TTC After a Loss

Can anyone that has seen/is seeing a MFM instead of a RE come in? (living child mentioned)

Hi ladies-

I'm doing some RPL testing with my OB (karyotyping done and clear) and the intention is that I will be referred to a MFM as based on my history (living child with no pregnancy issues, no problems getting pregant and successfully making it past 1st tri in both of my losses). I know that many on TTCAL are being managed by REs, so I was hoping to ask a few questions/get some insight from anyone who's gone through testing and/or made a plan for TTCAL with a MFM specifically. I'm hoping to get the referral from my OB tomorrow so that I can go ahead and schedule the initial visit with the MFM for once my thrombolytic testing results are in, so I want to start doing some research on what to expect, questions to ask, etc so that I can be my best advocate during this process. Thanks in advance ladies!

BFP #1- 4/2011; DD Brynn born 12/2011

BFP #2- 7/13; EDD- 4/2/14; Lost DS at 20 weeks (11/16/13) due to cord accident

BFP #3- 3/14; EDD- 11/28/14; Lost DD at 15 weeks (6/7/14)- cause unknown

To my angels- I held you every second of your lives and I'll love you every second of mine.

 

Re: Can anyone that has seen/is seeing a MFM instead of a RE come in? (living child mentioned)

  • I see an MFM- they are great **living child mentioned**



    With my 1st pregnancy, I had severe high blood pressure and other issues (I have no thyroid, had first trimester bleeding, an SCH, had vision loss) and they got me to 39 weeks. When I went for my first appointment with my MFM with my last pregnancy that I lost, they made all my recs for my lab work etc and they will be the one directing my care as we begin to try again.

    I can't say enough good things about my MFM and the care they gave me.

    As for questions that I had, I asked about clotting disorders, appropriate timing for when they'd want to see me if I get pregnant again, normal stuff, until I have results from the lab work (going end of this week as my loss was just June 13...) if my labs come back wonky then I'm sure I will have questions galore!

    Good luck.
    BFP #1-- 8-25-12, DD Born 5-1-13 
    BFP #2-- 5-6-14, MMC 6-13-14, D&C 6-13-14
    BFP #3 -- 8-26-14, EDD 5-10-15 

  • From what I understand, they are 2 diffenent types of Drs, basically the RE helps you get Pg, and the MFM Dr is if you are High Risk (once you are Pg)

    Thanks @wickedsugar.  That was my understanding too but I'm going to be seeing one while TTC (probably partially to help determine if there is a diagnosis that has led to my losses as well as make a plan for what is likely to help me while I'm TTC and once pregnant).  I'm guessing that I will see them once pregnant as well, I just don't see as many women seeing them during this diagnosis/TTC phase so I'm looking for some guidance in case there are others here who have done the same.

    BFP #1- 4/2011; DD Brynn born 12/2011

    BFP #2- 7/13; EDD- 4/2/14; Lost DS at 20 weeks (11/16/13) due to cord accident

    BFP #3- 3/14; EDD- 11/28/14; Lost DD at 15 weeks (6/7/14)- cause unknown

    To my angels- I held you every second of your lives and I'll love you every second of mine.

     

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  • I see an MFM- they are great **living child mentioned** With my 1st pregnancy, I had severe high blood pressure and other issues (I have no thyroid, had first trimester bleeding, an SCH, had vision loss) and they got me to 39 weeks. When I went for my first appointment with my MFM with my last pregnancy that I lost, they made all my recs for my lab work etc and they will be the one directing my care as we begin to try again. I can't say enough good things about my MFM and the care they gave me. As for questions that I had, I asked about clotting disorders, appropriate timing for when they'd want to see me if I get pregnant again, normal stuff, until I have results from the lab work (going end of this week as my loss was just June 13...) if my labs come back wonky then I'm sure I will have questions galore! Good luck.

    Thanks @Lalalady54.  I'd definitely be interested to know how your appointment goes regarding their management of your care as you begin to TTC again. I had a very uneventful pregnancy with my daughter and since our first loss was ruled a cord accident fluke (they even ran some basic clotting testing on me with no issues in the results), I think my OB probably feels like there isn't much she can do for me to help me get answers beyond the testing that we are currently doing.  Since I wasn't seeing a MFM with my last pregnancy, I'm interested to see how things go starting with one at this point.

