Referred back to NHS recurrent miscarriage clinic after 4th miscarriage

[MollySxx]

On Friday 19th March, my 4th miscarriage was diagnosed. They have classed it as a 'silent miscarriage' as my body didn't really recognise it.

I have scans from 5+4, empty sac measuring 3mm
6+4, empty sac measuring 7mm
7+4, sac with yolk measuring 9mm
I then waited 2 weeks for another scan, so at 9+4, it was confirmed the sac didn't grow, still a yolk sac, no baby.

I have since started bleeding and the hospital scanned me again yesterday and I have since passed the miscarriage naturally. The clot I passed I took to the hospital and they are testing it. And they are now referring me back to the miscarriage clinic. I had my first appointment with them in February and 2 days later I found out I was pregnant. I was sold the dream that progesterone would work. I was also on 150mg aspirin and 5mg folic acid.

Prior to the clinic I had bloods done for thyroid, thrombophilla, sticky blood, I had a pelvis scan which showed my womb fine, everything around it fine. I had cysts on my ovaries, which came back clear of polycystic ovaries. So that's clear. But what can they possibly do now this time now it's my 4th loss and all the tests they've done have shown nothing to be the cause. I feel like I'm fighting a losing battle and being pregnant and having a baby isn't for me and that truly breaks my heart.

All my miscarriages have been in a row, all over the space of 10 months. And all at the 6/7 week mark. I also had a stillbirth in 2015 with identical twin girls, but my girls were really poorly so that was their own battle. So I've been told that isn't counted in the investigations

So sorry for your losses. I was found to be carrying a chromosomal abnormality that explained my recurrent losses, I think they do investigations after 3 m/c.

@CommanderBurnham yes, I was referred to them after my 3rd miscarriage in December 2020, I had my first appointment February 4th 2021 and on February 6th 2021 I found out I was pregnant (we were TTC) so I did mention that being a possibility. They prescribed me 400mg twice daily progesterone pessaries, 150mg aspirin and 5mg folic acid.

Now I'm back there after the 4th loss after what they prescribed last time and of course that didn't help in preventing it. I'm just wondering what else they could no now. Regarding further tests for what I've already had

I guess maybe to review what happened, or maybe discuss further tests?? I know genetic testing takes a few weeks for results. Fingers crossed it goes well. I remember how unrelenting the appointments were but the fact that you have carried babies beyond 12 weeks is encouraging.

You are allowed to have a break from it all, maybe phone the clinic and ask the reason for the appointment?

@CommanderBurnham the reason for the appointment is my 4th loss I had on Friday. I was at the hospital yesterday for a scan to see if the miscarriage passed naturally or I needed medical treatment. It thankfully passed naturally when I bled myself on Saturday evening and passed the clot Sunday. They just told me I would be referred back.

I was just reaching out with this thread to see what people's experience was if they were referred back after a loss passed 3 miscarriages and what the further outcome was with more tests they haven't already had the previous times.

I’m very sorry for your losses OP.
I also had a stillbirth several years ago and then had 4 MCs after my child was born. I’m currently 20 weeks pregnant though, so it can happen. After multiple tests they figured that putting me on blood thinners might help (I have a mild clotting disorder and one slightly cystic ovary), and I’ve been on aspirin and clexane throughout this pregnancy.

I wasn’t on the NHS so I don’t know what extra tests they run, but for me the clotting disorders showed up on a blood test. I had similar protocol to you but also took Clexane

@ZaphodBeeblerox that's so wonderful to what you're currently pregnant and 20 weeks, oh my, congratulations💓

I've read a lot about karyotype (don't know if I've spelt that right) and people have had that test on the NHS with the miscarriage clinic. I didn't have that test and my partner wasn't tested for anything either. Many have said their partners were tested as well as then. But because of Covid I just had a phone call appointment. Not face to face.

May add, my pregnancy in 2015 was with my childhood sweetheart of 7 years. We were 19 when I was pregnant with our twins. 23 when we broke up.

My 4 miscarriages are with my current partner. I met my now partner at 24 and we are 26 this year

Hi OP.
You sound almost identical to me with my experiences.

I was referred after 3 miscarriages, attended appointments with the reoccurring miscarriage clinic, became pregnant, “sold the dream” like you of high dose folic acid, high dose aspirin, clexane injections, hormone boosters and still miscarried but that miscarriage just took much longer, torrential bleeding and severe pain resulting in hospital admission, gas & air and morphine injections for labour pains at 10 weeks pregnant.

I trotted off again to the reoccurring miscarriage clinic who scratched their heads and then confessed to having no answers for me as all testing hadn’t revealed anything of significance and in actual fact they don’t know the cause of over 80% of miscarriages therefore it was unlikely that they would ever have had any answers or explanations for me.
They advised that given my history, it’s likely that I would continue to miscarry with future pregnancies therefor the decision was mine about whether or not to carry on trying.

