Getting pregnant after 3 miscarriages including 2 D&Cs

[EricaBee]

Hi all. I'm just looking for any advice or stories you can share re getting pregnant after recurrent miscarriages and D&C. This is a summary of my living hell for the last few months...

I'm 40 and have had 3 miscarriages in the last 7 months. In June 2013 I had a MMC at 9 weeks (fetus 5.5 weeks) and ended up having an uncomplicated D&C. In October 2013 I had what was probably a chemical pregnancy, but then became pregnant again straight away. In this third pregnancy, I had 2 early scans at EPU at 7 weeks and 10 weeks both ok and saw heartbeat. But at 12 weeks scan today, there was no HB and baby looked like it had got smaller - it probably died soon after the last scan. I am devastated - really thought this one would be ok.

I have asked the EPU for another D&C as soon as possible. Does anyone know what are the chances of getting pregnant again after 3 miscarriages, and 2 D&Cs. I want to start trying straight away - though I know some doctors say wait for 1 cycle to be complete so the lining of the womb can heal. Is that based on actual hard evidence like medical studies, or is it just something they say? I don't feel like i have time to wait - even for one month.

Also, I will be seeing the recurrent miscarriage specialist, but I imagine the main reason i have miscarried is my age and poor-quality eggs. I have 2 DSs already (i know i am lucky in that respect) so I doubt any of the blood tests will show anything much. Or could they? Can you develop something like a clotting disorder after having successful pregnancies?

Thanks for letting me offload!

Hi Erica I'm sorry you have had such a shitty year. I had 3MCs between Sept 12 and June 13, as well as one between my 2 boys in 2009, so I know how it feels.
The 'wait for a period' AFAIK is not evidence based, but I do know of a lot of women who haven't waited and have had back to back miscarriages. Whether that was a lining issue or would have happened anyway I can't say. For balance I should say I also know of lots of cases where it's been fine. My own experience is that first period is often pretty unpleasant (after natural MC) which I take to mean there was some gubbins left behind that would not have helped a new pregnancy. After an ERPC I would assume if anything the lining is likely to be very thin.
What is probably more relevant is that most RMC investigations require you to take a break from TTC, probably for several months, whilst you get an appointment, have tests, wait for results.
I have 2 children and my miscarriages are due to immune issues which have developed subsequently. Having had previous successful pregnancies only really ruled out anatomical problems of the potential causes. I am 39 and was given a lot of crap about it being my age until genetic testing showed I was losing perfect embryos. I know of women in their early 30s who are being fobbed off with that line. Even in mid 40s MC rate is only starting to approach 50%, so while dodgy eggs may be a factor you are pretty unlucky to have got three dodgy ones in a row and there may be other things going on.
Do come and join the RMC thread, much tea, wisdom and sympathy available there.

I don't have anything to add to Bakingtins response but I just wanted to say that I'm sorry that this has happened to you again - it must be especially hard given that the earlier scans had been ok.

Thanks for your speedy and informative reply, bakingtins. That's interesting to hear your immune problems started after you'd already had kids - i didn't really think that could happen, but i'll make sure i get tested.
The RMC were actually going to see me after my second miscarriage, but by this time i was already pregnant so the appt was cancelled. I had some blood tests done by the GP (which were all normal) but haven't had thrombophilia screen or clotting factors or karyotype. Why would you need to wait for these tests as they shouldn't be affected by hormones etc after a miscarriage? Is it more to make sure you're psychologically feeling better?
Yes, i will visit the RMC thread -it helps to know I'm not alone. Thanks

Karyotype wouldn't be affected, but takes about 6-8 weeks to come back. Most other things are different in pregnant and non-pregnant state, I was told I had to wait about 6 weeks post-MC for the bulk of the blood tests, but can't remember exactly what was done when.
I have raised NK cells which seems to be common in women who have what you might call secondary miscarriage issues. Immune problems are triggered off by some event in your history. There is some suggestion they are more common in mothers of boys, not sure if that is true.
I had no probs with ds1, MC at 10 weeks with a pregnancy that had looked dodgy from week 6 but several scans with HB, Ds2 dodgy pregnancy, lots of bleeding weeks 8-14, he was lower than expected birthweight, placenta disintegrated and I haemorrhaged, MC2 8 weeks, MC3 9 weeks after HB seen, normal tests negative, MC4 9 weeks after HB seen but with obviously faltering growth from 7 weeks, perfect embryo when genetically tested, NK testing positive. I'm now nearly 20 weeks after treatment (and bricking it about scan!)

Thanks Forester. Thinking about it now, the only thing those early scans told me were that the fetus was alive on that day. Anything can happen from one day to the next. Sorry to be so gloomy! It's just my state of mind at the moment!

bakingtins - you have been through a lot with your miscarriages. That's great you are pregnant again - here's hoping the scan is all perfect.
Do you mind me asking what treatment you had for raised NK cells?

Steroids mainly. 20mg prednisolone a day from BFP until 12 weeks. I was also on progesterone, clexane (not for clotting, it's supposed to be cytoprotective for the developing placenta) and high dose folic acid. That's Prof Siobhan Quenby's protocol. Other women with the same condition treated by Drs Shehata or Gorgy in London have also had intralipids and/or IVIG (intravenous immunoglobulin) and immune modulating drugs
like humira. There's a thread about immune issues on the conception board called "TTC or pregnant on pred" if you want more info.

I see. That's pretty hardcore taking steroids during pregnancy....but fingers crossed it's working for you.
was wondering if anyone out there has any experience of getting pregnant straight after d&c and would be able to share their stories? I have the op booked in in two weeks time and am desperate to start ttc again straight after.

Losing 4 babies demands a hardcore response.
Prednisolone doesn't cross the placenta in any great quantity. It is associated with a slightly increased, but still small, risk of cleft lip and palate, and with low birthweights (though whether that's because even on meds the placenta is below par?) so I'll be having growth scans later on.
For the woman it does cause side effects while you are on it - for me, insomnia, v hungry and thirsty so put on weight, muscle weakness in my limbs. It can potentially cause adrenal exhaustion if you are on it longterm or you don't wean off gradually. Certainly not a decision to take lightly, but to increase my chances of carrying a baby to term from about zero-20% up to 60-80% I'm prepared to take the risk.