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Miscarriage/pregnancy loss

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Pregnant again after 3 miscarriages - aspirin?

23 replies

User06489 · 06/05/2024 10:00

Hello, think I might be pregnant again, it will be the 4th time in 12 months after 3 back to back miscarriages. I have no live children.

I'm on the waiting list to be seen by my early pregnant unit at my local hospital for recurrent miscarriage but I believe the waiting will be months.

I had my day 21 bloods taken for progesterone a few months back and it came back as 41 (I got a BFP the following day but again it ended in miscarriage),

My vfl was yesterday 9DPO and I am wondering do I start taking low dose aspirin today? I've not tried it before but after so many losses it seems like something I may as well try, and will likely be advised to do it anyway when I finally get seen at the hospital??

OP posts:
Cariadxx · 06/05/2024 13:00

I really wouldn't without speaking to a doctor, there are lots of reasons why you might be having mc which don't involve aspirin and it's not without side effects

User06489 · 06/05/2024 13:10

I understand what you are saying but how many miscarriages do I need to go through before just giving it a try.

OP posts:
AllThePotatoesAreSinging · 06/05/2024 13:14

Call the EPU/recurrent miscarriage clinic asap as in my experience they will get you in asap to see what they can do for you in this pregnancy. Recurrent miscarriage clinic is normally under gynaecology outpatients so if the EPU can’t help, try calling gynae instead. If you choose to start taking aspirin take it at night (it’s more effective when taken then). It used to be 1 baby aspirin but changed to 2 several years ago, again because 150mg was found to be more effective and make sure you check with your doctor that there’s no reason NOT to take aspirin. Also ask for progesterone because studies suggest it can support a pregnancy in women who have had 2 or more miscarriages, even if there has been no bleeding. If you have a sympathetic GP they might prescribe it to you. Good luck.

Sleepingbeauty123 · 06/05/2024 13:17

If your EPU knock you back try to find a private consultant to discuss and prescribe if needed. In my experience of recurrent mc, the NHS drag their heels/ stick doggedly to their guidelines when newer evidence is available.

AllThePotatoesAreSinging · 06/05/2024 13:18

@Cariadxx 150mg aspirin is a tiny dose and very unlikely to have any side effects. A headache dose is about 1200mg 4 times a day. Gastric friendly ones are readily available.

She is likely to be told to start taking it at her booking appointment given her history.

@Sleepingbeauty123 thats not been my experience at all. You just have to find the right people to talk to. Consultant secretaries are good numbers to get hold of! Putting things in writing helps too, especially if you can put it in an email to a consultant (never waited more than an hour for a response when I’ve had to resort to emails!)

edit - based my responses on 2 high risk pregnancies, Leeds and East Lancs recurrent miscarriage clinics and consultants. In case it helps to know as I am aware it can be a postcode lottery

User06489 · 06/05/2024 13:26

Thank you so much for all the helpful comments I really appreciate it! I do know the consultant I've been referred to is the EPU head of department so perhaps I will try and contact her secretary even though I don't think I would get to see her for months.

OP posts:
AllThePotatoesAreSinging · 06/05/2024 13:31

User06489 · 06/05/2024 13:26

Thank you so much for all the helpful comments I really appreciate it! I do know the consultant I've been referred to is the EPU head of department so perhaps I will try and contact her secretary even though I don't think I would get to see her for months.

I thought that too, and a direct call got me an appointment the following week due to cancellation. It’s worth asking.

Objectiontime · 06/05/2024 20:50

User06489 · 06/05/2024 10:00

Hello, think I might be pregnant again, it will be the 4th time in 12 months after 3 back to back miscarriages. I have no live children.

I'm on the waiting list to be seen by my early pregnant unit at my local hospital for recurrent miscarriage but I believe the waiting will be months.

I had my day 21 bloods taken for progesterone a few months back and it came back as 41 (I got a BFP the following day but again it ended in miscarriage),

My vfl was yesterday 9DPO and I am wondering do I start taking low dose aspirin today? I've not tried it before but after so many losses it seems like something I may as well try, and will likely be advised to do it anyway when I finally get seen at the hospital??

