Pregnant after a Loss

Has anyone here had 2+ losses RPL? Advice

KyCade3013KyCade3013 member
edited August 2016 in Pregnant after a Loss
Hi, thought I'd ask who here has RPL and if so, what route they took thereafter with testing, doctors, medicines, and acupuncture. I am a little confused. Do you see a MFM and RE? My doctor is giving me a referral and setting up a consultation with an MFM who is getting the panel /testing results from this last pregnancy. I want to give it our best shot and approach as best as possible. Also, has anyone had this happen after to live births? I've searched the boards, it's hard to search specific situations. I'm just learning about this now and researching/ trying to figure out the pieces to the puzzle which may never happen but I want to look out for myself, because doctors don't always do that. 

Re: Has anyone here had 2+ losses RPL? Advice

  • No personal experience, but my sister had testing done after her third early miscarriage. She has one living child. Turns out she has a blood clotting disorder so her next pregnancy she needs to take baby aspirin and a higher dose of folic acid. She is still seeing an OB. 

     

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  • I had 2 losses and found out after testing that I have mthfr. Blood clotting and folic acid disorder. I still just seen my ob for those issues. I was taking baby aspirin Lovenox shot tl guard (folic acid) and s prescribed prenatal vitamin. I started seeing a Specialist once I tested positive for GD. Which was early (14 weeks) I now have my rainbow baby. She's 10 weeks old. Sorry for your losses and best wishes!
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  • My RE won't see anyone for RPL until 3 losses. I was disappointed because I have no living children. Luckily my OB and PCP ran RPL bloodwork. I tried to send the second baby for genetic testing but the sample was not sufficient and so we never got an explanation. My RPL panel came back normal, but I was never tested for MTHFR, so I put myself on methyl-folate just in case. I'm now pregnant for a third time, and all is well this far with baby, but I have had some bleeding scares. To be more cautious, my betas and progesterone were closely tracked. All looked good. I've never made it this far, but it's still scary. Anyhow, it is possible to have no answers after testing. I believe about 50% of RPL moms will have no identifiable cause for their repeat losses. It's frustrating to say the least. I hope you get your rainbow soon! 
  • I had two losses 6 months of each other. My OB did a RPL panel looking for clotting issues, thyroid issues, and a saline sonogram to look for issues with my uterus. We found a small septum and she referred me to an RE to have it removed and along the way I found out I have PCOS that can cause miscarriages by ovulating poor quality eggs. I'm so sorry for your losses - I hope you can get an answer soon.
    TW: MMC
    BFP1 12/24/14 - EDD 09/07/15 (D/C 8w1d)
    BFP2 6/12/15 - EDD 2/22/16 (D/C 10w3d)
    ———
    Diagnoses and Treatments
    PCOS (myo-inositol, excercize)
    Indeterminant levels of APS IgM antibodies (baby aspirin)
    Sub-septate uterus (hysteroscopic septoplasty 12/18/15)
    ———
    BFP3 05/02/16 EDD 01/09/17 DS born 01/05/17
    BFP4 01/28/19 EDD 10/?/19 🤞🙏

  • I had all the basic fertility tests done and they found out I have a small septum and also a chromosome issue that could cause early miscarriage. Plus the fact that I'm older (39) doesn't help. The septum was small enough that they didn't feel it had to be removed. I have one living daughter who is 2.5, two MMC and now this pregnancy. 
  • I've had two losses.  They weren't in a row, however. So my pattern so far has been: living child, 14 wk loss, living child, 9 wk loss and now this pg.

    I knew I had PCOS and hypothyroidism before ever becoming pregnant. We had a long IF journey before DD1.  After my first loss I knew something more was off b/c of how it all happened. After DD2 I researched MTHFR and requested to be tested. Insurance didn't cover that $777 test, by the way. I do have an MTHFR mutation (homozygous 677), however since my homocysteine is ideal range and I've had 2 live births no one will really take that seriously. It worries me still. I take baby aspirin daily for that since it's a clotting disorder. I had my second loss shortly after finding out the results of that test.

    After my second loss, my OB ran a full clotting panel- no abnormalities.

    DD1 born 5/24/10.

    Missed M/C at 14 wks Feb 2012.

    DD2 born 5/14/13.

    Missed M/C at 9 wks July 2015.

    Expecting someone new 4/17/17.
  • Whether you see a RE or a MFM will depend on when are you miscarrying or if you've had trouble conceiving. I've had 3 consecutive losses: an early loss, another at 22 weeks and the last one at 17 weeks, and no living children. I was referred to a MFM after the last one and not and RE because my problem hasn't been conceiving but retaining the pregnancy. Doctor ran everything from hormonal issues, clotting panel, pre-diabetes, MTHFR mutation, physical abmormalities, pathology on both of the last two babies and everything came back normal, sucks that they couldn't determine a cause but it's good to know there's nothing wrong and I'm going into a possible next pregnancy with some sort of confidence.  
    I'm 29, husband is 30
    Together since 2006
    Married 01.17.15  <3

    Lilypie Angel and Memorial tickers
    Lilypie Angel and Memorial tickers Lilypie Angel and Memorial tickers 

  • Thanks, that helps to know. I thought a RE was better, do some RE deal with both? 
  • So, I've had 3 losses. Ist live birth, 2 miscarriages, 2nd live birth, then a stillbirth at 21 weeks. 

