Miscarriage - "a common process" as per NHs / options ?

[lovelondon8]

Hi - I have had a second miscarriage within 4 months of being pregnant via IVF and both times it hasn't even gone beyond 4 weeks. NHs took a casual approach as this is a 'common' process and to my detriment I found out how women are not treated with respect- I was sent to EPU the following day after waiting in urgent care for 6 hours bleeding heavily with horrendous pain and seen the GP who said there was no concern to be had as my BP was normal !! The emotional pain is beyond explanation but I have to carry on - We have urged the NHS to carry out further investigation as to why this is happening - for us to make the right decision - either surrogacy or adoption from foreign countries - America or India etc
The experience has left me and my hubby pain stakenly scared , I am fearful of another disappointment if I go for another transplant, hence the above options.

Any information, any input will be very welcome into the issues .... Sorry if this sounds bit scatty, I am trying to get my head straight, come to terms with the loss. Thank you

If you had ivf why didn’t your clinic investigate? They are the ones at the forefront of fertility technology with access to the latest recurrent miscarriage treatment protocols, not the NHS!

NHS don’t investigate until you have had three miscarriages. I had two missed miscarriages in a row, both were almost identical as well but they refused to investigate unless I had another. Just the way it is.

Hi,
I was under NHS like others, was referred to see a Gynaecologist who confirmed I was fine to conceive... opted for IVF due to my age- Im 45 and NHS do not offer IVf after 40 . I don't think I can go up against the system that is operated here. If one miscarries after an IVF treatment , they are referred back to EPU/ NHS. For IVF we pay towards the treatment, meds and first scan. However we will be meeting with the Clinical Director from the clinic to discuss options too. We are baffled as to why I have fallen in between Pvt clinic and NHs !! Do you know of any clinic which would carry out the investigation for unsuccessful treatment and not refer to NHS? That will be useful to know. Thanks.

Hi, you are right, NHS usually do not investigate if one hasn't had 3 miscarriages but we have pushed for it and have seen the clinical specialist who will be carrying out the investigation planned in Aug because I have miscarried within 3 months of 2 treatments and after 3 weeks of falling pregnant. even the specialist admitted that miscarriage is common and unless there are issues to be concerned about , they do not become proactive in investigating the matter - I am not trying to disrespect NHS but it was appalling treatment on the first day when I was bleeding so much I wetted my dress and after waiting for 6 hours I was told by the GP in urgent care that I don't have a miscarriage as my BP was normal, asked me to put my urine sample in the bin !! ! My dignity was compromised, other patients saw me bleeding with clots on the floor .... my husband has been asking for a wheel chair, it didn't appear before waiting for 3 hrs. My hubby had to guard me to take me to the loo to change my napkins - Can you imagine the distress ? We have complained so that others don't suffer the same detriment ....

Are you using your own eggs? If so did the ivf clinic tell you the stats for miscarriage at 45? It’s over 50 percent (more if you have other conditions) with the chance of a live birth between 1-4 percent. And recurrent miscarriages at 45 are more likely. However they should still be considering you for treatment protocols such as sterioids / heparin / aspirin and recommend further testing.

Clinic wise Care Fertility was good for me, but you may want a clinic like Zita West that specialises in older patients.

Sorry to hear about your miscarriages, but they are quite common. I've had 2 myself and I'm in my early 30s.

Like PP have said, the stats for miscarriage at 45+ is incredibly high, and that's if IVF even works in the first place.

Not what you want to hear, especially as time is ticking, but not much you can do until you either succeed in the next pregnancy or miscarry again when the NHS will conduct further tests.

I know this is a sensitive time for you but if both miscarriages were before 4 weeks then they would probably be classed more as a chemical pregnancies where the embryo failed to implant properly which is most likely due to genetic problems with its development (which is very common) and occurs with a lot of natural pregnancies as well as ivf. In this case there wouldn't be anything to investigate as it's just an odds game. This is why the NHS will not investigate before 3 losses as it can still be a case of just bad luck, especially with older mothers as egg quality is often lower to begin with. I hope if you try again that it works out better next time x

You could buy those NHS tests privately from the clinic - do something called Level 1/Level 2 testing - it tests for thyroid / clotting disorders / genetic issues plus white blood cell / autoimmune issues (which the NHS doesn’t always test or treat).

This is so sad, I’m really sorry for you op.

You are absolutely right, the process is not at all conducive to good recovery from this awful situation.

I could tell you stories that will make your toes curl in horror of my experiences with re occurring miscarriages. You wouldn’t believe me if I told you but I can assure you that it has been a horror show.

I have come out the other end of it as an older mum and by utter determination we got our long awaited child.
I have no answers and no words of wisdom but just wanted to offer my sympathies and let you know that I get what you are saying.

@lovelondon8 Did the doctor say that you couldn’t be having a miscarriage because of your blood pressure being fine? Or that they couldn’t admit you for a miscarriage because your blood pressure was fine?

Women experiencing miscarriages aren’t admitted to hospital unless they have life threatening bleeding (low blood pressure, tachycardia, fainting/collapse, needing to change a super absorbency pad more than hourly) or symptoms suggestive of infection.

Unfortunately it is so common that it isn’t possible to admit (or provide a private A&E room) to everyone and the criteria for admission is very cut throat really, it’s always a difficult part of my job explaining that unfortunately in early pregnancy the priority is ensuring the mother’s safety, as there is nothing that can be done to save the pregnancy if it is miscarrying.

Sometimes our EPAU appointments are in a weeks time, so I try to gently mention to people the option of private scans if it’s within their means. We can have up to 15-20 women a day attend for our “Vaginal bleeding in early pregnancy” pathway, and that’s a small district general hospital in a bit of a backwater town in the midlands, there isn’t the resource for everyone to see gynae on the same day, and it also isn’t necessary.