    BFP #1- 4/2011; DD Brynn born 12/2011

    BFP #2- 7/13; EDD- 4/2/14; Lost DS at 20 weeks (11/16/13) due to cord accident

    BFP #3- 3/14; EDD- 11/28/14; Lost DD at 15 weeks (6/7/14)- cause unknown

    To my angels- I held you every second of your lives and I'll love you every second of mine.

     

  • Wicked is correct. REs are to help you get pg MFM are for High Risk patients. I'm wondering why you've been referred to the MFM. Are they classifying you as high risk because you've made it past the first tri and had losses? Mine basically told me he'd see me when I was ready and pg again. I haven't may with him since my follow ups after delivery.

          THE DARK SIDE IT IS

     and GBCB

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    BFP 8/2/12 EDD 4/9/13 Addie was delivered 1/4/13 at 26 weeks due to Eclampsia  

    BFP 9/15/14 EDD 5/28/15 Please be our R A I N B O W take home baby BOY
    Lilypie Angel and Memorial tickers

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    ~All AL always welcome~

     

     


  • Poppy715 said:
    Wicked is correct. REs are to help you get pg MFM are for High Risk patients. I'm wondering why you've been referred to the MFM. Are they classifying you as high risk because you've made it past the first tri and had losses? Mine basically told me he'd see me when I was ready and pg again. I haven't may with him since my follow ups after delivery.
    @Poppy715 - I think that's what it is.  When we had our 2 week post-delivery appointment, I asked what our next step beyond the karyotyping/thrombolytic testing with my OB would be and if I'd be referred to a RE. She said she didn't think the best place for me was with an RE unless we found an issue with the karyotyping. If those results were normal- as we've now found out they are- her recommendation is a MFM since my issue isn't with getting pg or first tri loss. I guess maybe the underlying causes and/or protocols differ significantly for second/third tri losses? I guess if the referral is incorrect, the MFM can correct and redirect me to a RE instead. I guess we'll see.

    BFP #1- 4/2011; DD Brynn born 12/2011

    BFP #2- 7/13; EDD- 4/2/14; Lost DS at 20 weeks (11/16/13) due to cord accident

    BFP #3- 3/14; EDD- 11/28/14; Lost DD at 15 weeks (6/7/14)- cause unknown

    To my angels- I held you every second of your lives and I'll love you every second of mine.

     

  • I'm currently going through testing with mfm. I had one early loss and one second trimester loss.

    I was referred to mfm by my ob for a consultation prior to my next pregnancy for "recurrent pregnancy loss"

    So far, I met with the dr and he went over all of the testing done from my loss. (ie placenta, cord, genetic testing, autopsy, etc) I've also had blood work done. He also scheduled me for a saline sonohystergram to check for any uterine abnormality. I will have one more consultation with mfm to give me the final recommendations for the next pregnancy.

    I don't know if this info was helpful. I'm new to this too.

    image

    3rd pregnancy -- 1st baby -- praying for a rainbow

    #1 EDD 5/2014 -- MMC 10weeks ~~ #2 EDD 10/2014 -- Our baby girl, born sleeping 17weeks ~~ #3 EDD 8/2015

  • hmm, this was informative. I will be classified as high risk as well, once pregnant. I wonder if I'd see an MFM? I'm seeing my OB on the 21st and will ask about this. There isn't an abundance of MFMs around here, and I believe only 1 or 2 REs in the state (Maine).

    Keep us updated! I'd be interested in what you learn

    Image and video hosting by TinyPic   image image

        My Blog

    Lilypie Pregnancy tickers
      

    Lilypie Angel and Memorial tickers
    BFP# 1 7/7/12 Beautiful DD born still at 36 weeks 5 days on 3/2/13
    Diagnosed with PCOS in 2005. Started Metformin July 2013

    BFP # 2 8/7/14 EDD 4/22/15
    Please be our rainbow!!

