Ladies with multiple losses - some ?s
Carolee
member
I am currently experiencing my 3rd loss (4w2d). I had my first loss at 37 weeks, and then another in late June at about 5 weeks. I am going to be meeting with my RE sometime in the next few days to discuss. After my stillbirth, I had some of the tests from the RLP run (RVV time - negative, ANA screen - negative, Cardiolipin AB screen - negative, Protein S activity - normal). I also had the Protein C activity test, which came back high, and the test for MTHFR, which shows that I am homozygous for C677T.
Are there other tests (besides the others in the RLP) that I should request to have done? Also, I am going to bring up blood thinners again with my RE (he said he would consider them if I had a problem with early losses - this conversation occurred before my 2nd loss). I have been taking baby aspirin, Metanx, Metformin, and a prenatal.
I just feel so lost. At first, I couldn't seem to get pregnant. Now, I can get pregnant but I can't stay pregnant. I would love to hear any advice anyone can offer.
Thank you so much.
BFP #2 - EDD 2/26/12 M/C 6/28/11 @ 5w2d
BFP #3 - EDD 4/7/12 M/C 8/2/11 @ 4w2d
Too beautiful for this earth
BFP #4 - EDD 12/09/12, Lucille arrived 11/26/12
Re: Ladies with multiple losses - some ?s
TTC since 5/2010
DX with Diminished Ovarian Reserve - AMH of 1.1 - 7/2011; AMH of .42 8/2012BFP 9/1/10-M/C confirmed 9/8/10-Methotrexate 10/6/10
IUI #1 (w/clomid)-9/5/11-BFN ; IUI #2 (w/clomid)-10/5/11 - BFP - 11/1/12-No sac seen; 11/2/11 and 11/9/11-Methotrexate
IVF #1- ER 2/2; ET 2/5;-Two 8 cell embryos transfered = BFFN
Surprise BFP - 5/7/12
U/S on 6/8/12 - H/B at 128 BPM; U/S on 6/14/12 @ 9wks-No H/B-D&C on 6/17/12
IVF 2.0- ER 10/17; ET 10/20-One 12 cell, one 10 cell and one 8 cell embryo transfered
BFP! 11/16/12 U/S- Two nuggets with perfect heartbeats! EDD 7/10/13
5/31/2013- My miracles arrived at 34w2d! Welcome to the world Harper and Nolan!
My Blog- http://waitingonaangel.wordpress.com/
"Sometimes the smallest things take up the most room in your heart"
Our TTC Journey
I'm a mom to my 4 angel babies who were taken from us much to soon!
BFP#1 on 09/29/09 and EP discovered/Left Tube lost on 10/19/09 EDD 06/12/10
BFP# 2 on 03/21/2010 EDD 11/30/10 Natural M/C on 3/27/10
BFP# 3 on 02/14/2011 EDD 10/28/11 Missed M/C discovered 4/19/11 and D&C 4/21/11 On 5/6/11 we found out our Oct Angel was a beautiful little girl
IVF#1=BFP#4 on 8/31/11 EDD 5/12/12 EP discovered and MTX shot given 9/14/ & 9/21 M/C on 10/9/11
IVF#2 and Stims started 12/2 ER 12/16 ET 12/21 transferred two beautiful blastocysts. Please stick LO's! BFP 12/26
Benjamin Matthew Our Little Miracle Born 9/5/2012!
BFP 1/2/14 EDD 9/11/14
So sorry for your losses. We are in a similar situation in that it seems I can get pregnant, (be it infrequently), but not stay that way, though all my losses have been first trimester. The one thing I would say is that not all RPL panels are created equal. There isn't a standard RPL panel, (I used to think that there was, but I have compared lab orders with others and asked different RNs...I'm sneaky like that). Some REs omit things or do them slightly differently so you might want to do some research on your own to make sure that everything gets covered. Specifically, there are different things that REs might do under the heading of "genetic testing" on you and your partner. You need to be sure that when they do the genetic testing that they aren't just testing to see if you are a carrier of cystic fibrosis, but actually doing full karyotyping, plotting out the DNA markers for both you and your partner. I know of several people that thought their "genetic testing" in their RPL panel was the karyotyping only to find out later after another loss or failed IVF that it had not actually been done. The karyotyping is expensive and it can take up to 5 weeks to get the results. I think the expense may be why some REs don't do it or offer it seperately. You might also want to ask for more testing of your auto-immune system.
That's pretty much all I've got! Good Luck!
