Early pregnancy after miscarriage

[Princess2022]

Hello everyone
I just found put today that I am pregnant. 2 months back I had a miscarriage. I'm really afraid and worried. I want this baby to stick. Will doctor prescribe me something like baby aspirin or progesterone pessaries if I ask for it? I'm shaking and so stressed. My hubby said not to use the stairs at all. I'm getting so worked up. Please can someone give me any info if doctor will prescribe me for something to save my pregnancy?
I would really appreciate 🙁

It depends on the cause of previous miscarriage. If it was early then it's mostly chromosomal and there's no way to prevent or cause that. They would only prescribe progesterone if you had a history of low progesterone and aspirin if you have a blood clotting disorder or are thought to have one. I do not understand what you mean about stairs - stairs are not linked to miscarriage and keeping active is a positive thing in terms of pregnancy outcomes

I think it was a missed miscarriage. It happened at 9 weeks.
I want to be active but my in laws think coz I move around alot that's why miscarriage happened previously. Its silly. I know its nothing got to do with that.

@Princess2022 Im pregnant after a miscarriage in the summer too, I understand your anxiety and it really is a worrying time. Try not to panic too much, I haven’t taken anything for this pregancy as I don’t think mine was due to low progesterone but more a chromosomal issue. You could always call a gp/epu and ask for some support if you’re really anxious x

@Princess2022 your in laws don't know what they are talking about! I understand your fears - I had a loss where the baby died at 11 weeks. There is some NICE guideline that suggests progesterone supplements until 16 weeks, which you could look up and show your GP? I was actually given this but my fertility clinic said they didn't expect it to do much as low progesterone was not the cause of the loss (also missed miscarriage- which means for both of us our bodies kept progesterone nice and high). However, it doesn't have any real downsides (just cost to NHS and also it's a faff to use).

www.midirs.org/latest-news/news/2021/updated-nice-guidance-on-miscarriage-using-progesterone-to-help-prevent-pregnancy-loss/

@Princess2022 yes ignore your in laws, mine was a missed miscarriage also. It’s more likely to have a successful pregancy than another loss so try and keep that in mind, I know how hard that is though!

I'm taking low-dose aspirin because I know my CRP (C-reactive protein) is over 2.1, based on the US study from 2015, so I can make an informed decision. I doubt a doctor in the UK would necessarily support this though and you should always refer to and follow your doctor's advice.

Unless you know you have low progesterone levels or are having a threatened miscarriage, there is not going to be any clinical reason to give you progesterone. You can potentially argue for it on the basis that it won't do any harm. It won't however save a pregnancy that is non-viable.

That's partly why I'm testing hcg and progesterone by blood test, as I know my progesterone was low and fell with MMC in September. I did a lot of blood tests privately at the start of November to work out what was happening. That puts me in a position where I can potentially advocate medical staff based on those levels. The thing is, we don't really know if progesterone is low because a pregnancy wasn't viable or a pregnancy doesn't continue because progesterone is low.

The guidance for progesterone supplementation is that you need to already be bleeding and have had 3 or more losses for it to be seen clinically as beneficial (Tommy's PRISM trial).

Taking the stairs, etc won't make any difference either way. I fell off a running treadmill early in the pregnancy with my first daughter and the only thing it impacted was that it was really embarrassing at the time.

@somethingluscious are your hcg and progesterone blood tests something you’re doing privately? X

Hi ChloeN

Thank you for being supportive.
And congrats to you on your pregnancy x
I just found out today after doing pregnancy test. I will call doctors to book a blood test soon.

Hi IWillBeWaxingAnOwl
Sorry to hear about your loss 🙁
I don't think doctor will give me anything coz I just had 1 loss.
Thanks for the link 👍

Hi somethingluscious
Thanks for your info
I hope you have a nice healthy pregnancy 🙂
In blood test will it come up if my progesterone is low or something?

Yes @ChloeN, I send blood tests to Medichecks. They are finger-prick vials I can send priority with the royal mail as there is a priority post box across the road. Medichecks have an HCG test and an HCG/progesterone test.

