MMC, surgical management, and what next?

[meepthebeep]

Hi everyone,

We found out yesterday that our much-wanted first pregnancy has ended in a MMC. I’m 30 and DH is 32. I should have been 11+2 but the baby is only measuring around 6 weeks, so although we have to go back for another scan next week, we’re pretty much certain that this is it.

I think I want to go for surgical management, so that it’s (most likely to be) over in one go as quickly as possible. I know that sounds heartless but we’re so devastated and just want to get through Christmas together and try again in the New Year. How soon did you get booked in for surgery after having things confirmed by a second scan? (if you needed a second scan - I understand why they’re doing one but it feels almost cruel when we know nothing is going to change).

I’ve never had a general anaesthetic and the thought scares me, but I think the idea of a local for this particular procedure scares me more. If you had surgical management, did you go for a GA? Would you recommend it, if recommend is the right word?

After it’s all over, how long did things take to settle for you? We’re basically planning to hunker down and rest/recuperate over Christmas but we’d like to try again in the NY once I’ve got my first period - I think any uncertainty around dates for a next pregnancy would send me round the twist after what we’re going through now.

How long did it take you to have a successful pregnancy? We’re 30 and 32, generally fit and healthy, non-smokers and no underlying conditions that we know of, so hopefully all this is on our side.

Thank you all. So sorry if you’ve been through this too, but really grateful for any advice you can share. X

I’ve been able to speak to my line manager properly this morning, which has been really reassuring.

I had an MVA done under local anaesthetic earlier this year. I guess the procedure felt like pretty intense period cramps, but I was able to walk out ~30 mins after they were done and just had some paracetamol for the lingering cramps. I felt physically fine by the next day. I preferred that than the thought of GA, even though you probably get a bit more pain. I ended up with a week between the scan where we found out and the procedure (which was done immediately after the 2nd scan).

I ended up with a very small amount of retained tissue, which the midwife said would probably have stopped me conceiving on the first ovulation post-MVA (i.e. before the first real period). However that came out on its own with my period and we conceived again the next cycle.

I was in a similar place in April/May 2022, found out it was a mmc. Although I found out in a private scan at 9 weeks, but didnt start to miscarry until 12 weeks (I still felt pregnant until 11 weeks) and then had the surgery at 16 weeks because it was incomplete. We were 30&31. I conceived again three months later. I now have a healthy beautiful 8 month old ds.

I didn’t take anything for the second pregnancy (eg didn’t take asprin/progesterone) and he stuck. Before I got pregnant again I did pay privately for a thyroid test because my mum has it, but it was normal.

I didn’t even start the folic acid until I was 5 weeks because I was on holiday and trying not to think about tests etc. I knew I was pregnant on holiday without it though- I woke up at 4am consistently and then I got dizzy.

I paid for another private scan at 9 weeks with the second pregnancy because I was convinced it would happen again, and didn’t want to reach 12 weeks like I would have the first time. Only this time it all went well.

So sorry for your loss and hopefully you conceive and have luck in the new year. If it helps I know quite a few people who had a miscarriage and then a successful pregnancy.

The last sentence reads a bit harsh, of course it doesn’t help you at all in this moment. I worried through the second pregnancy due to the mmc. I just mean that in a positive way from all this horrible situation we go through. I still remember the time vividly and how sad I was. Sorry.

@meepthebeep I completely get it wanting to feel like you’re doing something - all the advice I was given from medical professionals is that early MCs and MMCs are often down to genetic abnormalities in the fetus, so whilst it can happen a second time (and I know there are lots of accounts on MN of this happening) the chances are small. I am now 8.5 weeks pregnant and EPU have been amazingly supportive.

I’m so sorry. I know how you’re feeling all too well. It’s sheer unbearable grief. I remember the wait and if it’s any consolation for me that was the hardest part. I felt so desperate for the surgery so I could start healing but also immense guilt for thinking that as I thought I should be making the most of the time I had with my first pregnancy. I remember the deep worry that I would never have a child. All I can tell you is that for me it’s two and a half years on. I have a beautiful boy and am now pregnant again. I know when I read messages like that when it happened to me they didn’t help but I hope it does for you. Please know that it does get better, it really does. The next few days or so will be very hard but they won’t last forever and the grief gets easier to deal with. If you have any questions do ask.