Jenn
IVF#1 BFN IVF#2 BFP, loss at 19 weeks FET#1 BFN IVF#3 BFP, m/c FET#2 BFN
Missing our twins Zachary and Madison, lost at 19 weeks on 11/13/09, edd 4/9/10
BFP 7/17/10, m/c 7/25/10, edd 3/25/11
Ectopic, lost left tube 4/20/11, edd 12/6/11
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I second the above, ask for a karyotype on both of you,
*hugs*
4 losses (cp Feb 28 09, mc April 9 09 (5w5d), mc Aug 10 09 (7w1d), d&c Apr 12 10 (grew to 6w3d, mc confirmed at 8w5d). RX: Overies PCOS (hormones normal) & Balanced Translocation of Ch. 7 & 13 (40-50% mc risk)
Cooking Blog
Oh hon. My heart aches for you. I am so so sorry
(((HUGE HUGSS)))
As far as testing, I did the RLP after m/c 2 and that is when they came up with my 2 clotting disorders. I was on Lovenox for BFP 3. After m/c 3, I met with the RE and he mentioned that my clotting disorders are unlikely culprits for my early losses (all less than 7 weeks) - clotting issues usually create more problems in 2nd and 3rd tri, according to him.
His big contention is that 90% of early loss patients he sees have what he calls either structural or hormonal issues. So, he was big on the HSG and 7DPO progesterone testing. (I'm still not clear about why we didn't do a SHG instead of HSG, but he seemed OK with just the HSG for me.) He says that the RLP looks for issues that all account for the remaining 10% of patients with repeat losses.
I also agree about the karyotyping point that was made above. We were given the option to do this test because some insurance won't cover it. I went around in a few circles with the RE and my insurance company to find a Dx code that would make it so they would cover it. I'm glad we had it done, though, to check that one off the list too. We also opted to have DH's SA done.
So far, it looks like he might have been on to something with me. All clear on my HSG but really low 7DPO progesterone, definitely too low to support a pregnancy, they said. Time will only tell if this that final stone we needed to uncover to stop this tyranny of miscarriages.
Hope that helps, hon. Again, I am just so sorry you even have to ask this question.
Aurora Rose born sleeping at 35w on 4-21-10
BFP#2 {Almond} - 2.1.11 EDD 10.12.11 C/P 2.11.11
I really don't know much about late losses at all, but it sounds like the loss you're going through now is a chemical pregnancy? I think, but I'm not sure, that that happens sometimes even with the correct meds. Again, I'm so sorry you're going through this and hope you find some answers.
(I see a PAL Welcome, but SIGGY WARNING just in case)
I'm so sorry for your losses. We had five before a combo of treatments led us to successful number six.
I agree w/ the suggestion of karyotypes for both of you.
When they found the MTHFR, did they check your homocystine levels? This will give the RE an idea of how much the MTHFR is putting you at risk for clots.
Also, I would ask about CD 3 blood work. We had run the RPL panel, found the homozygous MTHFR A1298C, started treating it w/ Lovenox and BA, and I still had another early loss.
My RE then ran the CD3 panel, and discovered elevated levels of estrogen. We controlled the cycle w/ Gonal-F and Ovidrel, and once I triggered ovulation, began the Lovenox injections to address the MTHFR.
I was on 4 mg FA, 2.2 mg Folgard and BA while TTC, also to address the MTHFR, and stayed on all of that throughout the pregnancy. My RE took me off all caffeine, because even a slight amount is thought to mess w/ FA absorption, and that's really the issue w/ this disorder (even more than the clotting).
There is a lot of debate over whether or not Lovenox and BA are needed if homcystine levels are not elevated. I do not have elevated homocystine, but my RE wanted to treat the disorder anyway, and I was comfortable with that. It's for sure something you should bring up again to your doctor.
Good luck, and I hope that was coherent. Bottom line, I would really suggest karyotypes, homocystine level check and CD 3 blood work.
Again, I'm so sorry.
Hi there,
Like you, we are able to get pregnant pretty easily, but holding onto it seems to be our problem. I did a full RPL panel, HSG and SA with all perfect results. It wasn't until my 4th loss, that my Dr. let us do the karyotyping.
We don't have family history of anything, so we were shocked to find out that my DH has a balanced translocation of chromosomes 4 and 10. Unfortunately there is no fix for this diagnosis, but we now know the reason for all of our misfortune. We are hoping that one of these times, we hit the jackpot and all of our baby's chromosomes are in the right spots.
I hope you are able to find answers soon, and I'm sorry you are experiencing this same heartbreak.
BFP #2 12/2/08 M/C 5w4days
BFP #3 6/9/09 M/C 4w4days
BFP #4 6/22/10 M/C 8w
Sept. 2010 DH Dx: chromosomal balanced translocation (4,10){q21,p15}
BFP #5 5/12/11 M/C 7w1days
BFP #6 8/6/11 Gavin Knox born 4/12/12!
BFP #7 10/1/2013 still birth @ 28 weeks following a UBT girl diagnosis
BFP #2 - EDD 2/26/12 M/C 6/28/11 @ 5w2d
BFP #3 - EDD 4/7/12 M/C 8/2/11 @ 4w2d
Too beautiful for this earth
BFP #4 - EDD 12/09/12, Lucille arrived 11/26/12