Fourth miscarriage

[amelied]

Hi - Im on for some advice please?

Had a second scan this morning to confirm last week's scan that I have had my fourth miscarriage. My history is im 40 - 41 at the end of the month, trying for four years for #1. Have had recurrent miscarriage tests after my second miscarriage and on paper there is nothing wrong with myself or DH.

#1 miscarriage - started spotting at 6+4 weeks. Natural miscarriage
#2 miscarriage - mmc - found at 7 week scan and confirmed at 9 week scan - D&C.
#3 miscarriage - scan at 8 weeks, could see a slight heartbeat but sizing not right, natural miscarriage at 9 weeks.

Last week's scan was at 7+4 weeks - no heartbeat found and measurements were for six weeks. No spotting or pain - Probable D&C this week.

I have gone as far as I could with NHS finishing off with six months of Clomid and a hysterocopy. Had an appointment with private fertility clinic when I found out I was pregnant with #4 pregnancy. We were thrilled and the consultant started me off with Clexane, Predosoline and baby asprin. I think injecting myself gave me a pro-active opinion and we felt we had hope this time.

If you have got through this far - thank you!

My question is I dont seem to get past the six weeks mark. Has anyone else had this situation and gone onto have a full term pregnancy? Have you been given any other medication to help you through the 12 weeks mark? Or is there a name for this problem I
seem to have?

I have a follow up appointment on the 24th of this month and would like to be armed with questions.

Many thanks for all your advice in advance.

hi amelied,

i had 1st m/c at about 11+4; was overseas at the time and didn't have same health care. got checked when passed large clot and by the time has u/sound, was sac but no baby. waited for natural m/c but ended up with d& c after about 2 weeks.

fell pregnant again, had DS.

noticed 2nd m/c (by spotting) at about same gestation time. this time walked straight into hospital and said wanted scan now (had just moved house and system here hadn't picked me up yet from their waiting list for scans); they said baby was only sized at about 5or 6 weeks, no heartbeat. Waited for natural m/c which happened within about 4 days (tho managed massive blood loss with it, emergency transfusion and d&c to stop bleeding).

I guess i'm saying I have had it much luckier than you, but have had similar 6 week losses (tho the sac sticks around), plus have lovely baby too. Best of luck with your journey.

Thanks MayfairMummy for your story, I appreciate it.
x

Amelied I am so very very sorry to hear your terrible news. I remembered you had an appointment in January so thought I would look you up but I am gutted to hear your news. I wish I had something comforting and helpful to say that would make you feel better, all that I can say is that I understand a wee bit of the pain you'e going through and I'm thinking of you xxx

hi amelied poor you. I have also had four miscarriages, the most recent on in October, so i really know how you feel, though I am lucky enough to have had one son before this nightmare started. He arrived without any problem - i did not have any miscarriages before him and had no reason to think i'd go on to develop this problem.
You don't explain what the medications you took - Clexane, + Predosoline, are? if your tests were clear, why were you prescribed these meds, if you don't mind me asking? I'm not criticising the treatment, just curious, as they are meds i've not heard of....
given your age (40+) there must be a chance that your miscarriages are linked to the declining quality of your eggs rather than anything more complicated? has this been ruled out (in so far as it's possible to rule it out)? my MCs have followed quite a similar pattern to yours. The pregnancies generally fail around six or seven weeks, though with my last one we got a heartbeat at eight weeks, but the baby measured too small and a week later it had gone .
i can imagine how miserable you must feel after four years of this and hope you find some good support here.
Are you in London?

Hi Aliboster - thank you for thinking of me, yep happened again.

How are you doing?
xxxx

Hi Kissmummy - I was perscribed Clexane and Predosoline as the consultants reckon I may have NK Cells (this is by their knowledge of my symptoms and not by any intensive bloodwork. My consultant is in touch with Dr Siobhan Quenby at Liverpool who has ran the NK Cells trials. Unfortunately I think this maybe a blighted ovum so never really got to find out if these meds make a difference - all I have left is an extremely bruised stomach where I was injecting, to show for it.

You have said what has been niggling at the back of my mind - that my elderly eggs maybe the cause, I just havent been brave enough to say it. I have had good AMH results but that doesnt give quality results only quantity.

Have you been given any reason to the six or seven week problem??

Im just outside Glasgow and attending GCRM.

amelied, so sorry for your losses.

I too, had 4 MMCs with no particular reasons found. The pregnancies were always between 6-8 weeks sized although diagnosed at different times.

My understanding is that 6-8 weeks is the time where the yolk sac stops sustaining the embryo and the placenta has to take over. This takeover sometimes (too often) does not work and the pregnancy stops growing.
I am not sure that medicins knows everything there is to know about this process... A lot of private clinics will offer tests not available on the NHS (NK cells for instance). Some of them are rather controversial and costly. Personally, we never went there... there be dragons...