I have researched the use of low dose aspirin in pregnancy quite a lot. First and foremost, you need to know that it thins the blood a bit so if you are taking Omega 3 you need to exercise caution, as that also thins the blood. If you have any gastric problems then you should not consider taking it. Asprin also has a cumulative effect in the bloodstream so in reality you should be able to take it every 2 or even every 3 days because that will cover the life of any new blood platelets, if you are of average weight or less I would absolutely suggest you start with one low dose aspirin, ie 75 to 71 grams and then take advice from your hospital on moving up to 150 after 12 weeks if they advise it. If you are a particularly large lady then you could possibly start on 150 g but the smaller dose is shat is recommended in terms of trying to prevent mi scarriage, etc to start with.
May I also suggest that you take it about half an hour after your evening meal with about half a pint of warm water. Then, after half an hour, drink another half pint of warm water. Do not lay down to sleep for an hour after taking it. All this will help prevent acid reflux and assist your body to absorb the aspirin.
You are probably aware that the two benefits of aspirin are that it potentially provides better blood flow to the pregnancy, which is potentially beneficial if you have thicker or quick clotting blood. If you havent then it can, unusually, cause bleeding. Some people get nose bleeds, for example. If this occurs and/or you notice any unusual stomach pain or blood in your stools you must stop taking it immediately!
Its other advantage is that it suppresses inflamation and therefore is said to work against any antibodies in the blood. I am absolutely not an expert in the field so I should not comment further on that.
If you feel that you want to try it, I would to be honest. There has been a lot of research to suggest there are more positives than negatives but whilst some doctors will absolutely support you trying it others will say no. I dont tolerate it very well so I take Omega 3 instead.

Objectiontime · 06/05/2024 20:51

I should have said, first, that I am sorry to hear of your miscarriages, it's a horrible club to be in. I so hope that your current pregnancy is successful x

katebushh · 06/05/2024 21:05

I had recurrent miscarriages and a stillbirth before being diagnosed with https://www.nhs.uk/conditions/antiphospholipid-syndrome/

Aspirin will thin your blood a little but you need to push for a proper assessment such as blood tests to rule this out.

Good luck Flowers

jjpolly90 · 06/05/2024 22:28

I had 3 miscarriages and read about taking aspirin online while I was grieving and so I gave it ago only a small amount once a day and I don't know if it was because of that but I now have a two year old! It's so heartbreaking I feel for you, I don't see why you couldn't try I'm sure a tiny amount can't go any harm but I may be wrong but good luck for the future 💐

Justbecause19 · 06/05/2024 22:32

I had 2 miscarriages in a row, when I got pregnant again I took a low dose of aspirin. That pregnancy is now a 2 year old. I then got pregnant again and took a low dose of aspirin like before and that pregnancy is now an 8 month old. I did have a healthy pregnancy before my 2 miscarriages with no aspirin so no idea if it helped, but it certainly didn't cause any issues.