So that was that, all hope gone in one 15 minute appointment.

I had 7 miscarriages in total.
But then.
After we gave up all hope, at aged 42 I became miraculously pregnant. I actually didn’t know as I thought I had some retained tissue from the last horrific miscarriage.
Turned out to my utter utter amazement and disbelief to be my little son.
I was 43 when I had this healthy little fella.

Nature. Fucking cruel, then fucking wonderful.

I'm so sorry for your miscarriage, it's really really cruel.

My story is 4 miscarriages, nothing found medically only our 4th had down syndrome so that's why we lost her. I'm currently pregnant now with no issues so it seems to be we were just so unlucky and it was just bad luck after bad luck and nothing medical. I did use 5mg folic acid and progesterone with this pregnancy till 16 weeks though.

It's so awful, I used to wish there was a medical reason so at least we could treat the cause. I really really hope you get some answers but for me there never was, just bad luck.

@Kroptopbelly

Hi OP. You sound almost identical to me with my experiences.

I was referred after 3 miscarriages, attended appointments with the reoccurring miscarriage clinic, became pregnant, “sold the dream” like you of high dose folic acid, high dose aspirin, clexane injections, hormone boosters and still miscarried but that miscarriage just took much longer, torrential bleeding and severe pain resulting in hospital admission, gas & air and morphine injections for labour pains at 10 weeks pregnant.

I trotted off again to the reoccurring miscarriage clinic who scratched their heads and then confessed to having no answers for me as all testing hadn’t revealed anything of significance and in actual fact they don’t know the cause of over 80% of miscarriages therefore it was unlikely that they would ever have had any answers or explanations for me.
They advised that given my history, it’s likely that I would continue to miscarry with future pregnancies therefor the decision was mine about whether or not to carry on trying.

So that was that, all hope gone in one 15 minute appointment.

I had 7 miscarriages in total.
But then.
After we gave up all hope, at aged 42 I became miraculously pregnant. I actually didn’t know as I thought I had some retained tissue from the last horrific miscarriage.
Turned out to my utter utter amazement and disbelief to be my little son.
I was 43 when I had this healthy little fella.

Nature. Fucking cruel, then fucking wonderful.

Oh my LORD! That has filled me with such faith. Congratulations to you.

But I am so dreading them being the same and not having any other answers. We aren't going to TTC for this year. Just going to leave it on the back burner and revisit it next year. I don't think I could go through it again. Not just mentally, my body needs a rest

Sorry for your losses. I had 3 MCs and been referred to the RMC. If you had the tests you've already mentioned, there's not much more they can do for you at the RMC, I don't think. You and your DP could have genetic testing but it comes back with results identifying whether you are more prone to MC or not, it's not a solution in itself I was told. Having said that, do enquire whether karyotyping might show if there's a reason why you and/or DP may have a gentic issue (one of you or combined) that prevents you from having a successful pregnancy. Perhaps there is a genetic reason and if so you could consider IVF, there is a special method used for couples with such issues which is more expensive but it can work very well.

Other thoughts:

Did you have genetic testing of the pregnancy tissue?

They could also check over your ovaries, womb, cervix, check if everything is in order and there are no anatomic reasons.

Were you checked over for Asherman Syndrome after your earlier losses? Did you have a D&C before? Any scarring of the womb?

Was your DP tested, sperm quality, count, etc.?

Any immune tests, lupus etc.?

Did you consider private testing for Natural Killer cells, eg in Coventry? This might be the reason from what you're describing, similar timing of MCs, pregnancy not developing as it should, recurring otherwise unexplained losses. NK issues can happen to anyone at any time, even if you carried the first pregnancy for longer.

When did you start on aspirin, was it from BFP? I would try that if you haven't yet, some women unknowingly develop sticky blood in pregnancy but aren't tested then. Results pre-pregnancy wouldn't show it.

I had all the same tests as you, nothing has ever been identified. I am now 20 weeks pregnant with my little boy and hoping everything will be OK this time. It happened completely randomly, I am on 75mg aspirin and was on Cyclogest in the first trimester, but only as a precaution.

Final thought, your RMC appointment will be more valuable if done after you have the genetic testing results of the pregnancy tissue. This is because your MC (last one and possibly previous too, we don't know) could have been chromosomal and if that's the case, there's nothing that can be done. You need to keep trying.

Sorry again and best of luck! xxx

I’m so sorry for everything you’ve been through OP. Are you in a position to go private at all? They will test for things that the NHS won’t

@PurplePansy05 oh my god, WOW! That really overwhelmed me to read😂

But no, no previous testing has been done from the 3 miscarriage tissue. The clot or sac I passed on Sunday, I kept and that is with them to be tested.

