Two MMCs in a row

[tttc2022]

Hi all,
I've just found out that I've had my second MMC in a row (first time was in August when the baby died at 6 weeks despite previously having a heartbeat, I found out at 8 weeks; this time, the baby died at 7+3 and I found out at 9+4, again after seeing a good heartbeat). I have a DD already and had no issues with that pregnancy so I'm at a bit of a loss as to why this has happened again. Two in a row feels like more than bad luck, although the doctor and nurse are saying that it won't likely be anything else as I have a child already.

I suppose it would be good to hear from anyone else who has also had more than one MMC, especially after seeing a heartbeat, and if there was any reason found? And if anyone went on to have a successful pregnancy and if they did anything different? I am thinking of taking low dose aspirin next time as the nurse at EPU mentioned these could be due to sticky bloods and I've asked my GP to do some blood tests as they won't refer me yet.

Thanks!

I had a MMC in late September after seeing a heartbeat at 6w2d where development must have stopped shortly after that and was picked up on a scan after 9 weeks. I've had previous losses at 5-6 weeks between my children. I am older, so more likely to have genetic anomalies, which my recent MMC was, but I also think there must be something else genetic like an unbalanced translocation due to the previous repeat miscarriages in my early 30s. There's something underlying where I have erratic luteal phases and my cycles gradually become more competent once they regulate.

I'm now almost 7 weeks pregnant after a successful scan at 6w3d. I've been taking low-dose aspirin this time and the EPU gave me cyclogest this week as I had private blood tests to show progesterone levels are low in the luteal phase and early pregnancy. That was prescribed this time based on the fact I have a history of losses, so it may help sustain the pregnancy but I don't really know yet if it's viable. I also tested day 2-5 female hormones, AMH, CRP (inflammation) and cortisol at the start of this cycle which gave me a good snapshot of my fertility as prolactin, cortisol and testosterone were raised, with low SHBG, but FSH and AMH were great.

It's just a matter of bad luck I think for me genetically, but probably now compounded by my age so my risks are higher. Under 35-40 any age-related risks should be a lot lower. I also read and implemented a lot of the advice and supplements in 'it starts with an egg'. I'm 44, but this is the most regular my cycles have ever been so it's been much easier to conceive, which feels almost ironic now. I lost about 19lbs as well eating low Gi, as that felt like the only risk factor I can actually control and impact. When I lost weight in the past we conceived my first daughter, but had 3 losses when trying to conceive our second and I try to remind myself that I had to go through those to have her.

I'm in the same boat, "glad" to see your post as I've been feeling like it was just me (silly I know!). Had a missed miscarriage in August at 10 weeks but baby had stopped at 8+4...I had full blown pregnancy symptoms and no idea at all that something was wrong until the first scan, no heartbeat. Got pregnant again end of October and another miscarriage at 6 weeks. Doctors all say it's bad luck and mother nature doing her thing because I'm 32 and have had a perfectly normal pregnancy with my now 3 year old. But it's not enough for me to hear that and to just keep trying. It's physically and emotionally draining and I want to know more - I'm going to try and find out as much as possible as I just don't get it. Sorry, not much of an answer, more of a frustrated and tired rant 🙄 but you're not alone!

@somethingluscious thanks so much for sharing your story, I'm so sorry to hear about your repeated miscarriages, it is truly awful. Congratulations on your pregnancy and wonderful that you've had a successful scan already, I really hope it all goes well. I've ordered the same book so hopefully it will have some good advice in there.

@EmC90 I'm so sorry that we're in such similar positions but like you say, I'm "glad" to not be alone in it (although I do wish both of our pregnancies had worked out). I'm also 32! It frustrates me how the doctors say I'm young and have time on my side as I feel that's not really the point, the physical and emotional toll is traumatic. I think we're going to take a few months off from TTC whilst we also look for answers as I can't keep doing this. Have you spoken to your GP about running some basic blood tests? The Tommy's website has a checklist of some that my GP has agreed to do. I've also contacted a couple of recurrent miscarriage clinics to see if they'll help at all at this stage and I've ordered the aspirin too.