    After my first 2 losses, my OB ordered the RPL panel, but I wish I would have sought out an RE who specializes in RPL. Nothing was found, but I think they didn't do a complete workup. They thought it was bad luck. 
    (Sidenote - they've found that a cause can be found with 2 consecutive losses as often as with 3 consecutive losses, so there is NO reason to wait. I'm glad your OB referred you to a specialist)

    My next pregnancy I empirically took progesterone and baby aspirin and that was a live birth. It's kind of the "we don't know why you've miscarried" protocol. That baby is now my super adorable 2 year old. :)

    The NEXT pregnancy ended at 21 weeks when she died due to placental insufficiency. SO - that is why I wish I would have pushed more to find a cause back in 2013 when I had the miscarriages. I feel like they are all related, but have no idea the cause.

    I hope you find a really great doctor who listens to you - my time after my second miscarriage was such a hard, dark time for me.

    A

    2010: son born 9/1 

    2013: 2 miscarriages + d&cs, both at 10 weeks: April & July

    2014: son #2 born 6/29

    2016: Baby girl stillborn at 21w6d 4/29 and baby boy stillborn at 20w 3d 11/16

  • Thanks @amwangel and so very sorry for your losses and everyone who shared. I wish none of us had to go through any of this, let alone consecutively. I will push for answers if I don't get them from the MFM. I'm planning to see an MFM and a RE if I can. That's allowed right? I want to try my hardest to cover my basis and if possible have a healthy next pregnancy. Like you said, progesterone and baby aspirin are the protocol-my OB mentioned the baby aspirin "when they can't find anything" to be safe but I want to know what's going on. I agree, twice isn't just "unlucky". Once is "unlucky". 
  • @amwangel, I'd you take progesterone the whole pregnancy or just first tri?

    DD1 born 5/24/10.

    Missed M/C at 14 wks Feb 2012.

    DD2 born 5/14/13.

    Missed M/C at 9 wks July 2015.

    Expecting someone new 4/17/17.
  • @KyCade3013 I think some REs deal with both, I know of at least two who do but it's not the norm. 

    @MWoodside this doesn't answer your question but after three losses and no live births and finding no results on all the tests, the MFM is gonna put me in baby aspirin and progesterone for the entire pregnancy, as a precaution. I also might get a profilactic cerclage, he'll asses that as pregnancy progresses 
    I'm 29, husband is 30
    Together since 2006
    Married 01.17.15  <3

    Lilypie Angel and Memorial tickers
    Lilypie Angel and Memorial tickers Lilypie Angel and Memorial tickers 

  • MWoodside said:
    @amwangel, I'd you take progesterone the whole pregnancy or just first tri?
    Just first tri. 

    A

    2010: son born 9/1 

    2013: 2 miscarriages + d&cs, both at 10 weeks: April & July

    2014: son #2 born 6/29

    2016: Baby girl stillborn at 21w6d 4/29 and baby boy stillborn at 20w 3d 11/16

  • KyCade3013 said:I'm planning to see an MFM and a RE if I can. That's allowed right? 
    I did that - but I was already pregnant again so there wasn't much they could do or tell me. It probably depends on your insurance, too. I had to get a referral from my PCP for the RE since I have an HMO. 

    A

    2010: son born 9/1 

    2013: 2 miscarriages + d&cs, both at 10 weeks: April & July

    2014: son #2 born 6/29

    2016: Baby girl stillborn at 21w6d 4/29 and baby boy stillborn at 20w 3d 11/16

  • First off, I'm so incredibly sorry for your losses(OP and everyone else). It's a world of pain that no one wants to be in.

    AFM, I have had 4 losses and I'm currently 32+3 PGAL. All 4 of my losses were first tri so this is not only the farthest I've gotten but also very likely to finally be my rainbow at this point. 3 of my 4 losses were after being able to pick up heart tones on an ultrasound(which supposedly means it's less likely to be a loss?) and the other was a CP. After the second loss my OB ran blood tests for clotting disorders which came back all within "normal" ranges. The CP was loss #3 and at that point we ran a chromosome analysis on both DH and I, plus we were sent to the RE. The RE ran the rest of the standard Infertility testing which included CD3 bloodwork and ultrasound followed by an HSG. When they ran my CD3 with they also tested me for Celiac's Disease. I'm still on the fence if I feel relieved or disappointed that literally everything they tested for came back "normal". The RE gave us the option at that point to keep TTC naturally and said that we would have about a 30% chance to miscarry with each pregnancy or we could try IVF with generic screening. After discussing our (limited) options, DH and I decided that IVF really isn't an option for us so we moved forward and conceived again. We suffered our 4th loss and I was hopeful that maybe there was something further we could look into but we were still given the same answers. IVF or try our luck again. I guess this time luck decided for us because apparently we didn't miss my FW while waiting for my first cycle after the last loss. I temped long enough to confirm ovulation but didn't pay attention much to when we had sex but I though we avoided like we were supposed to. When AF didn't show up I was shocked to get a BFP. The RE had me on progesterone thru first tri(which I admittedly wasn't diligent about taking) extra folic acid, low dose aspirin, (both of which I'm still on) and I tried a gluten free diet(even tho I tested negative for Celiac's) until about 22 weeks. It was stressing me out so I asked the OB and she said to just ease back into a normal diet as long I wasn't getting sick or anything by eating it.

    The RE monitored me until about 10 weeks then sent me back to my OB and I've never seen an MFM. 
  • Hi @tigerfish227 so sorry for your losses. I have an appt with a RE 9/19 and have feared if by random I got pregnant this cycle what would happen. I've also been writing down everyone's prescriptions so I can bring them with me at my first appt and ask if any might help me. I feel my last loss was chromosomal and the 1st I have no idea. Both are being tested I believe. 1st I had a D&C so they have the tissue I guess and the 2nd my doctor helped me misscarry and sent the sac/tissue for testing. I should have the results like this week I think, hopefully I'll have answers. You're story is really helpful and gives me hope! 
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