We have been very lucky and I did go on to have 3 DSs, and am expecting DS4 - I will be 44 .

Best of luck to you.

PacificDogwood - you are my hero - 44 that is brilliant news. Did they/you do anything different for your successful pregnancies???

Sorry PacificDogwood - another question!

Progesterone - have you been perscribed?

I have friends in Ireland and also in USA who have had recurrent miscarriages - it seems to be that it is a given that progesterone is perscribed in both countries to help sustain the pregnancy BUT anytime I ask about this with different consultants they just pull faces and tell me that in the UK it hasnt been proven.

Curious?

oh wow Pacific that's fantastic and offers lots of hope for all of us! it's amazing that you went on to have three sons despite having four miscarriages. amelied we're about to have testing for NK cells. I realise it's controversial but i've read Dr Alan Beer's book and it's very convincing. given the stage i'm at, i figure it's worth a try...but yes, it's bloody expensive. my mum had my little sister at 44 so i'm hoping i have a few more years left to try. i'm 35. we've had all the tests that are offered on the NHS and they were all clear.
my husband is in his late 40s and quite a heavy drinker and i've always wondered if sperm quality is a factor but much to his glee the consultants say it's irrelevant...

thats interesting Kissmummy about sperm quality as I am trying to convince DH that a tee-total life is the way forward as well as Zita West vitamins for men - its kind of falling on deaf ears....

Where are you going to be doing the NK cells testing?

I'm ok Amelied - just found out that 2 of my best friends are pregnant and both due at the same time so I'm finding that a bit hard - one of them sent me a text to tell me! so bit pissed off about that especially since she knows everything I've been through. Anyway, onwards and upwards, there's nothing else for it xxx

amelied I am so sorry. I have had 2 mca, successful pg, 3 mcs, 2 successful pgs in my 30s. All losses were in the 6 to 9 weeks mark. I am now 40. The Miscarriage Association helped with the emotional side and I now volunteer to take calls for them. I was diagnosed with Factor V Leiden and prescribed heparin and aspirin and this seemed to do the trick with the last 2 pgs. I think I was just v lucky with first pg. I think I have an inkling of how you are felling and I do think you are being so lovely and I am glad you are here. Top of my list if the NHS did not work was to go and see Lesley Regan (you can google her) and Dr Hasan Shehata (also google him) - Dr Shehata looks at NK cells. All the very best of luck. You are not alone. XXXXX

Mr Hassan Shehata MD MRCOG MRCPI is a UK based Consultant Obstetrician and Gynaecologist and a subspecialist in Maternal Medicine. His NHS base is at Epsom and St. Helier University Hospitals

at being anybody's hero... I just feel like I am a (very very lucky) bumbling along fool .

No, I never had any progesterone. The reason it is controversiol is because there are contractictory study outcomes. AFAIK, some IVF clinics use it in pessary form - I think a friend of mine had it.

And no, I did not do anything different in my successful pregnancies compared to the losses. My NHS investigations did not come up with a reason (no Factor V Leiden for instance) for the MCs, but did flag up a genetic problem which had not affected any of the embryos I had lost, but certainly added to the worry with every new pregnancy . So a bit less information would have actually been a good thing in my case. I ended up having amnio/CVS with all my successful pregnancies and no losses in relation to those tests..

In my very considered and specialist (not!) opinion, it is all such a darn lottery and the only way through for me to keep going was to have head firmly lodged in sand.

My NHS Consultant said and, from what I have heard, Lesley Regan agrees, that the best thing to do is to keep on trying. Though I understnad how hard that is. Just throwing the dice again and again in the hope that the right number will fall. XXX

amelied i too have had 4 mc, 3 of which just before 9 weeks. i have 2 dc but they were born before the mc's started.

hopefully i (an all the rest of us) will have a success story like pacific's one day.

my mum had my db then 7 mc then me then another 6 mc, all varying from a few weeks to 6 months plus. no reasons ever given.

but there are so many women out there who have 4 or more mc and go on to have health pg's

