Repeated chemical pregnancies

[Wordstosaye]

Hoping for some advice. I'm on my third chemical pregnancy in 4 months. I seem to have no problem at all getting pregnant, but I cannot seem to maintain a pregnancy beyond 5 weeks. I already have one DC who is 6 who I had a c section with (I had one chemical prior to that). We only just started trying for DC2 and it has been immediate pregnancy but they have all been chemical. GP won't refer me for recurrent miscarriage as they aren't "clinical pregnancies" as HCG present but nothing seen on scans as too early. I do have a pretty short luteal phase of about 11 days but I did with DC1 as well. I also have quite low post ovulation temps but again, same with DC1 and didn't seem to be an issue. Have no thyroid problems.

Any advice? I feel totally ignored by the GP.

Hi @Wordstosaye sorry to hear this. I’ve just had two CPs very recently albeit after IVF and it’s so disappointing. It could be an indication of poor egg quality (probably is for me but I’m 40) but I expect your doctor may only refer you for further tests dependant on your age and how long you’ve been trying. Best of luck

I'm 33 and only been trying 4 months.

I have had 8 chemicals (plus 2 mcs) ttc naturally and now doing IVF. For us it looks like the key issue is egg quality as we have issues getting embryos to last to day 5 and most of those (3.5/5) that do are chromosomally abnormal. This is age 39 though.

I also have the MTHFR mutation, a medicated but low thyroid (ignore NHS ‘normal’, you should have TSH 1.5-2 or so for ttc).

You are young so you have a better hope at good eggs - read ‘It starts with the Egg’, boost your diet, get your nutrient levels checked (esp vit D, B vits, folate)cut out the bad stuff (and get him to do same). Men are also a big component and things like booze, poor diet and smoking (plus some supplements) can cause sperm DNA fragmentation.

Also later on you can investigate if any of this has immune issues at the root too. Any autoimmune issues? NK cells? Clotting issues?

But also 4 months is super early, 12 months ttc is still ‘normal’!

I'd just be surprised if there is anything wrong like that now as there clearly wasn't when I had DC1.

I get 12 months ttc is normal but it's not conceiving I'm having a problem with, it's holding onto the pregnancy.

I feel like it is more likely to do with my previous c section.

I am seeing a private GP next week to do various blood tests etc.

@Wordstosaye I'm sorry about your losses and your GP. I have heard that c-sections can impact in some cases - I think you would need a saline 3D scan to check for that - or some other more detailed internal examination - I can never remember the names of all the different scans!

Secondary infertility (having trouble after your first healthy pregnancy) is not uncommon. Unfortunately having had one healthy pregnancy doesn't mean that none of those other issues mentioned by @Phrenologistsfinger are relevant for you. In terms of immune issues (very controversial area I should say) they often say that it kicks off after a successful pregnancy. I am under the care of a consultant in reproductive immunology. If you want to hear more about that, let me know.

Best of luck with your investigations and TTC x

I'm not saying I definitely don't have any immune issues but I have 0 symptoms of anything like that!

@Wordstosaye I'm honestly not a big proponent of immunology and avoided it for years even tho I was in the IVF world. There could be lots of other reasons so definitely explore them first.

Having said that, the only symptom of immunological issues for most people is not getting pregnant or having chemicals/miscarriages.

But see what the private GP says. Hopefully it all resolves more easily x

As @Janefx40 says your body is always changing, e.g. DC1 preg will have affected your immune system, and having one child is no guarantee of a second.

You should def still look at egg & sperm quality as younger eggs can correct for poor quality sperm in embryo development but as your eggs age, they will be less able to do so. Sperm is also far easier to improve (3 months turnover time) so an easy win.

You don’t have to listen to my advice but I’ve done a lot of research on recurrent chemicals so you do have some leads. In my (non-medical) opinion I think chemicals are either immune-related or due to poor quality embryos (dodgy chromosomes), which is egg/sperm quality. In my case, it’s both.

First steps for me will be a detailed thyroid test and then aspirin, decent prenatal vitamins and possibly progesterone supplements I think. If that doesn't do anything I'll look into a 3D saline scan in case of adhesions or other abnormalities. I've had two consecutive very early stage losses at this point (I think they do still techhnically count as chemicals even though test lines were good and strong), so I'm not quite ready for more invasive testing or (costly) investigations yet.

@Wordstosaye spynds like you’re doing all the right investigations. I had 2 chemicals in IVF. Even though my bloods came back normal I started clexane blood thinners 48 hours before transfer and it worked! Micro clots in the placenta derailing implantation are apparently a real issue. I know it’s really frustrating if tests come back all clear because you need a explanation. But if they do this showed us there are still things you can try xx

My chemicals seem to be a little different from many others I've seen in that the test lines get relatively strong but then fade off from about 18/19/20 dpo, so about 5 weeks.

When this happened last time I went to the EPU with bleeding and the womb lining was thick but they couldn't find any evidence of a pregnancy as too early, then HCG levels dropped and I bled. This time I haven't bothered with the EPU - test lines started getting lighter and I started bleeding (lightly, on and off) so I knew what was happening. Hoping I start properly bleeding in the next few days or I suppose it'll be back to the EPU for me to check it isn't ectopic or anything. Sigh!

@Wordstosaye it sounds like you're on the right track - start with the simple tests first. I won't lie - tracking down reasons for infertility/losses is a massive (and very expensive) rabbit hole so best to cover the basic bases first.

Best of luck and sorry you're going through this again x

Best of luck. Check it's not adenomyosis.

@Janefx40 sorry to jump on but I would be really interested in how you went about the immunology testing? I’ve had 4 losses at 6 weeks in the last 18 months. I’ve had all NHS tests and nothing has come up. Do fertility clinics do this testing or is it a specialist like Dr Shehata? I have a three year old which was my first pregnancy and all losses since, I had also heard immune issues are more likely after one birth

@Piper89 I'm sorry for your losses. I also have a 3 year old conceived via IVF but without immune treatment.

I was originally at ARGC (IVF clinic that has a strong focus on immunes) so did my original tests for NK cells, cytokines etc there. I am now at CRGH so repeated there plus had NK biospy.

I then went to Mr Shehata in Epsom and he now handles my immunes with IVF stuff at CRGH.

A lot of people alternatively go to Dr Gorgy for an even more thorough (if bracing) experience.

There's a FB group called UK Reproductive Immunology that you can join to ask questions. Most people on there are with Gorgy.

So so sorry you are going through this. This is super frustrating, especially since it sounds like your GP hasn't been too helpful. I would recommend seeing another MD if possible. Repeated miscarriages can be a sign of many potential issues - including chromosomal issues. Chemical pregnancies can leave women feeling confused since some providers will say just what yours did - they were not "clinical" pregnancies. Here is a great article which summarizes chemical pregnancies: www.mamasconnected.com/post/chemical-pregnancy-early-miscarriage
If there is a chromosomal reason for the miscarriages, fertility treatment, including IVF, has been helpful for some in order to identify healthy embryos. Best of luck x