Get checked for the MTHFR gene mutation, it's quite common and means people can't tolerate folic acid and have to take methylfolate instead

I'm in the same boat. 2 miscarriages in a row.

I'm not sure where to start with investigation/fertility support.

@somethingluscious did you go privately for your day 2-5 tests?

I've also had a subchorionic haematoma with both pregnancies, this time it was massive and would have been high risk even if the foetus had developed properly.

@tttc2022 thanks for starting the thread.

@Perditanoy how does one get this checked?

@Perditanoy thanks, is this something the GP could test for?

@FearEtc sorry that you find yourself in the same position, it is truly awful. I had a SCH in this last pregnancy as well, which I feel gave some false hope as any tiny spotting I had I just attributed to that.

@FearEtc I get blood tests done with Medichecks. I'm tracking hcg and progesterone, and did days 2-5 bloods, AMH and cortisol (because my SHBG was low) at the start of this cycle in November. I've just sent off for thyroid alongside CRP again, with vit B6, D and folate as want to see what those are like for me in early pregnancy. A lot of my results have always tended to be borderline, just within or above normal range, or sub-optimal. I also take methylfolate (by Jarrow) and low-dose aspirin now.

They are not the quickest turnaround, but give me an idea of what is going on and showed my hormones were still really good for my age, which probably partly explains why we can conceive more easily now. I went through primary and secondary infertility with my first two children and now because of my age and existing children I'm not eligible for investigation for fertility or recurrent miscarriage, but I know enough from previously to be able to understand tests, etc and what I can and can't do to make our odds better. The only thing I haven't done is further tests to see why we miscarry, but it is more likely to be age or genetics now and it wouldn't actually change anything. Younger couples if they have genetic issues can opt for pre-implantation genetic screening if they go through IVF, but even when we were younger that would have been too much for us emotionally I think.

I'm struggling at the moment thinking I have probably already had a MMC. It feels quite odd not knowing and trying to stop myself thinking so negatively, but it is hard to feel positive. There is a fair bit of PTSD I think associated with a MMC and I flash back to it from last time, whereas I don't really remember my very early losses other than the hcg not being good. I was wondering how I must have felt at this stage with my second daughter, but I think then because the hcg was good I would have thought everything was ok. MMCs really are pretty horrendous in the way they impact you. I'm reading a book called Rumination by Lana Otayo and trying to remember I have done everything I possibly can so hope whatever happens there is less emotional impact for me then.

Also, other things you can test for are Antiphospholipid syndrome tests, Full thrombophilia profile and Karyotype testing of yourself and partner. They are more expensive tests, particularly the last two.

There is a private antenatal baby scan clinic locally who can do these, but I haven't as they wouldn't really make any difference to our outcomes I don't think. The only thing is with karyotyping, if one of us did have a balanced translocation and that meant the miscarriages had an unbalanced translocation, it might mean our daughters could be carriers / have a balanced translocation too. That's where IVF and PGS testing can come in.

Those are the only things I haven't ruled out other than it being egg quality due to age / underlying subfertility. Part of me still wants an answer though as my infertility was always unexplained and I think it could have implications for my daughters down the line.

@tttc2022 I found on both occasions that the doctors didn't really seem all that bothered once it was clear it was a miscarriage - they just said cheer up, you are young and healthy, try again basically! On the one hand I suppose it is a lot more common than we think and doctors have seen it all a thousand times before - on the other, it is a traumatic experience and I don't want to wing it if I can. I have a private scan and appointment next week and I will ask to run blood tests for sure. Unfortunately I cannot get referred to specialists until it happens at least 3 times 🙄good luck to us all!

I had to go private for mthfr and other early loss trsts but you can also get a home test for it for £150. If you body can't process folic acid and its taken in large amounts during pregnancy then it can have a negative effect

Sorry for your losses OP.

