Miscarriage/Pregnancy Loss

Testing after miscarriages - tips please

Hi ladies,

I am new to this forum but not to miscarriage, unfortunately. I'm an currently in the process of my 3rd miscarriage since January. In January, I had a missed miscarriage (baby was 7.5. I was almost 12 weeks). She tested positive for Down's Syndrome. I had what would be defined as a chemical pregnancy in May (4.5 weeks), no answer other than to assume the puzzle pieces did not fit together. The current loss, I am at 7.5 weeks and baby apparently never made it past 4, maybe 4.5 weeks. We assumed chromosomal issue (and a fluke) with our first, but after three, we now need to look deeper. I do appreciate your thoughts/condolences, but at this point, I'm more in need of tips that can help me find answers.

What I know is that my progesterone levels have been beautifully high. There are no physical abnormalities with me or my uterus. I have had issues with ovarian cysts before, but resolved them with diet changes, and even then, they were occasional, and didn't point to pcos. On top of all these normal findings and adding to the puzzle, my first two pregnancies were absolutely healthy, and I have a healthy 11 and 8 year old (different partner). I am 35 now and was 24 and 28 with the first two, but I refuse to believe that my age is causing so much trouble. I do recognize the increased risk, but I'm generally healthy, and I don't feel we are victim to statistics here. So, before looking at my fiance's DNA replication as a potential cause, I want to make sure I've been screened for all possibilities. I'd have to address all these things before we talk about IVF with genetic screening anyway.

I also know that we have little problem conceiving. We conceived first cycle in Nov, loss in January. TTC again in March, pregnant April cycle, loss in May. TTC again first June cycle, not successful. Pregnant again 2nd June cycle. So, we've been successful in 3 of 5 months ttc (almost a year-long process including pregnancies).
Can anyone suggest a test or reason I haven't though of that could be causing these repeated miscarriages? What keeps baffling me is it would have to something that's changed with me since my last successful pregnancy, and that seems to rule out a lot of possibilities. I know nobody here can diagnose, but perhaps you've found some odd thing that caused your challenges and can help me ask for the right kind of screenings to get answers.

Here's the list that's been cleared or will be tested tomorrow: TSH, T4, T3, pre-diabetes, clotting factors, hopefully thyroid antibodies, progesterone, physical abnormalities ruled out. I do have fibromyalgia, but I can't find any clear connection to miscarriage (and I no longer take medicine for it, controlled with diet, so no medicinal causes). I am rh negative, but of course, that's been monitored and treated as it should be from the beginning of my first pregnancy. What else should I be asking about?

Re: Testing after miscarriages - tips please

  • You mentioned clotting factors, so this would probably include tests like Factor V Leiden,  Antiphopholipid Syndrome, and MTHFR. Each of these can cause small blood clots that cause miscarriage. But your doctor should recommend appropriate tests for you, as insurance doesn't always cover these tests. Some people have themselves and their partner kayotyped for being carriers of things, but obviously that is much more expensive.

    Me: 27 years old            DH: 27 years old
    Type 1 Diabetes since 2001, MTHFR hetero A1298T
    Dogs: Raider 4 yrs, Dex 4 yrs
    Married in July 2014
    TTC #1 since late Feb 2016
    BFP #1 3/29/16     MMC: 5/5/16
    BFP #2 7/6/16    SCH, D&C 8/4/16
    BFP #3 12/26/16     EDD: 9/6/17
    My Chart / My Diabetes/Pregnancy Blog
    My Type 1/TTC/Pregnancy Podcast: 
    Juicebox Podcast Episode 118
    1/12/16 6.7%
    5/25/16 6.0%
    11/2/16 6.1%
    3/22/16 5.8%
    4/27/17 5.4%
    6/13/17 5.3%
    "Sugar Fancy Tutu"
  • Ovarian reserve testing is also pretty standard: CD3 for LH, FSH, and AMH. Prolactin is usually tested too.

    Karyotyping, as @SugarGirl1019 mentioned, is a next step too. Some insurances will cover the cost (mine covered almost all of mine and half the cost for DH). Check your insurance policy's guidance document on recurrent loss treatment. Even if you don't have any IF coverage (I don't), they may still cover most of the RPL testing.

    Im on mobile and have trouble inserting links, but if you google "ASRM and Recurrent Pregnancy Loss", you should be able to find the ASRM's guidance document for what tests are and aren't recommended for RPL testing. It's written for providers or people with a science background, so there's a lot of jargon, but there is a table in there listing recommended tests.
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