Recurrent miscarriage

[fruityloop3]

Hi there, I would appreciate advice from anyone familiar with the NHS tests on recurrent miscarriage. Over the last two years I've had two miscarriages and a termination for medical reasons (all naturally conceived), and two failed rounds of IVF. We started ttc when I was 38, I'm now 41. Not going to do any more IVF as I wasn't a good responder, but can't bring myself yet to stop trying naturally. I know the miscarriages are probably a function of my age but I want to have the tests anyway to be sure there isn't another cause. NHS won't do them until I've had a third miscarriage so I'll have to go private (don't have time for another miscarriage...) Apparently the tests are :

Screening for anti-phospholipid syndrome
Screening for thrombophilia
A USS scan to look for structural anormalities

I'd appreciate any advice on making sure I get the right things done and, if needed, get the right follow-up. I've read about heparin and baby aspirin as a treatment for recurrent miscarriage, and more generally about immune system-related causes, and want to inform myself.

Thanks so much for any help or advice. The stats for a further miscarriage in a woman my age who has already had two are not great, but I think I might as well at least rule out the possibility there is a problem we can fix, rather than just age-related.

Hi there,

I had 3 miscarriages and had some tests through the nhs a few years ago pretty routine blood tests, progesterone and sticky bloody I think? Sorry I don't remember them that well as nothing showed up so we were classes as unexplained ... I had a consultation with nhs who said just keep trying and I asked about baby aspirin to which he just said take it if you want it won't do any harm so I did when I got my next bfp and conceived my daughter so who knows ? I did take vitex (Angus castus) for 3 months while we were having tests done as I was sure I had a progesterone issue (late ovulation/short luetal phase) but no one listens to you about that or helps even though they say progesterone is essential to maintain a pregnancy in first 12 weeks so its so frustrating! Anyway perhaps that also helped to balance out hormones? I also tried acupuncture.

I wish you all the luck in the world and good luck doing your own research it's what I had to do to get where I am now x

I know that high % of DNA fragmentation can cause this. Don't forget to check your OH. Good luck

Go to a fertility clinic and ask for Level 1/2 testing. They can cost 2-3k depending on whether you include karyotyping but are worth it if you can afford them. Just bear in mind that the gold standards for treating recurrent miscarriages (low molecular weight heparin / steroids / thyroxine as required) may not be available to you on the NHS.

Hi, I'm 41 and pregnant after 7 miscarriages- all first trimester and first one age 34. My top tip would be to go to your Gp and lie- tell them you've had a positive pregnancy test then in the time it's taken to get your gp appointment you have miscarried. They didn't do anything to confirm any of my miscarriages so they won't know the difference but you can then ask for a referral to a recurrent miscarriage clinic.
For me I tested (and husband) negative for everything but they have been giving me 75mg aspirin since first day of positive pregnancy test ( in case of sticky blood but because of your age you may as well do this anyway because they will prescribe it to you to help prevent preeclampsia as soon as you see a consultant anyway). I'm also on daily low dose injections of heparin, again in case of sticky blood even though I tested negative because they don't know for sure if it helps ir not. I take 800mg if folic acid daily (pregnacare plus a 400 top up pill) because of age again so you can start that now if not already doing it. Other than that, unless you test positive for anything or your partner does (you can ask for sperm tests), then there are limited things they can do but I can't overstate the benefit of being in the recurrent miscarriage clinic. Mostly just because they just get what you're in about and totally understand and empathise. They make you feel reassured and more relaxed/less stressed just because you know they know what they're doing and doing everything they can so you can stop fighting for help and just do as your told and look after yourself as best as you can. I found it much easier to focus on exercise, eating healthy and keeping my mental health on track as soon as I was under their care.
It's a nightmare trying to process all this stuff and try to come to terms with what may or may not be without the right professional help. Hopefully you'll get that soon xxxxx

Hi there, thanks so much to all of you for these messages. Really helpful, and I appreciate you sharing your experiences. I have a complicating factor in that I live abroad; through my employer I'm eligible for funding for whatever the NHS would offer, but I have to navigate a different system without a GP (they barely exist here) to try to find it! Which takes quite a bit of work.

Anyway, I'm already on 5 milligrams (as opposed to standard recommended 400 micrograms) of folic acid daily, as is my husband, recommended by my Ob-Gyn here. I'll ask her about low-dose aspirin too (as RachRainbow's doctor said, it can't hurt and I was taking it from week 12 in an earlier pregnancy to manage pre-eclampsia risk). I'll also ask about heparin injections. Since my original post I've had the immune system tests done, and they seem to be coming out negative, so I think it'll be a case of just keeping trying and hoping. I wish there was a recurrent miscarriage unit here! They sound great.

Good luck Ginny1234 for your pregnancy!