I have had two losses st 12wks and 13wks. No reasons found. I went on to have three healthy pregnancies the first being 11 months later all c-sections.

It was a really worrying snd difficult time. All the best OP.

Thanks @arghtriffid. Did you do anything different for your healthy pregnancies? I think next time I'm going to take 150mg aspirin from 1dpo and request progesterone pessaries so I at least feel like I'm doing something to help. It's awful feeling so helpless.

Hi @tttc2022 and everyone else I'm so sorry you are going through this.

I attend Centre for Reproductive Immunology and Pregnancy Miscarriage in Epsom. It's expensive and a long journey although I have met people who travel there from all over! But I just wanted you to know that it exists if you get to that point.

I dismissed reproductive immunology for a long time as many medics are skeptical and research evidence is mixed at best. I am also older and put it down to that. But after I had an early loss with an embryo that had been tested as normal, I looked back at my history and reconsidered. I'm currently 20 weeks pregnant.

By the way secondary infertility is quite common and, those that subscribe to the world of reproductive immunology would say that the first pregnancy can trigger the immune response.

At this point I don't really know the rights and wrongs but I do know that it seems to have worked for me.

Best of luck and sorry again that you are going through this x

Thanks @Janefx40 and congratulations on your pregnancy! That's really helpful to know. In a way, I feel almost better about when we do try again as hopefully it will result in a healthy baby but if not, then at least we can have investigations to work out what is going wrong. The first MMC felt like a blip but accepting a second as "bad luck" just doesn't feel that likely to me but I can't get referred at this stage so it's waiting in limbo.

We are also in the same boat. Miscarriage in October at 6 weeks then a missed miscarriage at 9 weeks after seeing a heartbeat at 6.

As I'd had private scans the nhs wouldn't treat me for missed miscarriage until I had 2 further scans (which I didn't want) so I was booked in for treatment with bpas today (3rd jan) but I miscarried naturally on 26th Dec.

I have two DC's already so to now have 2 miscarriages within the space of 3 months was a huge shock. DH isn't entirely sure he wants to try again to avoid the disappointment and the heartbreak.. I'm actually OK about trying again but want to try and find as much information as possible.

I had two other chemical/early miscarriages in 2014 and 2016 prior to getting with DH. My nhs trust will do investigations for secondary infertility (no ivf or assisted reproduction) but you need 3 consecutive miscarriages before they will act and my gp won't prescribe cyclogest without a fertility referral. Our other complication is we have male factor infertility as well so they're not so interested in me.

I can't really see I have many other options other than to try again and 'see what happens' but I'm not really sure I can take another loss.

@s14a I'm so sorry to hear that, it's so heartbreaking and unfair. I've ordered a couple of books to try and arm me with as much knowledge as possible, one being It Starts With An Egg and the other is the Lesley Reagan Miscarriage one. Like you, I just want answers. We've decided to keep going as we desperately want one more child, I just hope that journey isn't much more painful. Can you ask your GP to run some basic blood tests? I emailed Tommy's who said they couldn't help yet but recommended I ask for a full blood count and thyroid function test and said they recommend that for anyone who has had at least 1 loss.

I have also had 2 missed miscarriages after 2 years ttc and no children. My last one was just 7 weeks ago and I think I am pregnant again. My period hasn't arrived post miscarriage and I had a strong positive test on NYD. Feel guilty already as I have drunk so much between Xmas and NY 😬
My doctor arranged some tests a few weeks ago, I think for lupus, thyroid and blood clotting? They all came back as normal. She explained that they can't run anymore tests until 3 miscarriages.
I feel quite traumatised after both mmc, especially the second. There is something just so awful about thinking you are still pregnant and then finding out you have been carrying around something that stopped growing. My first one in April I needed a d&c but the last one happened naturally a week after my scan.
I know I have to go to the doctors and get my bloods done and get a scan but I am so scared to go back into that scan room. I almost prefer being in this stage of denial. It hasn't helped that I have zero symptoms this time, not even sensitive breasts. I feel completely normal.