AllThePotatoesAreSinging · 06/05/2024 23:12

Objectiontime · 06/05/2024 20:50

I have researched the use of low dose aspirin in pregnancy quite a lot. First and foremost, you need to know that it thins the blood a bit so if you are taking Omega 3 you need to exercise caution, as that also thins the blood. If you have any gastric problems then you should not consider taking it. Asprin also has a cumulative effect in the bloodstream so in reality you should be able to take it every 2 or even every 3 days because that will cover the life of any new blood platelets, if you are of average weight or less I would absolutely suggest you start with one low dose aspirin, ie 75 to 71 grams and then take advice from your hospital on moving up to 150 after 12 weeks if they advise it. If you are a particularly large lady then you could possibly start on 150 g but the smaller dose is shat is recommended in terms of trying to prevent mi scarriage, etc to start with.
May I also suggest that you take it about half an hour after your evening meal with about half a pint of warm water. Then, after half an hour, drink another half pint of warm water. Do not lay down to sleep for an hour after taking it. All this will help prevent acid reflux and assist your body to absorb the aspirin.
You are probably aware that the two benefits of aspirin are that it potentially provides better blood flow to the pregnancy, which is potentially beneficial if you have thicker or quick clotting blood. If you havent then it can, unusually, cause bleeding. Some people get nose bleeds, for example. If this occurs and/or you notice any unusual stomach pain or blood in your stools you must stop taking it immediately!
Its other advantage is that it suppresses inflamation and therefore is said to work against any antibodies in the blood. I am absolutely not an expert in the field so I should not comment further on that.
If you feel that you want to try it, I would to be honest. There has been a lot of research to suggest there are more positives than negatives but whilst some doctors will absolutely support you trying it others will say no. I dont tolerate it very well so I take Omega 3 instead.

I’ll preface this by explaining that I have antiphospholipid syndrome so aspirin in and out of pregnancy is a way of life for me, and my experience is a bit more than read a few online articles.

Sorry but you’ve given quite a bit of incorrect or outdated advice here. One is potentially dangerous.

  • 150mg is the common dose. It’s not been 75mg for years.
  • it doesn’t thin the blood that much. Many hospitals will operate on you if you take a daily dose of up to 200mg.
  • Gastro resistant aspirin is widely available for less than a pound. It has a coating that prevents gastric problems.
  • Nosebleeds aren’t a reason to stop aspirin. Most pregnant women get nosebleeds because of hormonal changes and extra blood volume.
  • Omega 3 is nowhere near a comparative substitute. If you can’t take aspirin, clopidogrel (plavix) would be then nearest suitable medication.

The dangerous advice: don’t skip a dose unless you are advised to.
Women like me with clotting issues generally have planned deliveries and are advised to stop taking it in the last 10 days of pregnancy, and it’s very scary knowing we are unprotected for one day let alone 10. Quite a few don’t stop taking it because of the risk of clotting and what that might mean for a pregnancy (I’m not passing opinion on that - like I mentioned it’s a low dose and many hospitals will operate on low dose patients).

The theory behind aspirin is that some women clot easily in pregnancy. These can be tiny clots or big clots. Tiny clots can form in the lining of your womb, preventing implantation, or restricting blood flow to the placenta. They can form elsewhere in the body, break off and travel around the body, picking up sticky little platelet friends along the way, until they end up in the placenta or umbilical cord (or ends up somewhere that causes a problem - or does nothing bad and just breaks down over time).

All women get sticky platelets to some extent in pregnancy. It’s the body’s defence mechanism to stop us bleeding to death in childbirth. Very clever except with anything you can have too much of a good thing, and some women produce more clotting antibodies in pregnancy than others.

Aspirin is an antiplatelet. It works by binding to your platelets and preventing them from sticking together and forming clots. Once it’s bound to a platelet it alters the surface of that platelet forever until the platelet dies at about 10 days old. New platelets come from your bone marrow. Humans have a circadian rhythm which means things in the body happen at the same time every day. Cortisol production peaks at 7-8am. Platelet productivity peaks early morning (this is one of the reasons we take aspirin before bed). About 10% of your platelets are regenerated every day (like most things this is an average so if your platelets only live 8 or 9 days then it’s going to be more like 15%). It’s not a guarantee of preventing clots as it only works on platelets, coagulant factors can still cause clotting, but it’s a good option if sticky blood is suspected to be a problem.

If you take your aspirin before bed on Monday and then skip 2 or 3 doses then that is an awful lot of platelet regeneration. In 3 days at a minimum 30%. So almost a third of your sticky little platelets travelling around your vascular system untreated and with the potential to cause a clot in seconds (that’s how quickly a clot can form). Having had 4
miscarriages due to APS there is no way I would risk missing a single dose. No. Way. There is no magic fix if a clot forms. You ride it out until it breaks down again. Or causes havoc. And you don’t know which one of these will happen.

