Hello...testing after recurrent loss?

Rachaeleigh

Just wanted to introduce myself. I just had d&c on Thurs (3rd loss). DH and I aren't actively ttc obviously this moment bc of the "nothing in the vagina" rule after d&c and it'll take a bit for my body to get back to "normal." My dr is also going to do some testing since it's my 3rd loss, which I am looking forward to for hopefully some answers. I have already started getting ansy though wondering how long testing will take so that we can get back on wagon, so to speak. Any experience?

buckeyebaby814

Welcome to the board, I'm sorry for your losses.  

A few things before I answer your question, if you haven't yet, check out TTCALs blog, located at the top of the board or in my siggy (in purple, listed as 'tb TTCAL blog).  There's fantastic information there for newbies and other TTCAL information  

There are many different 'check-in' groups, feel free to find one relevant to you (multiple loss, Ladies in Waiting, EDD groups, etc), this is a fantastic way to get to know the ladies here!   

I had RPL testing done after my third loss and genetic testing after my fourth.  My RPL testing came back ok and I'm still waiting on the genetic test results.  There are a handful of ladies here who have had this testing done, so maybe they would be more helpful than me!  Good luck and welcome!

GatorBaby2012

Welcome to the board. I am very sorry for your losses.

To answer your questions (sorry this may get lengthy, and I apologize for typos, I'm on my iPad). I had three types of tests done:

1. Recurring loss panel - This test is done when your beta levels have dropped to almost zero. It is a blood work up that, for me, was about 10 tubes. It looks for vitamin deficiencies, genetic disorders (primarily for clotting issues), and such. I was told that I would get the results in 2 weeks, but ultimately got the results in 1 week.

2. HSG - This is a procedure involving an X-ray and an iodine based dye that is inserted into your uterus and tubes via catheter. This was done after I got my first period, but prior to CD10. The timing is important because of the position of your cervix and also to confirm you haven't O (and therefore won't be pg). This procedure checks for any anatomical abnormalities that may either cause infertility or miscarriages. The whole procedure lasts around 5-10 minutes and you get results immediately. There are similar procedures known as SHG or SIS that involve a saline solution and an ultrasound.

3. Karyotyping - This is another blood test that can be performed on both you and your DH looking for chromosomal abnormalities, such as balanced translocation, which is where you and your DH's chromosomes are fine, but when they go to make a baby, they "flip" which can cause abnormalities. For me it was around 5 tubes and DH was 1-2. I was told I would get results in 3-4 weeks, but got them in 2 weeks.

In addition, if you haven't had your thyroid checked, I recommend having a full thyroid panel, including TSH. I was diagnosed with hypothyroidism and under regular monitoring prior to my losses, so this wasn't part of my RPL testing.

Also, if you aren't already, I recommend that you work with an RE. I plan to still use my OB once I have an established pregnancy, but RE's are more equipped (and patient) dealing with you when you are TTC as well as in early pg. mine is going to do regular early blood tests and multiple u/s. Then, if all is well at 8w, I will graduate to my OB.

Lastly, I recommend talking to a financial counselor with your dr's office to discuss cost and insurance coverage for these procedures. I think for all of this, we spent around $2,000 out of pocket.

HTH. GL! 

littlemaybaby

GatorBaby2012:

Welcome to the board. I am very sorry for your losses.

To answer your questions (sorry this may get lengthy, and I apologize for typos, I'm on my iPad). I had three types of tests done:

1. Recurring loss panel - This test is done when your beta levels have dropped to almost zero. It is a blood work up that, for me, was about 10 tubes. It looks for vitamin deficiencies, genetic disorders (primarily for clotting issues), and such. I was told that I would get the results in 2 weeks, but ultimately got the results in 1 week.

2. HSG - This is a procedure involving an X-ray and an iodine based dye that is inserted into your uterus and tubes via catheter. This was done after I got my first period, but prior to CD10. The timing is important because of the position of your cervix and also to confirm you haven't O (and therefore won't be pg). This procedure checks for any anatomical abnormalities that may either cause infertility or miscarriages. The whole procedure lasts around 5-10 minutes and you get results immediately. There are similar procedures known as SHG or SIS that involve a saline solution and an ultrasound.

3. Karyotyping - This is another blood test that can be performed on both you and your DH looking for chromosomal abnormalities, such as balanced translocation, which is where you and your DH's chromosomes are fine, but when they go to make a baby, they "flip" which can cause abnormalities. For me it was around 5 tubes and DH was 1-2. I was told I would get results in 3-4 weeks, but got them in 2 weeks.

In addition, if you haven't had your thyroid checked, I recommend having a full thyroid panel, including TSH. I was diagnosed with hypothyroidism and under regular monitoring prior to my losses, so this wasn't part of my RPL testing.

Also, if you aren't already, I recommend that you work with an RE. I plan to still use my OB once I have an established pregnancy, but RE's are more equipped (and patient) dealing with you when you are TTC as well as in early pg. mine is going to do regular early blood tests and multiple u/s. Then, if all is well at 8w, I will graduate to my OB.

Lastly, I recommend talking to a financial counselor with your dr's office to discuss cost and insurance coverage for these procedures. I think for all of this, we spent around $2,000 out of pocket.

HTH. GL! 

This is a super comprehensive answer so I don't have much to add.  (I had an SHG instead of HSG.)  I would add that while it seems like a lot of testing my RE said that about 50% of cases come back as unexplained - meaning these tests find nothing.  Unfortunately this is where DH and I have landed so I don't really know what to do next.  