I am definitely going to be taking asprin next time. I was already prescribed it from 12 weeks at 150mg per day but I am going to take 75 mg from conception next time. I think progesterone is only really prescribed if you have early natural miscarriage. People like us, where the embryo dies but the body retains the pregnancy almost certainly dont need it because basically our hormones have held on to the pregnancy. Basically our bodies did their job but tge embryo failed to develop further. There is a hell of a lot going on with the embryo between six and eight weeks which can go wrong so this is likely why miscarriage or MMC during this period is a common time for it.
These forums have been a Godsend to me in the aftermath but it is worth keeping in mind that those of us who join these forums whether it is the pregnancy, conception or miscarriage ones or all of them are quite often people like us who have had an issue or are particularly worried about something and so we get a lot of negative stories and less positive ones on the forums. Bit like when people go to a hotel for a couple of nights. They are more likely to write a negative review when things go wrong than they are to write a positive one when all goes to plan.
People dont join these forums to say, hello, I'm pregnant, took a couple of months and all ok. They join for support when things go wrong or there are issues/potential issues and that's a pretty small portion of all women having babies.
I am sure this wont make you feel any better and I agree, it doesnt ease my terror for a new pregnancy but it is definitely something to keep in mind.
I will get a private scan done at eight weeks next time to see how things are going, I cant wait to 12. I will be terrified but I will get it done xx

Thank you all so much for your replies. I’ve been reading them and showing them to DH too. I’m on my phone so tricky to reply to all of you individually at the moment but just wanted you to know that I’ve read and really appreciate all of your messages 🙏🏼 thank you

I know far more women who've had a miscarriage than not, they're very very normal (and very very shit). The odds are very much in your favour to go on to have a successful pregnancy, especially if you conceived quickly. Only one friend had a problem with recurrent miscarriage and she now has 3 DC.

Sending hugs

Hi everyone, thank you again so much for your replies.

@ginny93 that’s great that you conceived the next cycle and things worked out with your period. I was thinking about trying again straightaway (with a negative test etc), but the potential dating issues would drive me mad, I think. So I think I’ll want to wait to get my period back too and go from there.

@Blue2020 congratulations on your lovely son. I’d definitely want to go for more scans next time. If EPU can’t offer them, I was thinking of asking where they might recommend locally. I don’t think it sounded harsh at all 🙂 in fact, the one thing that helps at the moment is hearing from women and couples who this has sadly happened to but who’ve gone on to have healthy children. So thank you 🙏🏼

@Wise0wl thank you. That’s sort of how I’m trying to reassure myself for next time. This one never really got going and although my guess is as good as anyone’s, I suppose it must be because something was wrong from the start and it never got past that very early stage of developing. Congratulations on your pregnancy, so glad EPU are supporting you.

@LittleRobins your post was one of the ones I showed DH yesterday. It honestly really does help to read that and I’m so pleased for you that you have your beautiful babies. I’m crossing everything that it will happen for us next time. Thank you so much.

@Longbarn5 that makes so much sense re. the progesterone. I said to DH that the positives (such as they are) are that we conceived quickly and that I clearly hold on to them 😕 so it makes sense that we wouldn’t need progesterone next time. I’ll definitely try aspirin though for blood flow (I think?), and of the two, that’s easy to get hold of.

I totally see what you mean as well about reading too much online. This place is fantastic for women to share their experiences and I appreciate them all so much and think it’s really important to have this space to share, but I do see what you mean. You don’t tend to read threads on Relationships saying how nice people’s DHs are and how kind of loving and (in a nice way) uneventful their marriages/relationships are. I suppose it’s the same sort of thing.

@ColleenDonaghy that’s so true for me too. Everyone we’ve spoken to over the last few days either has a story like this themselves or knows someone who has - friends, family, work colleagues. I found out yesterday that DH’s aunt’s third pregnancy ended in a miscarriage. She already had two children and went on to have five more babies. DH’s mum went on to have three more babies after hers as well. It seems to be so so common (and devastating), and we only hear about it when it happens to us.