When I was ttc with my 14 and 11-year-olds it was through combined care of fertility clinic and my GP, so the GP always did HCG doubling rates for me when I was taking clomid to conceive our 11yo. My GPs have retired and I ended up changing practice because the new GP in the practice was really awful. My new GP is great, but I pay for blood tests privately myself as they are not deemed necessary. Even the EPU said blood tests are not something they use as they go by scans. I think as well progesterone results can vary over the course of the day because progesterone releases in pulses so I'm not convinced of the accuracy. I had a low result for 7dpo last cycle and I'd clearly ovulated from my chart and resulting luteal phase. I'm waiting for progesterone results for 6 and 8dpo for this cycle and I started using Mira as well just to get a better idea of what was going on across my cycle.

With the progesterone test I had at 6w3d it had lowered from one at 18dpo and I was advised to talk to the midwife about progesterone supplements, but by that time it was probably too late and I got the results a few days to a week after too.

I did day 2 blood at start of November to check my FSH, LH, AMH etc and CRP. My prolactin and cortisol were raised so that's indicative for me (cortisol steals progesterone as the body will always prioritise cortisol at the expense of progesterone). I'm older though at 44, so the results probably have more bearing. This is my 7th pregnancy now and I can't handle not knowing if it's progressing or not. Blood tests are unlikely to help improve outcomes though iyswim, but they do give me info on the best lifestyle changes or vitamins/supplements, etc, plus my FSH and AMH were really, really good for my age so when they talk to me about 'old' eggs they're not exactly doing so in a clinically informed manner - not that it necessarily makes a lot of difference!

Hi somethingluscious
I had a prolactin issue last year azwell. It became high. Then after some time periods came back normal. I have really sensitive breasts atm since so many days. Is it got to do with prolactin? Or its most probably pregnancy symptom coz it's common to have that

@Princess2022 no problem lovely, I hope you get some help and support from your gp and congratulations☺️xx

@somethingluscious I checked my hcg through line progression I suppose but now I’m over 6 weeks I can’t really do that. I would like to know my progesterone though, I used the proov strips this month but that was only at 6 and 9dpo so not sure they’re overly accurate! I thought I could poss have lower progesterone as I spot before periods sometimes but everything else I’ve seen indicates that low progesterone and mmc aren’t linked, it’s all very confusing 😫

High prolactin can raise your miscarriage risk or can interfere with or suppress your cycles. You don't really know what your prolactin is now, but I'd mention that to your doctor / midwife if you have a history. Even with mine, they said to retest prolactin in a month just to be sure. Sensitive breasts are probably more likely from pregnancy, but I tend to get that after a few weeks once hcg gets higher.

I used proov strips this cycle too - I think you recommended them to me! That lined up pretty well with what Mira was saying for me for PgD. The issue I have with PgD urine tests is the variability with the concentration of urine. I always get stronger results later in the day and they are not useful or diagnostic for pregnancy. Also, my luteal phase temp charts don't seem to correlate exactly / well with my progesterone levels and I've been trying to work that out.

I tend to overanalyse things. The midwife delivering my second daughter totally read me in terms of how I like to feel in control of uncontrollable things and that I then tend to get in my own way. I never really get spotting and never have a threatened miscarriage with any bleeding, apart from one very early loss, so wouldn't really be eligible for progesterone unless I argue based on history or that it won't do any harm.

The only reason I know progesterone was an issue with my MMC was because at 18dpo it was already low, then at 32dpo the day after a successful 6w2d scan it had dropped further. That was also very much retrospective as results take about a week. Again though, a doctor might just argue that the results of progesterone tests can vary over the course of a day so aren't that accurate. My HCG was great in September up at 15000, which was why I relaxed and was sort of blindsided.

@somethingluscious ah yes were we talking on the miscarriage thread?? I had heard after that proov weren’t that reliable but glad to hear they matched up with the Mira, surely that’s reliable with the cost! How far along are you now? X

@ChloeN I am really early as just had a positive test last week. Was a bit of a surprise as thought it would take longer and was already planning ahead for timing my next cycle / fertile window over Christmas break lol! I have a reassurance scan at EPU end of December when I should be 6w3d based on ovulation. They time it for 8 weeks, but based from the start of last period. Not sure how reassuring that will be though! I think what's hard is all the tests and scans just provide a snapshot at the time or a trend over time retrospectively iyswim. So it's fingers crossed and try to trust your body to do its best.

@somethingluscious ah what a lovely surprise! I’m only just over 6 weeks so really early for me also. Let me know how you get on at your early scan, think im going to book one for after Christmas xx