Wheelchairs in urgent care or A&E are often a free for all, and it’s down to whoever to go and just find one, usually they gather outside the front door near the car park where people have dumped them.

With regards to referral for investigations as to why it’s happening, you probably do need to push for that, but it doesn’t happen as an inpatient.

None of that is any excuse for the fact that you weren’t treated with warmth and dignity, though.

Hi Teddybear - thanks for the info- very useful. I am going with London bridge centre. Its donor eggs - due to my age egg quality not being good - went for that option. You are right re recurrent miscarriage at 45 and it seems that although I am conceiving fine, something is going wrong after 2/3 weeks. For donor eggs they carry out genetic tests like chromosomes, cystic fibrosis etc. This is why its a bit of a mystery as to what is going wrong but saying that the NHs specialist will be carrying out a the of a blood test which will ell me if my blood is helping the foetus tis tick or not. We will ask the CD when we meet about what you had mentioned. Very useful. Thanks VM. Will look into ZitaWest.

I would investigate a private clinic which covers aftercare, not just implantation and leaves you to it.

The nhs are just acting on their own rules. 3 miscarriages before investigation. It’s harsh, but miscarriages are very common, especially at 45, and investigation at nhs speed will likely get you nowhere- time is not on your side.

Find better private care. The nhs don’t do ivf after 40 for a reason. They probably won’t do much about your miscarriages for the same reason- the chance of a successful pregnancy after ivf at 45 is slim. Finding a treatable reason for miscarriage is also very unlikely.

Have the investigations privately.

As an aside, why adoption from abroad rather than the uk?

Thanks MFB, we have seen a NHS gynae/specialist who will be carrying out tests in August. So fingers crosses and also we will be posing various questions tot eh clinical director from the clinic as to what they could have done and should be doing and further advice ...... these pvt clinics are of course very quick to take the dosh ... being cynical !! I guess its also luck too in these matters as much as nature's intervention and decision ..... thanks again for the support.

I've had a miscarriage after ivf so I know how awful it is, but the reality is that miscarriage is common and miscarriage at 45 is very common indeed. It doesn't mean that anything is "wrong" as such. The number of non-viable eggs increases hugely with age. As has been said there are some investigations that can be carried out but they will need to be conducted privately.

Get the level 1 and level 2 testing. If they’re donor eggs then you might have a problem with conception

Implantation not conception!

Hi C62 - thanks very much for your message - really appreciate. I am very happy for you that you have got a child.
What I have noticed in both processes - with NHs and the pvt clinic - there is lack of communication, unless you ask or you as a patient have to be very savvy and have to push for matters to take shape. And yes- as it seems that only determination is the only way to carry on to get where we want to get to - to have a child. Are we in 21st century ? We are looking into adoption etc and the red tape is unbelievable simply and yet there are those lovely children who could do with stable home and love. Like you I have to be just determined and focussed to have a child. thank you.

thanks for the suggestion - We will look into another clinic but will approach HFEA for any failure to treat patients properly. We are simply looking for other options - adoption from here, if not here fro abroad - etc etc we would like to be parents - so surrogacy - any option that can be tried and works.

concur - seems like that! The clinic won't get away - we will push for investigation , thanks TB

Great, thanks for the suggestion, much appreciated.

In the UK most adoption agancies will not let you begin the formal process of registering as adopters until several months after you have finished the ivf process. This may be something to bear in mind if you have a time line in your head of when you would like to become parents as adoption itself is often a lengthy process. Maybe set yourself a deadline for ivf attempts/investigations and then draw a line under it if you are unsuccessful otherwise it might be a few years before you get your family when you add on the total time for the adoption process?

concur, will bear in mind. Once the investigation is done in aug, the NHS gynaecologist said that she will chalk out a management plan, then we will decide- at the moment we are gathering info. Thanks for your suggestion. x

So sad for you. I had 3 miscarriages in a row. NHS tests revealed nothing. Next two pregnancies were successful then another miscarriage then another successful pregnancy. I don't know anything about increased risk of miscarriage from IVF but I do know from my own experience opening my eyes that miscarriage really is very very common, it's just not talked about much so you don't realise until it happens to you and all you can see around you is pregnant people. Talk to the clinic and hang in there.

I'm sorry you are going through this. They should have been more clear that miscarriages are very, very common. If anything your post tells me that we don't mention them enough. Once you are miscarrying they cannot do anything to save the baby. For your health and future fertility it is best to miscarry naturally if possible. There is nothing you can really do but get through it. Take the paracetamol and/or ibuprofen, keep a hot water bottle with you, have a good cry and be nice to yourself.

(My stats: 5,5 years of fertility treatments including ivf; 4 early/chemical miscarriages,1 at 11.4 weeks, 1 ectopic so abortion at 8.4 weeks, 1 termination for medical reasons at 18 weeks; still trying, I am not yet 40 but almost. You are not alone, far from it. I hope that we will all get our wish granted one day)

OP I'm so sorry for what you're going through

Just outside London but easy to get to I highly recommend Herts and Essex Fertility. I am currently 16 weeks pregnant after IVF with them. I had a really stressful first 12 weeks with a few episodes of bleeding (red and brown) and their care was excellent. They have an on call nurse 24 hrs a day 7 days a week and they had me in for scans whenever I wanted one basically but weren't pushy either. They were recommended to me by our NHS consultant when we were kicked out the NHS system (long story but shouldn't have happened). They are very knowledgable and we are so happy with the treatment and care we have received.