Thank you again, you’ve all been utterly brilliant and so so helpful on this thread. 💐🙏🏼

Op I’m so so sorry for your loss. I now how painful and shocking Mmc is and really feel for you.

I wanted to post to say that I had surgical management for Mmc a few years ago and it was definitely the right choice for me personally. I researched because I was worried about it and read the MIST miscarriage study tracked 1,000 women and at the macro level there was no negative impact on fertility after the op.

I know you said you are keen to ttc again and if it helps at least a little I have two children now after a very painful Mmc.

You may already have been told this, but we were told the chance of a second Mmc was only 1%. Sending and lots of support to you for the coming days.

Thank you @MissHavershamReturns, that means a lot. It sounds like the surgical route is definitely the best option to go down for us personally as well.

I’ve started writing down a load of questions in the notes on my phone to take to EPU, which feels somewhat productive as well.

It's something like one in four pregnancies that ends in miscarriage, so if a woman would like to have multiple children, it's sadly something she's likely to encounter along the way.

So sorry to hear this OP 💓 i was the same age/situ as you and now have 2 x DC, i did turn out to have factor V but i have no idea if that caused the MMC or not.

I had a MVA under GA. It turned out ok but i ended up going into a bit of an Asherman's disease tail spin and the following 2/3 months being paranoid that i had it, i even went to the UK expert on it as i had convinced myself that i had it - for this reason, if i were to ttc and MC again i might chose medical management for my own MH reasons.

Xx

Oh dear, this has made me quite worried about Asherman’s. How rare/common is it? I was so sure that surgery was the right option for me. I want this to be dealt with and over as soon as possible, I don’t want to wait or go through medical management and then still end up with retained tissue. But I also want to conceive again as soon as we can.

Can anyone advise about the Asherman’s risk?

Would medical management be better? I’m so scared of the pain and the sadness of passing my baby at home. Please help

FFS, I’ve been reading about Asherman’s. I’m going to have to go for medical management instead now, aren’t I? This isn’t what I wanted. At all.

I’ve re-read the leaflet my trust gave me about the options. It sounds like MVA under general rather than D&C - it mentions a small suction device. Would this decrease the chance of Ashermans?

I was so so sure surgical was the right option. I really don’t want to do medical but I can’t bear the thought of any furhter complications. I don’t normally scar at all, will that help me?

Please advise if you can. This thread was really helping 🙏🏼

Deep breaths OP. Any procedure you have will have risks, as will medical management. Surgical management is very common and thousands of women have it with no ill effects.

Don't overthink the Ashermans risk - remember with medical management there's also the chance it doesn't fully work and you might end up needing surgical management anyway. Every options has its risks and it's upsides. I've had it twice and no Ashermans.
There is no better or worse option in general, it's a personal choice of what you feel is best for you.

I was worried about Ashermans but in the end the benefit of ERPC under GA rather than MM was better for me.

The procedure was fine but I ended up going private because the wait on the NHS was going to be three weeks. I was already 11 weeks and baby stopped progressing at 7, I didn't want to wait that long.

I was pregnant with identical twins who are now 13 8 weeks afterwards.

Thanks, everyone. Sorry, this afternoon’s not been a great one. Thank you for your help

Ashermans is rare. It is generally seen in people who have had several D&C procedures. My surgical management was via suction also. Complications are very rare.

You remind me so much of myself sweetie and I wish I could be with you to hold your hand and talk you through this, I really do. Stay away from Google. There are risks with literally anything. If you Google about different types of hormonal contraception you’ll find articles about their increased risk of cancer etc. Google is a nightmare for things like this.

One step at a time. Step 1 is the scan on Monday. Whilst you’re there you can ask the professionals about any concerns you have at all. They will have seen it all and heard it all before and will know just what to say. It’s totally your choice but, simply because your worries are so much like mine, I would advise the surgical management 100%.

Thank you. I’m so sorry, I’m an absolute mess this afternoon. This morning I was ok about everything and all of a sudden I can’t stop crying. I don’t know if it’s hormonal or the situation or both. I’ll speak to the EPU people on Monday. This has been the longest week of my life. I’m so sorry.