscarriages and self referred to professor Quenby at Tommy's Birmingham. We went on to her CERM trial which is to test for endometrisis (not endometriosis) then they treat with doxycycline (I think that is what @NovRainbow5 is referring to). I tested positive and was given the doxycycline. I also banged the drum about my thyroid which I was sure wasn't right and after being blood tested at 6/7 weeks I was put on thyroxine. I am also on progesterone. The good news is I am now 15 weeks pregnant having never gotten past 10 weeks.

Her and her team are absolutely wonderful too and very supportive. I wish you all the luck in the world

SORRY Tommy's Coventry. NOT Tommy's Birmingham.

Thanks so much all for your input. I feel so much better knowing that many of you guys have got through a similar situation. For those of you in the same boat as me, I hope you get your rainbow babies soon 🌈

I’ve got lots of questions ready for the doctor on Thursday! Will update you when I’ve got some answers. I think we’ll keep trying in the mean time as age isn’t on my side!

Find out if you have any polyps and fibroids, if so, get those removed.
Take a vitamin like pregnacare.
Take CO q10 abiqional 300mg twice a day.
Don't smoke.
Don't drink alcohol.
Don't drink caffeine.
Cut down on outside food.
Cut down on carbs and sugar.
Take a Bob's Best 4 greens type supplement.
Make sure your thyroid is below a certain value (I'll come back to you on this one) - If not take Levothyroxine - doctor will have to prescribe it.
You've lost one tube, go to IVF straight away.
Best of luck x

@siaa what meds did you take?
I've had two miscarriages in a row and my blood tests came back normal so I'm none the wiser either. It's so isolating. I lost mine at 6/7 for both

@Hopingforarainbow27 so sorry to hear you've gone through that twice

I had tonnes of tests, it seemed that there were two tiers of tests, the second of which was optional and we went for the whole lot so they tested for:

• blood clotting - this came back normal but as it can't harm I was still prescribed 75mg aspirin daily until near the end of the pregnancy
• progesterone - this one was slightly abnormal in that I don't produce enough after ovulation so I take 2x cyclogest pessaries from cycle day 18 until 12 weeks
• thyroid function - this was normal but since my first pregnancy I've had thyroid issues so for this current pregnancy I have a fragmin injection daily until 12 weeks to reduce any possible inflammation
• they tested mine and DH's genetics together and no issues there
• they tested to check I'm ovulating correctly but I am so no prescription there, otherwise would have been chlomid
• they offered me a (painless) procedure to flush dye through my Fallopian tubes to check for blockages - this came back all fine but apparently sometimes just having that procedure can flush a small blockage without you realising there was one, so maybe that was my issue!
• I was also prescribed 5mg folic acid as my BMI is higher and you can need more folic acid if that's the case and it can help reduce miscarriage risk
• final thing was once I have the first scan at 6 weeks and they establish there's a pregnancy in the right place, I am prescribed HcG injections twice weekly until 16ish weeks

No idea what it is that helped me have my first baby (4th pregnancy) or if it was a cocktail of all of the above, but something worked! I'm on it all again now for my second baby. Hope this helps you x

@siaa thanks for all the info!
They said once I get a positive pregnancy test they will put me on progesterone even though my levels are normal.
I'm not sure what my issue is. I'm so fearful to get pregnant again and also fearful I won't get pregnant again :(

@Hopingforarainbow27 I know it's so hard to see a happy ending when you're right in the middle of it isn't it, it's so tough. Try to take some comfort in the fact that a lot of the time it is something they can tweak with a bit of medication. You've also possibly just been really unlucky and had two pregnancies which weren't viable but I know that doesn't make it any easier to deal with either.

Would you not ask for HcG as well once you've had an early scan in case your issue is that you don't produce enough of that? I don't think that's something they can easily test for once you've had a miscarriage and apparently it doesn't harm to have extra so it's worth a shot.

Also if your BMI is over 30 it's worth considering the higher folic acid dose, you can get that easily from your GP.

Try not to fear trying again, I know exactly how you feel but I'm sure it will happen and you just have to push on and keep moving forward to get there x

My bmi is 22 but the midwife did say to take 5mg of folic acid. I had only been taking the recommended dose.
I will ask about hcg if I ever get to that stage in pregnancy again.
I'm seeing my sister in law tomorrow who is pregnant and is due two weeks before I was so I'm really dreading that and have so much anxiety about it

I'm so sorry for your losses

I had 3 mcs, but only two were consecutive - baby stopped growing around 5/6 weeks in all. I was referred to the recurrent miscarriage clinic and was lucky to have just had a bfp on the day of my first appointment - I had just turned 36. I was prescribed progesterone and 5mg folic acid. All bloods from first round of Investigations came back clear, so my mcs were put down to bad luck. At 12 weeks I came off the progesterone and started 150mg aspirin.

I had scans at 4, 6, 8, 10, 12, 16, 20, 28, 32, 36 and 38 weeks and all were fine. There is a study that shows increased monitoring lead to slightly better outcomes for women like us.

My baby boy is sleeping on me right now. I hope you get some answers and your 🌈 baby.

@Hopingforarainbow27 if you find you're struggling to even get pregnant next time, there's things they can do to help there too so don't lose hope x

Very sorry you’re going through this.

None of us can tell you that it’s ‘going to be OK’ fertility wise, sadly. Lots of us have gone on to have biological DC, some haven’t.

NHS MC clinics vary hugely in quality and what tests are offered.

I found Prof Lesley Regan’s book on MC helpful and the MC service at St Mary’s in London helpful.

I paid for investigations privately after experiencing poor quality services at another NHS London teaching hospital.