    **All AL Welcome**

  • I'm currently going through testing with mfm. I had one early loss and one second trimester loss. I was referred to mfm by my ob for a consultation prior to my next pregnancy for "recurrent pregnancy loss" So far, I met with the dr and he went over all of the testing done from my loss. (ie placenta, cord, genetic testing, autopsy, etc) I've also had blood work done. He also scheduled me for a saline sonohystergram to check for any uterine abnormality. I will have one more consultation with mfm to give me the final recommendations for the next pregnancy. I don't know if this info was helpful. I'm new to this too.

    @daffodil428 - thanks- this is definitely helpful. If I had to guess, this may be very similar to the process I'll go through as well. Our last autopsy took almost 3 months to come back which seems ridiculous compared to what it sounds like others have seen. I'm just banking on it taking that long this time as well, so hopefully I can schedule an appointment with the MFM for early September and have all of the various testing results in to discuss. 

    I'm interested to see if there's a recommendation for some sort of anatomical test for me as well.  I had a HSG before more first pregnancy bc I had a uterine septum and my OB wanted to be sure that it didn't divide my uterus.  Everything was fine and the septum was removed after my daughter was delivered and it obviously hasn't caused any issues with conceiving since, but between that and the fact that my uterus had a partial prolapse around the 12th week of my last pregnancy- they might think it's worth checking out.  Thank you so much for sharing!

    BFP #1- 4/2011; DD Brynn born 12/2011

    BFP #2- 7/13; EDD- 4/2/14; Lost DS at 20 weeks (11/16/13) due to cord accident

    BFP #3- 3/14; EDD- 11/28/14; Lost DD at 15 weeks (6/7/14)- cause unknown

    To my angels- I held you every second of your lives and I'll love you every second of mine.

     

  • hmm, this was informative. I will be classified as high risk as well, once pregnant. I wonder if I'd see an MFM? I'm seeing my OB on the 21st and will ask about this. There isn't an abundance of MFMs around here, and I believe only 1 or 2 REs in the state (Maine).

    Keep us updated! I'd be interested in what you learn

    Hi @shandorfml2 - I know that since my first loss was ruled a cord accident/fluke, I wasn't automatically considered high risk enough to require a MFM with my following pregnancy and just saw my regular OB. She would have referred me if I wanted but she was doing additional testing and seeing me more often, so I think I was getting the "high risk" patient treatment there. Since it sounds like there are limited MFMs in your area,

    it might be worth going ahead and getting the referral from your OB (if she says that's where you'll be referred once pg anyways) so that you can get established with them.  I know getting appointments with MFM/REs here can be tough or delayed and we have a very large medical presence here in Houston, so might be worthwhile if you can get in for a pre-pregnancy consultation so that you're not starting as a new patient from scratch when you get pregnant.

    I'll let you know what happens as we move forward- let me know how your visit goes on the 21st as well!

    BFP #1- 4/2011; DD Brynn born 12/2011

    BFP #2- 7/13; EDD- 4/2/14; Lost DS at 20 weeks (11/16/13) due to cord accident

    BFP #3- 3/14; EDD- 11/28/14; Lost DD at 15 weeks (6/7/14)- cause unknown

    To my angels- I held you every second of your lives and I'll love you every second of mine.

     

  • hmm, this was informative. I will be classified as high risk as well, once pregnant. I wonder if I'd see an MFM? I'm seeing my OB on the 21st and will ask about this. There isn't an abundance of MFMs around here, and I believe only 1 or 2 REs in the state (Maine).

    Keep us updated! I'd be interested in what you learn

    I would think you would be classified as such. Many very late term loss mothers are considered high risk their next pg. I would be sure and ask v

          THE DARK SIDE IT IS

     and GBCB

    image    


    BFP 8/2/12 EDD 4/9/13 Addie was delivered 1/4/13 at 26 weeks due to Eclampsia  

    BFP 9/15/14 EDD 5/28/15 Please be our R A I N B O W take home baby BOY
    Lilypie Angel and Memorial tickers

    imageimageimageimage
    ~All AL always welcome~

     

     


  • I saw an MFM for a pre-conception consultation due to an already diagnosed clotting disorder. At the consultation, we discussed family history and potential treatments once I'm pregnant (Lovenox injections). MFMs are for people who have been classified as high-risk, so I met with mine only a few months into TTC to make sure we had a plan in place. I'm not sure if I'll actually need to see her again once I'm pregnant, or if my OB (and now I guess my RE) will just follow the plan she sent after our consultation.


