Recurrent miscarriage - What factors where causing it and did you get your rainbow baby?

[Kent91]

Hi,

I'm a mum to a 2.5 year old. Since summer '24 i've had 3 back to back miscarriages in 7 months- all early loses. They all showed slow rising HCG, I could tell by the premom preg tests. My 1st and 3rd were chemical pregnancies at 5.5w. My second was a PUL at 7.5w.

I've started testing for possible causes - did you find out what you had? What was it? And please tell me you had your rainbow baby?

I'm 33, non smoker, not a massive drinker and have a healthy weight, and other than having a toddler, my lifestyle/health hasn't changed since 2022. I got pregnant straight away with my son and with my miscarriages too... there is just something not working..

I had a hysteroscopy and a biopsy for the EMMA and ALICE yesterday, done privately, as the NHS won't see me until July. I'll report back

Hi so sorry for your losses.

I had two straightforward pregnancies in 2020 and 2021. Conceived again easily in Oct 2023 which was a MMC discovered in Jan 2024, this was complicated by retained products which lead to chronic endometritis. Following that had two chemicals one in May 2024 and then another in August 2024. I then fell pregnant again Sept 2024 and had first scan with heartbeat seen but then loss of heartbeat at 8 weeks. After these 4 consecutive losses I went private as soemthing was clearly wrong. Hysteroscopy and biopsy confirmed ongoing endometritis and elevated uterine nk cells. Bloods via fertilysis as showed peripheral raised nk cells.

Glad you have had Emma and Alice etc sent at this will exclude the endometritis. I personally would want to exclude immune issues as it’s one of top reasons for recurrent miscarriage. Fertilysis so a good recurrent miscarriage blood panel or there are few top reproductive immunologist in London. I personally think my immune dysfunction is down to me having retained products for 9 weeks and my system is in overdrive but there isn’t a 100% proven link between the two as of yet.

Hope things get better for you and you get correct investigations

Hi, sorry for your losses @Kent91 . I hope your 2.5 yr old is keeping you going - remember they are the proof your body can do this.
I’ve had 3 losses too but in a different order to you. I had 2 before my daughter. Then she came along as a successful pregnancy. I came across your post as sadly I have just had another miscarriage in our attempt for Baby #2. I’m 33 too.
When it gets to miscarriage #3 I feel less accepting of people just putting it down to ‘bad luck’ although granted it still can be. Hope the tests you’ve had give you some answers or alternatively that you get your rainbow baby soon.

I’m so sorry to hear about your losses. I had 3 MMC. After the second, I went private and saw Mr Rai at the recurrent miscarriage clinic at St Mary’s in Paddington. I turned out to have sticky blood and took half an aspirin. It didn’t prevent my third MMC but my fourth pregnancy was successful and I have a lovely DD aged 12.

I read a great book by Professor Regan (wbo was the lead at St Mary’s) and it explores a number of different reasons for miscarriage. It’s worth a read.

i also went to Serum in Athens (pre successful
pregnancy). They were excellent and did a gamut of tests but eventually I decided to follow the advice and treatment pathway of St Mary’s and it all worked out.

If I learnt anything it’s that it’s unfortunately possible to be unlucky with pregnancies for no particular reason. I really hope all works out for you.

Thank you ladies, I don't have anyone close to me that has had recurrent miscarriages, so thank you for your stories and suggestions.

I'm hoping to get the immunology test and thrombophilia test done soon too, to rule out. It's hard to try not to look at clues when it comes to your body. I have a new monkfish allergy that I didn't have before my son, and wondering if my leg rashes that I thought were just post-loss anxiety could be psoriasis and all linked. But then again, I still have an ugly bruise from my canula from last tuesday's sedation so naturally I wonder if it's a blood clotting issue. So easy to go down the rabbit hole..

I was so ill after my second MMC - just nasty virus after nasty virus. I’m never ill but it was one thing after another. I think the grief really undermined my physical health.

I had an horrendous haematoma after my first MMC. It was after the op where the cannula had been sited. I couldn’t use my hand at all for about 8 weeks it was unbelievably painful. I still have issues re anything intravenous even now. This was possibly a sign of my blood issue but I do have very poor veins so maybe it was just that?