I had a gastric bleed in my last pregnancy (not from aspirin, from gestational diabetes). I missed a single dose on doctor’s orders and I was under hospital observation the whole time. They gave me my next dose before I went home. That’s how serious it is not to miss a dose if you need it in pregnancy.

Please refrain from giving advice if you aren’t an expert.

AllThePotatoesAreSinging · 06/05/2024 23:24

Objectiontime · 06/05/2024 20:50

I have researched the use of low dose aspirin in pregnancy quite a lot. First and foremost, you need to know that it thins the blood a bit so if you are taking Omega 3 you need to exercise caution, as that also thins the blood. If you have any gastric problems then you should not consider taking it. Asprin also has a cumulative effect in the bloodstream so in reality you should be able to take it every 2 or even every 3 days because that will cover the life of any new blood platelets, if you are of average weight or less I would absolutely suggest you start with one low dose aspirin, ie 75 to 71 grams and then take advice from your hospital on moving up to 150 after 12 weeks if they advise it. If you are a particularly large lady then you could possibly start on 150 g but the smaller dose is shat is recommended in terms of trying to prevent mi scarriage, etc to start with.
May I also suggest that you take it about half an hour after your evening meal with about half a pint of warm water. Then, after half an hour, drink another half pint of warm water. Do not lay down to sleep for an hour after taking it. All this will help prevent acid reflux and assist your body to absorb the aspirin.
You are probably aware that the two benefits of aspirin are that it potentially provides better blood flow to the pregnancy, which is potentially beneficial if you have thicker or quick clotting blood. If you havent then it can, unusually, cause bleeding. Some people get nose bleeds, for example. If this occurs and/or you notice any unusual stomach pain or blood in your stools you must stop taking it immediately!
Its other advantage is that it suppresses inflamation and therefore is said to work against any antibodies in the blood. I am absolutely not an expert in the field so I should not comment further on that.
If you feel that you want to try it, I would to be honest. There has been a lot of research to suggest there are more positives than negatives but whilst some doctors will absolutely support you trying it others will say no. I dont tolerate it very well so I take Omega 3 instead.

Also you are conflating aspirin recommendations for women with BMI over 35 with the outdated 75mg dose.

150mg is the standard dose for recurrent miscarriage, low Papp-A, being a geriatric pregnancy, being a BMI 35+ pregnancy, having a clot/stroke/heart attack risk. They don’t start you off on the lower dose to see what happens because getting that wrong potentially leads to miscarriage. You may be confusing it with LMWH injections, for which doses do increase based on weight.

Completely agree that investigations are needed. Most countries around the world recognise that 2 miscarriages is a sign that all is not right, and they are a lot better at referring women for tests at this point. Even the USA gets this right (and I don’t often say that about their healthcare!) Hope it all works out for you OP x

Nori10 · 06/05/2024 23:35

I had two consecutive miscarriages and took low dose aspirin when I found out I was pregnant a third time. I didn't ask my GP first because I just was desperate to try something, but I did tell my gp at the first appointment I had and he said it couldn't do any harm. I ended up taking it throughout the pregnancy (which was a successful pregnancy). I'm not sure if it made a difference, I took it again for two subsequent pregnancies and one ended in miscarriage again and another successful, but from talking to consultants, midwives and my GP, low dose aspirin is considered safe for most women.

I say follow your gut and then just be open with your gp / midwife. Good luck.

Objectiontime · 07/05/2024 10:37

AllThePotatoesAreSinging - Apologies if I got it wrong. A lot of advice about many things is given on MN in different forums and I suspect that the vast majority of time it is from non experts in different fields. Nevertheless, you are right and medicines are probably left to discuss with doctors and not on a MN forum so apologies again and I will leave this subject alone. X

AllThePotatoesAreSinging · 07/05/2024 13:09

Objectiontime · 07/05/2024 10:37

AllThePotatoesAreSinging - Apologies if I got it wrong. A lot of advice about many things is given on MN in different forums and I suspect that the vast majority of time it is from non experts in different fields. Nevertheless, you are right and medicines are probably left to discuss with doctors and not on a MN forum so apologies again and I will leave this subject alone. X

Your heart is in the right place, that’s easy to see x

User06489 · 07/05/2024 14:14

Hi all, I started 150mg last night of aspirin. Wasn't sure whether to go for 75mg or 150mg. I am normal BMI. Will see how things go...