I can say that, God forbid, if we have another loss I will travel to see a reproductive immunologist.  It's still a relatively young field and many REs haven't bought into the whole RI science at this point. 

I am so sorry for your losses.  I hope you will find some answers. 

GatorBaby2012

littlemaybaby:

This is a super comprehensive answer so I don't have much to add.  (I had an SHG instead of HSG.)  I would add that while it seems like a lot of testing my RE said that about 50% of cases come back as unexplained - meaning these tests find nothing.  Unfortunately this is where DH and I have landed so I don't really know what to do next.  

I can say that, God forbid, if we have another loss I will travel to see a reproductive immunologist.  It's still a relatively young field and many REs haven't bought into the whole RI science at this point. 

I am so sorry for your losses.  I hope you will find some answers. 

Oh, yes, I should have added that all of my results came back normal. While I have no new strategies, I at least have peace of mind that no stone has been left unturned. My OB and RE said that it is more common than you think to just have unexplained losses. 

KacyChicago

I am so sorry for your losses and that you find yourself here.

I have only suffered one loss, so we are not able to test as of yet, so I can't offer you any advice there, I can only wish you the best of luck. The boards are slow sometimes on the weekends, so hopefully you get more answers as the day goes on. (EDT: I took to long to post, as I got distracted  by the dog, and GatorBaby answered with probably all you need to know ... These women are great like that!)

I wish you all the best, and hope you find a lot of love and support here.

panacea05

I just experienced my 2nd loss 3 weeks ago, and I've already had my RLP bloodwork done (everything's normal there). When my first AF arrives, DH and I are supposed to go in for karyotyping, and I'll have my SHG done. After I O, my doctor will do a endometrial biopsy to check my lining for who-knows-what. I'm still confused about a lot of things because my appointment was just last week, and it was a lot to take in. Seems like it's a relatively quick process, though, so that's good.

I'm very sorry for your losses. I hope your doctor is able to find some answers for you. ((hugs))

OO cupcakes OO

I just went through the testing.

I waited for AF to return to do the HSG (check out the ute of structural issues) and had the b/w done the same day.  I had all the results within a week/week and a half and was able to TTC this cycle (1st cycle after D&E cycle.)

I know my doctor warned me that over half of all couples tested will not get any answers so don't be disappointed if they don't find anything.  It may just be really bad luck.  Mine turned out to be a genetic blood clotting disorder and I'm seeing an MFM this week to discuss treatment and our future pregnancies.  

You could probably do the genetic part now if you wanted to and then do the HSG (or HCG) right after AF (but before O- they wouldn't let you do the HSG at my hospital after CD10 so check when you schedule.)  The HSG results were immediately avaiable and the genetic tests took less than 2 weeks.  If you start now you should be able to TTC next cycle if your doctor doesn't have an issue with it.

GL!  Update us! 

jinxycat24

GatorBaby2012:

Welcome to the board. I am very sorry for your losses.

1. Recurring loss panel - This test is done when your beta levels have dropped to almost zero. It is a blood work up that, for me, was about 10 tubes. It looks for vitamin deficiencies, genetic disorders (primarily for clotting issues), and such. I was told that I would get the results in 2 weeks, but ultimately got the results in 1 week.

2. HSG - This is a procedure involving an X-ray and an iodine based dye that is inserted into your uterus and tubes via catheter. This was done after I got my first period, but prior to CD10. The timing is important because of the position of your cervix and also to confirm you haven't O (and therefore won't be pg). This procedure checks for any anatomical abnormalities that may either cause infertility or miscarriages. The whole procedure lasts around 5-10 minutes and you get results immediately. There are similar procedures known as SHG or SIS that involve a saline solution and an ultrasound.

3. Karyotyping - This is another blood test that can be performed on both you and your DH looking for chromosomal abnormalities, such as balanced translocation, which is where you and your DH's chromosomes are fine, but when they go to make a baby, they "flip" which can cause abnormalities. For me it was around 5 tubes and DH was 1-2. I was told I would get results in 3-4 weeks, but got them in 2 weeks.

In addition, if you haven't had your thyroid checked, I recommend having a full thyroid panel, including TSH. I was diagnosed with hypothyroidism and under regular monitoring prior to my losses, so this wasn't part of my RPL testing.

Also, if you aren't already, I recommend that you work with an RE. I plan to still use my OB once I have an established pregnancy, but RE's are more equipped (and patient) dealing with you when you are TTC as well as in early pg. mine is going to do regular early blood tests and multiple u/s. Then, if all is well at 8w, I will graduate to my OB.

Lastly, I recommend talking to a financial counselor with your dr's office to discuss cost and insurance coverage for these procedures. I think for all of this, we spent around $2,000 out of pocket.

HTH. GL! 

 I'm so sorry for your losses.

Yep this was me too. My RPL came back positive for MTHFR so I started additional folic acid daily and baby aspirin every other day.I also had a OHS done with my RE which basically involved a catheter into the ute and then injecting water. I had a bit  of cramping but was far less uncomfortable than the HSG. 

AngnShaun

I am so sorry for your losses.  I had testing done after our 3rd loss as well.  From the time that we had our blood work done to the time that we go into the office to go over it it was just about a month.  The bw took 3 weeks for the lab to complete.  We were able to start again after the bw.  But my 3rd loss was a chemical so my beta never got very high.  It might be different after a d&c.  

Welcome to the board & good luck!