Even if you do have an issue with your blood it could be fairly simply remedied like mine. It was literally half an aspirin until the third trimester and then Clexane post delivery. All that heartache and the answer was a baby aspirin!

My friend was diagnosed with an infection and had to take antibiotics and when they were finished she's had two healthy pregnancies since, the first Ivf and then a surprise

I'm sorry you're going through this. I had similar after DS1. 3 miscarriages all at around 12 weeks. I had some tests and no clear cause but they did say my fertility was dropping. We had a years break from trying as the miscarriages took their toll physically and emotionally. Then we tried again. I am now the proud owner of 2 teen/tween boys 😊 I did wonder if the fact I was still breast feeding while trying to conceive that affected it but suppose I'll never know. I really hope you get your rainbow baby in the end x

@Picoloangel I took baby aspirin and progesterone for my last loss, which was a chemical - but of course I could have just been unlucky and had chromosomal abnormalities in that one. You just never know!

@Kent91 sorry for your losses. I'd definitely echo the previous advice in looking into immune issues. The main tests tend to be natural killer cells (either blood or uterine- bit of a complex topic as different consultants take different approaches) and also th1 and th2 balance. If you're not getting anywhere also look into getting your partners sperm tested - sperm dna fragmentation levels can play a big factor in recurrent miscarriages and it's often overlooked. Good luck.

Thank you @Applecrumble11, I am really leaning towards the immunology testing, even if its privately and the NHS doesn't cover it. Just for peace of mind, even if they did find something in my microbiome with the EMMA and ALICE tests. My husband has called his GP to see if he can get testing done through them too

TTC for 6 years.
Decided to have some blood tests done after my 3rd miscarriage.
Results showed elevated NK cells so added Prednisone for my subsequent pregnancies and now have 2 babies.

4 MC, one between my two boys and then 3 in a row. NHS investigations didn’t find anything, last loss chromosomally normal. High UNK cells diagnosed at Coventry implantation clinic, successful pregnancy on prednisolone, clexane and progesterone. Good luck.

Yes these measures will not help with might be termed a “normal” miscarriage. I do wish you well and the book by Prof Regan is well worth a read,

@Miloarmadillo2 and @YoungMacDonald so glad to hear you had successful pregnancies! I’ll definitely try and get that test done.

It's worth getting tested for Lupus

A friend had 3 MC in a row, then they tested for this and it was positive

Next 2 pregnancies she had daily injections to combat it and now has 2 healthy dc

They told her Lupus is a common reason for recurring MC

I had 6 MC in a row when TTC #3. NHS ran the basic panel and nothing was found. The consultant I saw put it down to ‘age’ but was somewhat reassuring it would happen for us. I increased my weight by a few kg (I was slightly underweight) and also prescribed progesterone. I’m happy to say I’m currently 34 weeks (at age 44!)

I really hope you get some answers and an action plan. Really sorry you’ve had to go through this and the best of luck!

Did you have a c section with your first? A PUL could easily have been an ectopic - my c section ultimately caused some of my recurrent early losses (turned out they were likely ectopics due to scar tissue from the c section damaging my tubes)

If you are having back to back losses are you not waiting a month or so inbetween? That may also not help as miscarriages can cause infection/fluid in tubes which can be toxic to a new pregnancy and you should wait at least one cycle inbetween losses before trying again (I know it's hard - I've been there)

Ah congratulations @Stressheadshouldbeinbed! I am a healthy BMI but i’m definitely carrying a bit more than I should so putting more weight on is not part of my options ha!

@justanothercrapbedtime no, i had a vaginal birth, very straight forward and very quick - almost had him in the car! My second loss was straight after a CP. Had 2 cycles in between for my last loss.

Ah I see. I had multiple miscarriages after my eldest - ultimately all tests came back negative "normal" (aside from the ectopics - if they weren't ectopics I was still miscarrying) - I ended up going down the IVF route x

Hi, I lost 4 pregnancies (3 MC and one ectopic). I went to the Tommys clinic at Coventry and Warwickshire hospital and was diagnosed with high NK cells. Used progesterone and prednisone with my next pregnancy and now have a son!