OP posts:
Sleepingbeauty123 · 07/05/2024 20:35

AllThePotatoesAreSinging · 06/05/2024 13:18

@Cariadxx 150mg aspirin is a tiny dose and very unlikely to have any side effects. A headache dose is about 1200mg 4 times a day. Gastric friendly ones are readily available.

She is likely to be told to start taking it at her booking appointment given her history.

@Sleepingbeauty123 thats not been my experience at all. You just have to find the right people to talk to. Consultant secretaries are good numbers to get hold of! Putting things in writing helps too, especially if you can put it in an email to a consultant (never waited more than an hour for a response when I’ve had to resort to emails!)

edit - based my responses on 2 high risk pregnancies, Leeds and East Lancs recurrent miscarriage clinics and consultants. In case it helps to know as I am aware it can be a postcode lottery

Edited

I'm pleased that that hasn't been your experience, but it has been mine. If it had 'just' been a case of finding the right email, I might be in a very different situation at the moment.

AllThePotatoesAreSinging · 07/05/2024 20:55

Sleepingbeauty123 · 07/05/2024 20:35

I'm pleased that that hasn't been your experience, but it has been mine. If it had 'just' been a case of finding the right email, I might be in a very different situation at the moment.

Edited

It’s not a case of ‘just finding the right email’, I’ve made it sound over simplistic. In my case I was able to gain a sympathetic ear and they were able to help. There was definitely some luck involved. Not caring if I am being a pest too. Like I said being in the right place helps, which is why I’ve mentioned the hospital Trusts. I’ve had occasions where the NHS has fallen short. I don’t know your circumstances but infertility is a shit club to be in. If I had exhausted my options I would have turned to private consultants too.

Sleepingbeauty123 · 08/05/2024 12:43

AllThePotatoesAreSinging · 07/05/2024 20:55

It’s not a case of ‘just finding the right email’, I’ve made it sound over simplistic. In my case I was able to gain a sympathetic ear and they were able to help. There was definitely some luck involved. Not caring if I am being a pest too. Like I said being in the right place helps, which is why I’ve mentioned the hospital Trusts. I’ve had occasions where the NHS has fallen short. I don’t know your circumstances but infertility is a shit club to be in. If I had exhausted my options I would have turned to private consultants too.

I'm wary of oversimplifying or generalising as I think it feeds into the often heard misconception that women are simply not trying hard enough to make that baby happen - in various ways. Not relaxed enough/ too relaxed/ not enough supplements/ too fat/ too thin/ not persistent enough/ 'obsessed'. It's a narrative that puts the responsilibility firmly in our court, which contributes to the declining mental health of many women with infertility.

It is a shit club, all day every day.

OP, I hope that things are working out for you.

User06489 · 09/05/2024 16:53

Update, FRERs have not got any darker and seem to be lightening and are barely there now 13DPO so appears to be another chemical pregnancy loss.

OP posts:
PrincessBootsie · 06/02/2025 09:05

I have had 3 consecutive miscarriages and no living children. I have ordered ovum supplements to take over the next 3-4 months as well as starting 150mg of daily aspirin. My husband is also taking recommended prenatal supplements. We have changed our diets, cut out alcohol and trying to eat clean through a varied diet as well as gut healthy probiotics. Were also builiding our fitness levels with low impact but frequent exercise. All this is whilst we wait to see a specialist for fertility. We're at the point where we have decided to just throw everything at it and see what happens. We're past 35 so its a case of running against the clock it feels like!

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