     

    TTC since July 2012 
    BFP 5/22/13. Lap. to remove ectopic and dx with endo. 6/16/13

    RE consult: June 2014

    DX: FVL, endo, hypothyroidism, blocked left tube

    Oct. 2014: First treatment cycle: Clomid+trigger+IUI=BFN

    November 2014: Clomid+trigger+IUI again=BFP!

    BFP 11/28/14 MC discovered 1/14/15

    Blogging to stay sane

  • Poppy715 said:

    hmm, this was informative. I will be classified as high risk as well, once pregnant. I wonder if I'd see an MFM? I'm seeing my OB on the 21st and will ask about this. There isn't an abundance of MFMs around here, and I believe only 1 or 2 REs in the state (Maine).

    Keep us updated! I'd be interested in what you learn

    I would think you would be classified as such. Many very late term loss mothers are considered high risk their next pg. I would be sure and ask v
    I think so as well.

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        My Blog

    Lilypie Pregnancy tickers
      

    Lilypie Angel and Memorial tickers
    BFP# 1 7/7/12 Beautiful DD born still at 36 weeks 5 days on 3/2/13
    Diagnosed with PCOS in 2005. Started Metformin July 2013

    BFP # 2 8/7/14 EDD 4/22/15
    Please be our rainbow!!

    **All AL Welcome**

  • BethKate2 said:

    I saw an MFM for a pre-conception consultation due to an already diagnosed clotting disorder. At the consultation, we discussed family history and potential treatments once I'm pregnant (Lovenox injections). MFMs are for people who have been classified as high-risk, so I met with mine only a few months into TTC to make sure we had a plan in place. I'm not sure if I'll actually need to see her again once I'm pregnant, or if my OB (and now I guess my RE) will just follow the plan she sent after our consultation.

    @BethKate2 - Thanks for this info! It will feel good to have a plan in place and sounds like I'll get that with a MFM, even if I don't end up with a specific or treatable diagnosis.

    BFP #1- 4/2011; DD Brynn born 12/2011

    BFP #2- 7/13; EDD- 4/2/14; Lost DS at 20 weeks (11/16/13) due to cord accident

    BFP #3- 3/14; EDD- 11/28/14; Lost DD at 15 weeks (6/7/14)- cause unknown

    To my angels- I held you every second of your lives and I'll love you every second of mine.

     

  • With my first pg I initially saw an ob and then was followed by mfm when I started with PTL. With my second,third and fourth pg I saw the mfm as well but the only thing he did was an early u/s and a prescription for extra folic acid and aspirin. After my third loss he referred me to the RE who did more thorough testing and fertility meds. My mfm wouldn't prescribe fertility meds and has a limited knowledge of pre conception issues. Trust me my mfm is awesome when I was pg but I put my faith in my re to get and attempt to get me out of first tri.
    align="center">

    BFP #1 9/6/2009 EDD 5/29/10. Missy Moo born 5/12/10 after 3 months of bedrest due to PTL, IC and a bicornuate ute causing IUGR
    BFP # 2 1/28/12 EDD 10/6/12 No heartbeat seen @ 10 weeks, Autumn
    BFP #3 8/18/12 EDD 5/2/13 No heartbeat seen at 7w3d, Mae
    BFP #4 01/31/2013 EDD 10/15/2013 No HB seen in our little girl at 10w2d due to trisomy 12, Abigail
    BFP #5 6/27/2013 EDD 3/10/2014 diagnosed with protein S deficiency heparin twice a day. Luke's HB stopped at 8wks
    BFP#6 12/22/2013 EDD 9/4/2014 No HB seen at 7w2d, Leia

