Intro and opinions needed--BC????

laralen02 · August 2015

Intro--
I'm 31, DH is 30. We have been married for 4 years. We conceived our first child in May. At 10 weeks, I started with some brown spotting. No heartbeat at the OB, and the baby measured 7.5 weeks. It was a Friday, so they scheduled the D&C for Monday am due to MMC.

I naturally MC before that appointment on Saturday 7/25. At the movie theater. I caught the baby in a paper towel and wrapped it, then put it in an empty makeup bag.

(Sorry if that's TMI, I'm an RN and we are known to be gross, plus it was super traumatic).

Also, OB had sent me home over the weekend with a kit (just in case I MC naturally) so we can test for problems. So I had to find a way to get the baby home from he theater...

This is my second MC. The first was 8 years ago (I was raped in an abusive relationship, and I always thought I MC due to stress).

Sorry for the long intro...but here's my frustration.

At my followup appointment a few days after the MC, both the OB and my midwife said NOT to get pregnant again right away. I spoke to them separately. Both said that you are more fertile after a MC, and the OB recommended waiting for 3 months, the midwife said FIVE. Both suggested birth control during this time, and want me to start the Sunday after bleeding is done. That's TODAY. Hubby is all for it. But I'm an RN, and I need some medical research to show this is the right choice. It feels so counterintuitive to be taking birth control.

I have 3 main thoughts:

1) There's a fertile period??? Take advantage of it!

2) I can see how BC could theoretically help with hormone regulation and possibly build up the uterine lining.

3) Maybe they want to wait for the genetic testing to come back from the baby and myself to make sure there won't be a 3rd MC?

After the first MC, I obviously wasn't TTC with Mr. Abusive Rapist, so this is all new to me.

Does anyone have any experience with this, or any medical studies about this? I'm looking for studies involving a waiting period for conception after MC, as well as BC to assist with future conception after MC.

Sorry for the long post. These thoughts are just circulating in my mind, and I can't help but feel that BC is a mistake.

laralen02 · August 2015

Also--DH and I tried for this pregnancy for 13 months. I feel so defeated after this MC, and now BC????

Edaggrr · August 2015

Sorry for your loss! With my first miscarriage I had a lot of problems so my doctor said to wait three months. I ended up needing a second d&c so waiting did make sense. With my most recent miscarriage my doctor said to just live my life. She said to not actively try, but that I didn't need to prevent. She also said the main reason they say to wait is to date with your last menstrual period and that a lot of doctors say to wait due to emotional recovery. If you get back on BC it is supposed to be out of your system for three months before you start ttc again, so I wouldn't think that would be a great idea. I would email your doctor and ask why they want you to wait. I think every doctor has a different opinion on this and there is no right answer. Good luck!

queenklau · August 2015

I am sorry you had to go through this! I agree with PP, ask them why. My doctor wanted me to wait one cycle. I asked why and he said that he wanted to make sure that the uterus had healed. Some doctors add more time for emotional healing. I think it depends on your doc and your particular situation, I have have heard so many different combinations of wait and reasons why on this forum. The best would be to ask about YOUR situation, we are all different. Be gentle to yourself, and I wish you the best on your journey to rainbow baby

MrsGargoyle · August 2015

I am so sorry for your loss, and the trauma surrounding both losses.

You are right to be skeptical of BCPs after a loss. In my experience, many doctors/NPs push BCPs as a tool to gain compliance of their request that you not get pregnant right away. I have found no peer-reviewed articles that give convincing evidence that BCPs regulate hormones beyond the time frame that you are taking them. The only regulation is the nature of the hormones in the BCPs themselves, so it is artificial regulation, not a way to correct the body's production of these hormones. So, take them if you want to wait as your doctor advises, but don't think they will 'fix' your body somehow.

As for peer-reviewed articles on studies that explore a 'fertile period' after a loss, There are several. The most notable was from the UK and another from Ireland (I don't have the links anymore, sorry about that). One concluded that women who got pregnant within the first 6 months after a loss were more likely to go on to have a live birth than women who took more than 6 months to get pregnant again. The other concluded that most women got pregnant within the first 6 months after their first loss. Both of these had semantic issues with their conclusions, though their studies were generally well designed and executed. In both cases, they drew their conclusion based on correlation, and ignored causation. The reason I say this is as follows.

While it takes a healthy, fertile couple up to a year to conceive, most become pregnant within the first 6 months. After a non-complicated first loss, this trend will hold. This is because the fault almost always lies with a genetic issue in an individual embryo, and not the couple themselves. So, it is not surprising that if you follow a population of first loss moms, you will find that most will get pregnant again in the first 6 months. However, this does not give any indication that there is some magical increase to fertility after a loss. Secondly, women who get pregnant within the first 6 months of a loss are the same section of the population that is unlikely to have any underlying fertility issues. So it is not surprising that those women are more likely to go on to have a live birth. If there is an underlying fertility issue that decreases the chances of fast success, there is a greater likelihood that that the underlying fertility issue will also contribute to another loss.

Given that you are pursuing tissue testing after your second loss, I would absolutely wait until you get that result before trying again. You may find a reason to be sent directly to an RE, or you may find that it was a loss caused by being on the wrong side of statistics and that you can proceed with confidence that it probably won't happen again. But, I wouldn't use the BCPs unless you want a relatively easy way of avoiding an oops pregnancy while you wait for an answer.

Hope that info helps.

MrsGargoyle · August 2015

For some reason I can't add an ETA to my previous. I did want to add that there is something that has shown pretty strong anecdotal evidence of a temporary boost to fertility. I know several REs who swear they have seen patients who have failed to get pregnant after 12 or more months of well-timed intercourse get pregnant immediately after having an HSG. Their opinion is that the viscous dye clears the fallopian tube of previously shed cells that were gumming up the works in an otherwise fertile system.

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