fingers crossed for you

xx

hi again amelied - i was prescribed progesterone in my last pregnancy but rather reluctantly. After my third MC, my favourite GP (who i hardly ever get to see, this being London) told me to ask for it as soon as i got pregnant again. I did, but the different GP i saw was very sceptical and not keen to give it to me as she regarded it as pointless. I pushed a bit, and she eventually agreed to give it to me on ethical grounds - saying that it would be wrong to have led me to think i could have a treatment and then refuse it!- but she rang a consultant and he agreed with her that there wasn't much point. I just wanted to feel like i was doing something or anything that might help. it wasn't much fun to take and i don't know if it made any difference at all. i still miscarried. however unusually, this time we did get a heartbeat before the pregnancy failed. But i don't think the progesterone really helped.
I am going to the Lister Fertility Hospital for NK Cell testing.
We went and saw Zita West who recommended it. i have to say she was absolutely brilliant - i half expected some nonsense about drinking more green tea/taking extra vitamins, which would have pissed me off no end after four MCs, but right away she said it was obvious i had a medical problem and needed to see a specialist. She also organised fantastic counselling (also fantastically expensive, but...) and i now feel like i have a "base" for my care if i get pregnant again. I have never really known where to turn with my previous pregnancies and have ended up being scanned at four different private clinics so there has not been any continuity of care.
Dr Shehata is well recognised for NK Cell testing, but may not cover all the other "conventional" testing. This is why i was sent to the Lister, as they do everything. (including hysteroscopies etc if you need one.) The consultant we saw there is Yau Thum and we've only seen him once so i can't give a full report yet but he was very pleasant.

Hi Amelied
I understand how you feel totally. I had four miscarriages in a row (missed m/c, bleed, d&cs, you name it, all between 6 and 12 weeks but foetuses had all realistically never developed beyond 6 weeks). I had all the RCOG tests as did my husband and all came back as normal but I felt convinced I had an immune problem because of the reaction I felt in my body when I was getting pregnant. I went to see Zita West who did not dismiss me (unlike GPs) and referred me on to Mr Yau Thum at the Lister Hospital and I was found to have elevated NK cells, so for pregancy number 5 I took progesterone and prednisolone 25mg, which WORKED and I had a little girl on Xmas Day 2008. That said, I have sadly just miscarried again at 6 weeks following the same medication plan, so I would say to you, keep calm, regroup, have ACUPUNCTURE, take vitamins (B6, B complex, Magnesium, Selenium etc) TALK to someone, cry, kick the wall but most importantly have another go, coz it can happen for you. I am going back to see my consultant tomorrow to see if he would recommend changing anything for my next pregancy and will pass on any words of wisdom he has. good luck xxx

Hey ladies, I've just stumbled across this thread.
I'm so sorry to read of all the heartache and elated to see the successes.
I'll be honest.... My head is a little fuzzy so bear with the miss- jointed ramblings.
Found out today that we've lost another Bean.
I am taking part in a double blind trial at The Liverpool Womens Hospital. I am under Dr. Siohhan Quenby.
I was either taking Prednisolone or a placebo.
I'd got to 9 weeks, seen a heartbeat (twice) which has never happened before as my last 5 mmc had happened between 5-7 weeks. We were assuming as we'd got this far (and a few mild side effects) that it was the Steriod.
Dr.Quenby seemed to think Bean may have had a chromosome defect as on the scan the placenta and bean looked perfect. So not connected to u(NK) cells. One of those things again!
Just got to keep trying and focus on the one we eventually get will have been worth the wait.
I'm going to definitely going to get the Prednisolone next time.
I'm wondering if to mention Progesterone too?

hi MegMum25 i am delighted to find someone else who is being treated by Yau Thum following a referral by Zita. I am seeing him too - we had our first appointment a couple of months ago and i was at the Lister today to give bloods for NK cell testing. i really hope the tests show something. I have not noticed you on this board before? it is great that you at least managed to have one successful pregnancy. Sorry to hear you've lost this one. It's so hard to know whether treatments have made any difference or not but for most of us recurrent miscarriers doing something feels better than just rolling the dice again and again.
By the way have you ever asked anyone (Yau or Zita) about Strep B and miscarriage? lissielou posted a link to some very interesting research a few weeks ago. I am strep B positive so was fascinated. I didn't find out about it until after my consultations with Zita and Yau, but i am going to take the research to show them next time i'm in.
MrsGazebo i'm gutted for you. with my last MC we also saw a heartbeat for the first time and like you i thought it was really going to work. it makes it all the harder. i am SO sorry. Did you just find out today? i know how utterly devastating and desolating that moment is, when they can't find a heartbeat on the scan. i hope you are with people you love and who understand, at least a little, how it feels.

Ladies - many thanks for all your messages and advice. I spent most of yesterday at the hospital having another scan and signing the consent papers for tomorrow's ERPC.