My partner has been tested for anything as like I said the appointment was over the phone and they just came to the result of progesterone being a help and that was that.

I've had a pelvis scan in October last year and it came back fine. Just my ovaries came back showing cysts, as stated was tested for polycystic ovaries, came back clear and they were told to be functional cysts. My ovaries has since been checked in my scans and all fine.

@PurplePansy05 also, was on aspirin from when we started trying. I took 75mg myself and then it was upped to 150mg when I was pregnant. As well as taking progesterone pessaries twice daily and 5mg folic acid

@Teakind I am in a position to do that, if we broke into our house savings and spent that completely into private fertility and then would have to start again for our house savings. That's a option I have to take as a "it's one or the other" and I don't think I'm prepared to do that to not only myself, but my partner.

I would really recommend looking in to your partner having the sperm DNA fragmentation test. It's not available on the NHS but if the levels are high it can cause infertility and miscarriage. The NHS put all the focus on it being a woman's issue but that's not necessarily the case.

Have a look in to natural killer cells for you as well. It's contentious but treatment for high levels seem to prove successful for many women. You'll find lots of women talking about it in threads called things like 'the pred thread' as they are put on steroids to prevent miscarriage.

Hi OP,

I'm so incredibly sorry for your losses, its so heartbreaking.

I was referred to recurrent miscarriage clinic after three losses. Nothing found in either me or the baby they tested.
They told me then and there that since nothing was found, they wouldn't be able to stop any further losses, but that clexane might help. It didn't, had a fourth loss and then a fifth loss on clexane and progesterone.
After that, I decided the sixth try would be the last try. I took no medication, but turned up to the EPU every fortnight for scans. I had a little girl March 2019. Got pregnant again last year. The research had by then said that progesterone would help in circumstances where women were bleeding in a current pregnancy and had three or more losses, so I took progesterone from five weeks. Sat breastfeeding my two week old baby girl.
It's utterly scary and lonely going through multiple losses. When nothing is found, it feels like nothing can ever be fixed, but there is hope...I wish you all the best!

My sister had something they refer to as super fertility - so she would get pregnant very easily, followed by early miscarriage. This was a while ago so I don't know if thinking has changed, but it was thought that it was because embryos were implanting that had genetic issues that normally wouldn't get as far as a positive pregnancy test. She did go on to have two successful pregnancies with no special treatment, but it was basically a heart breaking lottery each time she got pregnant.

I would also look into your partner having a fragmentation (I think) test - where they test the quality of sperm.

It’s hard to offer up advice on these threads because some of the trite stuff - stop thinking about it, relax, just have sex - is not v helpful. But also medical professionals are not massively helpful since so many repeated MCs are inexplicable.

I have found that getting into a workout routine seems to help (but because I’m normally very sedentary I think this is more of a shock to the system effect). And looking into blood thinners. I know some people who’ve had success with acupuncture (I don’t know if it’s a placebo effect or real), and taking proceive or a stronger daily vitamin. If you are taking a break anyway (and it seems like you are so young) then might be something to do in the background before exploring more invasive fertility treatments as it were

We have looked Into the sperm testing. £550 before we even walk in the door🥴 but anything after this point to rule anything out and hopefully get down to answers (if there is any) and I've also received my consultation appointment with a different consultant from the NHS recurrent miscarriage clinic. I have an appointment on April 9th

@Olga83 reminds me so much of me, no problem getting pregnant. It's getting past that 7 week mark that is failing me. No doubt about it that I can get pregnant by just sneezing by my partner. But actually having a pregnancy, that's the thing not so easy

@ZaphodBeeblerox yes, we are both 25. So lucky to have age on our side at the minute

The clot/tissue/sac I passed myself on Sunday and I took into hospital Monday has been approved by a consultant to be sent for testing. They've just informed me. I'm not hopeful of it showing much. But fingers crossed it could shed some light on something. They said they'll ring me or write a report and send it to me with the result

Smoking, tight jeans, lack of vitamins, can all affect partner's sperm quality. My friend had 3 miscarriages, followed by three kids, aged 38 when pregnancies followed. She sat down with partner and insisted he give up any toxic substance, alcohol cannabis, cigarettes. It worked. I think there is a seven month delay before it works...takes that long for sperm to regain health.

@Nettleskeins my partner doesn't smoke, can admit we both socially smoke when out with friends. But we haven't in over a year now. My partner doesn't wear tight jeans, he would die at the thought😂 he also takes men's vitamins since we started trying. We both do. We've done everything by the book, I honestly don't know what else we can do/of could of done