I had no issues falling pregnant, staying pregnant was the issue. I hope you get to the bottom of it.

I had 6 losses before I had my Daughter aged 37

I had my son with no issues aged 28

all nhs tests were normal

The only thing I did privately was go to prof Brosens at Coventry where I had 2 womb biopsies which showed I had very low nk cells which correlates with poor implantation . I took sitagliptin for 3 months which is meant to increase stem sells in the womb . I then conceived for the 6th time and had another loss . Two weeks after I conceived again and the pregnancy was txtbook just like my sons before the miscarriages . I never had any of my losses tested so I had no concrete answers and I don't know if the treatment from Brosens made a difference. I took no additional meds not even progesterone x

I know prof brosens wanted to do more work around sitagliptin but I think in the end only a very small study was done .

www.tommys.org/research/research-topics/miscarriage-research/can-sitagliptin-help-increase-stem-cells-wombs-women-who-have-suffered-recurrent-miscarriages

everyone else seems to have high no cells and mine were low. 🤷🏻‍♀️

I was convinced something was 'wrong ' but looking back my guts tells me it was extreme bad luck / crappy eggs . I'll never know basically .

wishing you all the best for the future .

I've had 4 miscarriages now, all MMCs between 8-11 weeks. All tests on me were normal for the main causes but the genetics from our 3rd loss came back with trisomy 15 so me and my partner were tested and turns out I have not one but two chromosome abnormalities, as I have 2 cell lines with a different abnormality on each (which is apparently quite rare).

But....my most recent 2 losses were not caused by my chromosome abnormalities, we had the tissue tested and the 3rd loss was trisomy 15 (my issues are with 9 and 13), and the 4th one is really the kicker, it was due to triploidy, where you have a full third set of chromosomes that aren't meant to be there. And the most common cause of this is 2 sperm fertilising one egg. So basically, sheer bad luck. Which sucks when I'm already at a higher risk of miscarriage or stillbirth.

So in summary - 2 unknown (but presumed to be genetic due to how I miscarried - no clue if my issues or random), 2 random. No kids yet, going through counselling currently to decide what we want to do and if we want to move to IVF with genetic testing.

Oh @Moosey898 , i’m so sorry! But how lucky to have science to have some answers. Sending you lots strength!

I’ve had 3 in a row between 8-11 weeks, I’ve just found out I have factor V Leiden, an inherited blood clotting disorder. I also have possible markers for Antiphospholipid syndrome, another blood clotting disorder, which I need to get retested in 2 months. Sadly no living children for me yet but hopeful with the plan of daily blood thinning injections if I get pregnant again that next time might work.
I was on aspirin and progesterone last time and got the furthest I had but it obviously wasn’t enough.

Update So I had bloods taken for APS, and waiting to hear back (Although I already take aspirin). I have also received the results back from the EMMA and ALICE test - it came back positive for an imbalance, that is causing endometritis. I have high Staphylococcus and Streptococcus and very low Lactobacillus. I am now taking Amoxicillin-Clavulanate for a week, as well as probiotics long term and will need a second biopsy to confirm that the microbiome is balanced.

The outcome explains my symptoms of painful miscarriages, ovulation and implantation, as well as slow rising Beta HCG so I'm hoping this diagnosis will lead to our rainbow baby.

Rant: Why is pain in women not being taken seriously? The EMMA and ALICE tests were not the first suggestions from doctors even though I had complained of pain during my cycle (but still had regular periods) and I decided to trust my gut and did that test first. I also feel that probiotics are not being marketed enough? I've done so much research and have mostly come across supplements in the form of vitamins. Taking antibiotics for a week and probiotics seems such an easy fix, part of me wonders why this is not recommended without testing the same way that progesterone and aspirin are recommended to be taken after miscarriage regardless of hormonal and APS blood tests. (I appreciate that your body can build resistance to antibiotics, but would happily take them myself on the off chance that they would help).