Would like to answer you all individually:

Alibobster Im sorry it seems to be happening for everyone else close to you. I know the feeling only too well - I either have friends bursting into tears when they tell me of their pregnancies or I have one friend who sent me a text to tell me she was six months pregnant and couldnt find the right time to tell me (!) She lives in another country so I wouldnt have known but NOW she bombards me with emails of photographs of her DC on a weekly basis - argh! I am delighted for my friends, I am in awe of anyone who can hold a pregnancy for 40 weeks and deliver a baby, but if truth be told Im sad as well, for myself, but that is human nature and I try not to beat myself up about it. I hate the way miscarriage has made me this person that no-one can share their good news with. x

LunaticFringe I know it is strange - I have seen some women on me who have been perscribed it. My friends who have been perscribed it, that I spoke of earlier, both went onto have live births, happy coincidence or just the right time for them, I don't know?? x

SpeckledHen Thank you for your kind words and all the detailed information too. Im in Glasgow so London isnt really an option for me BUT I have started with a Glasgow Fertility clinic which is meant to be in the top 3 in the UK. Hats of to you for volunteering with the Miscarriage Association. I think I would like to do something like that in the future. x

PacificDogwood This pregnancy malarkey is a HUGE lottery - you are still my hero x

Just1moreplease Im sorry you have been through this too - your Mum has been through so much too - you must be a family of strong women. x

Kissmummy Im going to my consultant on the 21st and go through this with him. Good luck with Yau Thum - maybe we can swap notes??? x

MegMum25 Im sorry to hear of your history too but delighted to hear of your Christmas daughter!!! I have done acupuncture in the past and really enjoyed the calmness it gave me but I was finding it too expensive - I have spent SO much money over the past 4 years with every lotion and potion promising a miracle. Thank you for all the info on vitamins and wish you all the best x

MrsGazebo Im so sorry to hear of your news today and of the past. My third pregnancy/miscarriage was the only one we saw the heartbeat although they said it was too slow which resulted me losing my angel the following week. We were on such a high when we saw the heartbeat. My consultant speaks extremely highly of Dr Quenby. I understand it is a trial and someone has to have the placebo - it must be heartbreaking though. I was put on Prednisolone, Clexane and Baby Asprin. It looks like a blighted ovum so never really had a chance to see if this medication worked. Maybe metion the progesterone and see the reaction? Would be interested in your findings.

My next move is IVF now - that way they can grade the eggs which I am beginning to think is my problem. I have attached an article that my consultant Dr Gaudoin features in (sorry dont know the easy way to attach on this site - can cut and paste)

www.heraldscotland.com/new-fertility-drug-works-for-couple-who-failed-at-ivf-1.8924 42

Nite ladies, I have to get up at 6am to head to the hospital - wish me luck!
xxx

Good luck at the hospital today with your ERPC (I hate that it's called an ERPC, it's so clinical for something which is so emotional). I hear you about the expense of it all, I spent £100 on vitamins alone the other day, but I think the calming effect of acupuncture is so beneficial. Maybe try and get it thru the NHS?...hmm, not likely. either way, the IVF route sounds interesting and very positive as then you can eliminate the 'non viable' (again, horrible expression)ones before you start and give yourself the best possible chance of carrying to term. xx

Kissmummy, I have never been on a forum before (as I think you can tell as I don't know any of the shorthand!)but I have just got to the point where I think my husband and friends are a bit sick of me, it's as if I should be able to shrug it all off now I have had a successful pregnancy but it feels good to chat to people who know what I am talking about and how it feels and how nuts it makes you!! Most people have never heard of these expressions, tests etc. I am seeing Yau this afternoon at 2, snow permitting, and I am going to ask him whether I should take the prednisolone earlier next time. I am also going to mention Strep B as I am not sure whether I have ever been tested for that. I have also heard that some practitioners also give HCG injections so might mention that too. Let us know how your bloods come back and what next steps he recommends. I hope that my story gives everyone hope that when the conditions are right (and god knows what that means as I just tried the exact same thing and it did not work) it can work out but I agree with KissMummy that it feels so much better to actually do something and claw back a bit of control over the situation, as it sometimes feels to me that there is this whole universe goinhg on inside your body while you try and get on with a normal life and its torture not to be able to influence the outcome.

I am so sorry Mrs Gazebo about your loss, especially after the joy of seeing a heartbeat, it is soul destroying and each time your heart breaks, I wish you so much luck next time. xxx

amelied, Dr Gaudoin is fab! He has got a lot of my patients (I am a GP) pregnant ! If nothing else, he will look after you really well and give you all the facts straight.
All my care was done under Prof Alan Cameron at the Fetal Medicine Unit at the Queen Mum's - they are of course just in the process of moving to the Southern General (I think closing on the 8th, reopeninig at SGH on the 13th). The Recurring Miscarriage Clinic there is what has kept me sane over the last 10 years - that is how long we have been at this babymaking lark, gah, I cannot believe it myself.
So just best of luck for the future - and of course your ERPOC today (hate the phrase too) . It shouldn't really matter, I know, but you being kind of local to us makes your whole situation "realler", daft ...

Best of luck to everybody else - it can happen... but it is so hard to keep going.
Oh and other people having babies: it helped me to remind myself that I did not want their baby, I wanted mine! And it is not like there is a finite pot of babies that would run out if others have lots of them, IYKWIM! Well, it made sense to me at the time and helped doing ante/post-natal care at work, nevermind seeing friends with babies.