Recurrent Miscarriage Update

I had a follow-up appointment yesterday with the OB who performed the needed curretage a few weeks ago.  I can’t say that I really learned anything helpful from the meeting. 

Pathology on the baby came back normal though apparently no chromosomal analysis was done.  I hadn’t realized that the pathology would only rule out ectopic or molar pregnancies.  I already knew from the ultrasound that neither of those were concerns.  So that was a costly dead end.

Chromosomal abnormalities?  Perhaps, so she recommends testing for both me and my husband.  I assume that we will go ahead and do that.

Progesterone deficiency?  Perhaps, so she recommends taking Clomid when I’m ready to conceive again.  I was not previously aware of using Clomid to treat potential progesterone deficiency or apparent “luteal phase defect.”  Since I ovulate on our around the 15th cycle day, I don’t think LPD is my issue.   However, I’m not ruling out some sort of hormone imbalance.  When I’ve had HCG levels tested, those numbers have been just fine.  But I’ve never had my progesterone level checked, and this OB wouldn’t do it anyway even after Clomid treatment.  I find that odd.  What if the Clomid wasn’t quite enough to sustain the corpus luteum until the placenta takes over?  Wouldn’t it make sense that I could still possibly need progesterone supplementation even after conceiving on Clomid.  (Remember that I have no conception problems; I’m just “failing” to sustain pregnancy right now.)

Immunological problems?  Not suspected though I am inclined to disagree.  I have a history of endometriosis, depression, low energy, and adult onset acne, for instance.  My mother has rheumatoid arthritis which is an auto-immune disease.  I rarely feel particularly “great,” but then again, given what I’ve been through this past year it would be hard to identify a great day even if it was right under my nose.  I found the Reproductive Immunology Associates’ information on miscarriage prevention to be interesting, encouraging, disheartening, and overwhelming.  I will pursue some of these ideas with local care providers.

Next month I will follow-up with another OB in town.  I may also go see an endocrinologist who has been recommended.  There are evidently fertility specialists as near as Spokane, so perhaps I should be contacting them?  I have so many questions, and I don’t know if I’ll ever find answers.  That’s perhaps the scariest part.  At this moment I think I could deal with being told that trying to conceive again would not likely be successful for X, Y, or Z reasons.  We do have one incredible child, and I might be inclined to consider adopting from abroad.  But to have to deal with the unknown is what really worries me.  Three miscarriages in a row “just” bad luck?  How will I overcome that “diagnosis” if it is the most likely deduction?

Time will tell.  Each day is different.  Some days are ok and some are not.  I am living moment to moment, hour to hour, day to day.  Planning ahead for anything is excrutiating.  But “ahead” will come whether I like it or not, whether I can deal with it right now or not, and whether I can deal with it then or not.

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12 responses to “Recurrent Miscarriage Update

  1. Wow I would have assumed pathology of the baby was for chromosomal issues, it was for me. LPD is more how long your cycle is AND when you ovulate. Clomid produces basically a hard bounce to force your body to respond. Progesterone levels in general are a chicken and egg question: Is the progesterone low because the pregnancy is failing or is the pregnancy failing because the progesterone is low? Hang in there.

  2. My sister had 3 miscarriages before she successfully carried a pregnancy to term. She had a septum in her uterus which they removed; but since there was also the possibility that the miscarriages had been caused by low progesterone, they put her on vaginal progesterone suppositories (the pharmacist had to compound them and put them in little molds–it wasn’t readily available in a little pill–not sure if it’s changed since then–10 years ago). Anyway, she successfully carried two babies to term after that, both times taking progesterone as a precaution.

    I also find it odd that the OB wouldn’t check your progesterone, knowing that could be a problem. Perhaps you could change doctors? You are the paying customer, after all, and ought to get the service you want/need.

    There are natural substances which act like progesterone that you may want to look into–I don’t know them right off-hand, but I think that soy products and perhaps yams have it. I see that you have some natural/alternative “sites of interest” (as well as some excellent blogs on your blogroll–you can check out my blogroll for more like-minded sites) so you might check there as a starting point. A fellow childbirth educator recommended naprotechnology.com as a site that deals with female issues. It’s a Catholic site, and I think is primarily intended for “natural family planning”, but it has much more than that, including sections dealing with infertility.

    It may be that your hormones are just out of whack, and some simple dietary measures might help. Your other symptoms you mention (low energy, acne, etc.) are also sometimes related to food sensitivities. Dr. Denise Punger (permissiontomother.blogspot.com) just recently posted that although it’s not medically recognized, she has found out that she’s sensitive to sugar, and her acne clears up when she gets off of it. I forget the name of the website she mentioned for the blood test to check food allergies and sensitivities, but you can check out her “sugar-free diet” category of posts and it’s in one of them (it’s something like alltech.com or something).

    Kathy
    womantowomancbe.wordpress.com

  3. I echo the sentiments of the other commentators (with far less helpful suggestions, unfortunately), I am waiting a bit but I do plan to visit my friend’s acupuncturist. She swears by him and he provides a lot of feedback about diet and lifestyle, which I’m sure is fairly typical of this community, so maybe someone along those lines will be able to provide some help?

    I’m surprised that they would suggest Clomid without checking progesterone, especially when getting pregnant is not your medical problem.

  4. I am so sorry for your loss, I had several first trimester miscarriages while trying to conceive my 2 children. With the my second child I was on progesterone for borderline LPD (9-12 days average sometimes as low as 8 though) and a regimen of 5mg of folic acid, baby aspirin + prenatals for a bood clotting mutation MTHFR. Have you been tested for blood clotting factors? There are a few different disorders and it is thought that they can cause early miscarriages. treatment is different depending on your test results but can range from aspirin, lovenox or heparin injections. Just a thought. And I hope I’m not intruding, just stumbled across your blog and it came to mind.