    BFP #7- 5/12/14 EDD 01/2015, ruptured ectopic 5/31/14

  • zapgurl44 said:
    With my first pg I initially saw an ob and then was followed by mfm when I started with PTL. With my second,third and fourth pg I saw the mfm as well but the only thing he did was an early u/s and a prescription for extra folic acid and aspirin. After my third loss he referred me to the RE who did more thorough testing and fertility meds. My mfm wouldn't prescribe fertility meds and has a limited knowledge of pre conception issues. Trust me my mfm is awesome when I was pg but I put my faith in my re to get and attempt to get me out of first tri.
    Thanks @zapgurl44. I'm sure it will ultimately depend on my diagnosis and if issues are found that are considered pre-conception related, they may change me over to a RE. Sounds like a lot of this stuff is trial and error, again depending on the diagnosis, so I guess we'll have to see how things go and readdress as needed.

    BFP #1- 4/2011; DD Brynn born 12/2011

    BFP #2- 7/13; EDD- 4/2/14; Lost DS at 20 weeks (11/16/13) due to cord accident

    BFP #3- 3/14; EDD- 11/28/14; Lost DD at 15 weeks (6/7/14)- cause unknown

    To my angels- I held you every second of your lives and I'll love you every second of mine.

     

  • @BethKate2‌ they discovered a clotting issue with my placenta through all of the post loss testing. They want me on aspirin before I conceive then on lovenox and aspirin once I hit 8weeks. They're currently doing bloodwork to see if I have a clotting disorder.

    I was really upset about the idea of daily injections. It's nice to know I wouldn't be the only one out there going through it.

    Have you been on lovenox before?

    image

    3rd pregnancy -- 1st baby -- praying for a rainbow

    #1 EDD 5/2014 -- MMC 10weeks ~~ #2 EDD 10/2014 -- Our baby girl, born sleeping 17weeks ~~ #3 EDD 8/2015

  • @BethKate2‌ they discovered a clotting issue with my placenta through all of the post loss testing. They want me on aspirin before I conceive then on lovenox and aspirin once I hit 8weeks. They're currently doing bloodwork to see if I have a clotting disorder. I was really upset about the idea of daily injections. It's nice to know I wouldn't be the only one out there going through it. Have you been on lovenox before?

    @daffodil428, No, I haven't been on Lovenox previously. I talked to my doctor about it when I was pregnant, but because my numbers were so low from the get-go, we knew something was wrong, and he hesitated to get me started on the injections. I'm not on anything right now because I have no personal history of clots.


     

    TTC since July 2012 
    BFP 5/22/13. Lap. to remove ectopic and dx with endo. 6/16/13

    RE consult: June 2014

    DX: FVL, endo, hypothyroidism, blocked left tube

    Oct. 2014: First treatment cycle: Clomid+trigger+IUI=BFN

    November 2014: Clomid+trigger+IUI again=BFP!

    BFP 11/28/14 MC discovered 1/14/15

    Blogging to stay sane

  • I was on heparin twice a day from bfp until no heartbeat at 8 weeks. They weren't too bad.
    align="center">

    BFP #1 9/6/2009 EDD 5/29/10. Missy Moo born 5/12/10 after 3 months of bedrest due to PTL, IC and a bicornuate ute causing IUGR
    BFP # 2 1/28/12 EDD 10/6/12 No heartbeat seen @ 10 weeks, Autumn
    BFP #3 8/18/12 EDD 5/2/13 No heartbeat seen at 7w3d, Mae
    BFP #4 01/31/2013 EDD 10/15/2013 No HB seen in our little girl at 10w2d due to trisomy 12, Abigail
    BFP #5 6/27/2013 EDD 3/10/2014 diagnosed with protein S deficiency heparin twice a day. Luke's HB stopped at 8wks
    BFP#6 12/22/2013 EDD 9/4/2014 No HB seen at 7w2d, Leia

    BFP #7- 5/12/14 EDD 01/2015, ruptured ectopic 5/31/14

  • @zapgurl44‌ I'm glad to hear they weren't that bad

    @BethKate2‌ I see. I'm glad you don't have to be on them all the time.

    image

    3rd pregnancy -- 1st baby -- praying for a rainbow

    #1 EDD 5/2014 -- MMC 10weeks ~~ #2 EDD 10/2014 -- Our baby girl, born sleeping 17weeks ~~ #3 EDD 8/2015

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