    It does get easier. Maybe set aside your vbac concerns for now and focus on 1 thing at a time. When I was going through my miscarriages trying to conceive my vbac baby I had to stay away from ICAN too… just to hard when it feels like everyone is way further down the road than you are. I’ll be watching your blog hoping for some positive news.

    A fellow VBAC mom with some of her very own angels~ Lindsay

  5. I was just checking in on you as I’ve think about you daily! I’m so sorry to hear that the dr couldn’t give you more of an answer or anything conclusive. After reading your blog from today I wanted to make sure to tell you that I think you should consult with a reproductive endocronologist or RE. After ttc for 3 years and being told I’d never have children by my OB I went to an RE and within 7 mths was pregnant with Seth. The RE did so many other tests and asks so many other questions and knew so much more than the OB. I can’t praise my RE enough. He is the reason we have our three children. So I would definitely go to a specialist and skip the second OB! Just my two cents.

    Miss you terribly.

  6. When it comes to hormone supplements, I collaborate with:
    Pete Hueseman, R.Ph., P.D.
    Consultant Pharmacist at

    Bellevue Pharmacy Solutions
    1034 S. Brentwood Blvd. Ste. 102
    St. Louis, MO 63117

    http://www.bellevuerx.com
    1-800-728-0288 or 314-727-8787
    fax: 1-800-458-9182 or 314-727-2830
    Consultph@bellevuerx.com

    Its worth calling and talking to him.

    Alcat.com is the food sensitivity test. You can actually order the test without a physician thorugh the website.

    For recurrent miscarraige, I’d speak with Pete over the alcat. He can only take signed orders for Progestrone from a physician or provider who has seen the client in person. He may be able to help you find someone local. He is nationally known for his work. His prescriptions are taylored to your symptoms and labwork.

    Denise

  7. Hello. I have been keeping you in my thoughts as you go through this tough time… I also wanted to let you know that two of my friends had three miscarriages trying to keep their second. One of them kept on trying and eventually it worked and the other went to see a specialist in Chinese medicine and she swore that it was what he did that worked because she conceived shortly after the treatments. Have you ever thought about Chinese medicine? I recently took a workshop that was basically Chinese Medicine 101 and the instructor mentioned she works with a lot of couples who have problems with miscarriages and fertility. I remember reading somewhere when I was helping my friend that three miscarriages in a row happens to a lot more people then you might realize. I seem to remember that it mentioned it was after 4 or 5 that you should question if there is a problem. I will see if I can find the source…. We don’t talk about miscarriage in our culture so unless it is a close friend, you would never know. I remember how nervous people were when I told them I was pregnant when I was only 4-5 weeks. I am sure they were thinking, uh oh, how will I react if something happens…
    Be well,
    Kat

  8. Thank you, all of you, for your thoughtful comments. I am slowly getting back on track. I’m hoping to feel more assured after my meeting with a different OB (who does more infertility work) on the 8th.

    I probably will search out TCM or at the very least accupuncture.

  9. May I sugggest that you go through a good naturpath but especially a specialist acupuncturist /Chinese herbalist? As a trainer of post grad. acupuncturists (specialising in pregnancy and fertility and women’s health) I can say that you do need not just someone who SAYS that they can help, as it really is a multitherapeutic field and taking the best of a number of modalities tends to work best.

    As both I see a lot of women in your shoes. People usualy come as a last resort – especially when IVF proceedures give lovely embryoes that do not make it – apparently unexplained, but usually very often explianed through BBT – taking your temp in the am first up and checking whether it is within normal range will be a surprise probably – I suggest that you go to http://www.fertilityfriend.com and allow them to tutor you – they have a great chart you can download for free . . .

    One of the interesting things to stop looking at the matenal factors and just Google ‘male factors in miscarriage’ and start knocking off all the ‘risk’ factors.

    One no one seems bothered about in caffiene – and a zero tolerance there, plus upping paternal and nmaternal nutition is a great move.

    http://www.forsight_preconception.co.uk and http://www.acubalance.ca would be places to start – also http://www.easybabies.com.au There are often multiple issues – and ultimately Mother Nature is saying – something is broken – fix it frst . ..

    It s just that following orthodox trial sit takes so much longer as they have no way to diagnose or correct QUALITY issues, and without going to natural and resolving there, it may be that the problems continue.

    Hope this helps
    Best wishes
    Heather B

  10. Thank you all for the wonderful suggestions. It’s a lot of food for thought. I’m exploring naturo- and allopathic approaches at the moment. We’re going to wait several months before ttc again.

    I agree that Mother Nature is telling me something is busted. Hope we can get it resolved in the next few months!

    ~ Kimberly

  11. I am so sorry for all youhave been through. I am 38 and two years ago Iexperienced 3 early miscarriages within 9 months. After testing with a FE, they told us great news. Nothing was wrong. Now what? We tried Clomid three months to no avail. In January of this year, I attended an acupuncturist and herbologist after doing some research. WE feel IVF is not for us. For that amount of money we will adopt.
    I am now nearly 6 weeks pregnant and staying on the prometruim(progesterone) suppositories and a baby aspirin a day to help, although these have never been idientified as a reason. My overall health improved with the acupuncture even though I considered it very Voodoo when I started. If you are looking for alternative more natural methods I suggest you look for a licensed acupuncturist and herbologist.
    My friend has been going to Emory University for fertility issues over the last year. They have now insisted she try acupuncture as well.

  12. i am so happy to find this website. i have had 6 maybe 6 miscarriages in almost two years. frustrated and upset – 3 fertiltity specialists llater and every test done, nothing wrong……..
    my next step is acupuncture/chinese medicine – what excatly happens at these appointments ?

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