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Testing

olivemommaolivemomma member
in TTC After a Loss
hi ladies. I’m just wondering if anyone has had any testing done (particularly after multiple losses) to determine if there is something they can alter to increase their chance of a successful future pregnancy. I had back to back MMC - my doctor did do a blood draw to check all of my blood cell and platelet counts and also checked my thryroid levels - all apparently normal. However, because I have had two previous successful pregnancies they basically told me it wasn’t worth testing for much else as my odds of anything else having developed in the last couple of years is so small. I am getting close to AMA (will be 35 in January and my DH will be 35 soon after) and they said it’s almost definitely a chromosomal issue. Has anyone had further testing done? Would you recommend pushing for it? I keep feeling like there is a possibility we are missing something (a blood clotting issue maybe) but they just seem unwilling to test for it. Any advice or similar experinces?? I want to make sure when we try again I am doing everything in my power to ensure it will be successful. 
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Re: Testing

  • Mack2342Mack2342 member
    @olivemomma more than likely it is chromosomal.  I am AMA and have had 3 consecutive losses.  They always told me chromosomal too especially since I have an almost 3 year old and all my losses came after him.  I accepted it for the first too but demanded a genetic test with 3rd MC and then follow up blood work.  I don’t know what all was tested now but they took 8 vials of blood and it all returned normal.  After that I didn’t push as we also got genetic testing back around same time and it was chromosomal.  My point is if you feel like it’s necessary then push for it. I was being seen by a RE so it wasn’t difficult to push 
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  • bakerstreetboysbakerstreetboys member
    I agree with Mack2342, it's most likely chromosomal.  I'm 40, and my losses came after my DS, who I had at 38.  My doctors tested for all the usual things, and it all came back normal other than lower AMH because of my age.  Having said that, if you feel that there's something off, or if more testing will bring you peace of mind or reduce anxiety, than I'd push for it.  If we have another loss, I will ask for genetic testing. 
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  • coco2787coco2787 member
    I'm in a similar boat as you.  I'm 31 so not AMA yet, but my first (and only) successful pregnancy was over 5 years ago, so I still wonder if being older is a factor.  My first MMC we just assumed chromosomal and we didn't do any testing.  I had two CPs after that so we pursued RPL testing.  I had all the testing done that could be done with an OB.  She tested thyroid, A1C, antiphospholipid antibodies (auto-immune clotting disorder), and I had a hysteroscopy.  Everything was normal.  With my most recent MMC we did the NIPT at 10 weeks and were told our baby was low risk for chromosomal abnormalities.  Testing is being done on the tissue this week so we'll see if they find anything.  Since I've lost two ultrasound verified pregnancies insurance will now cover karyotyping, so the next step is to do that.

    If your OB is not willing to do more testing I would get a second opinion and/or see an RE.  I don't know exactly what testing an RE will do, it probably varies, but like you, I feel that I need to do everything I can to prevent this from happening again.  Keep in mind that 50% of RPL is unexplained, and the fact that you've had successful pregnancies makes it even more likely that they won't find anything.  
    Me: 35  H: 35
    Married: 4/5/13

    "You know that place between sleep and awake, 
    that place where you can still remember dreaming?
    That's where I will always love you.  
    That's where I'll be waiting."
    ~Peter Pan 

    *TW*
    BFP #1: 11/12/12  EDD 7/25/13 Baby boy: 7/27/13
    BFP #2: 10/29/17   MMC dx @ 9 weeks
    BFP #3: 2/2/18 MC 2/7/18
    BFP #4: 3/2/18  MC 3/9/18
    RPL testing and hysteroscopy: all normal
    BFP #5: 4/1/18 MMC dx @ 14 weeks ----> genetically normal girl  :'(
    Hysteroscopy to remove scar tissue 9/28
    BFP #6 11/5/18 EDD 7/20/19  <3  Rainbow baby girl born 7/23/19 
    BFP #7 12/8/2021 EDD 8/22/2022 
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  • olivemommaolivemomma member
    Thanks everyone. I think they would do the testing if I really really pushed. Their advise was more along the lines “this is so unlikely don’t go looking for a needle in a haystack that probably isn’t even there”. I’m also in a small town that’s fairly remote so there aren’t a bunch of options for second opinions. They did say if I had another loss they would want to send in the remains for thorough testing. I’m just not sure how Many more I’m willing to put myself through before I just count my blessings with what I have. 
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  • lin0442lin0442 member
    @olivemomma I’m sorry for your loss and what you’ve had to deal with. Like others have said, it’s likely chromosomal. If it isn’t though, there’s a range of causes that can and can’t be addressed medically/clinically. Doctors are understandably very hesitant to test for things that they (or other specialists) can’t do anything for, and clotting/thyroid/diabetic status are some of the most common and easily addressed problems.

    It starts getting more esoteric from there and there are diminishing returns as the conditions get rarer and the testing gets more invasive and expensive. It is painful to go through, but medically it makes sense to put off more advanced testing until the signs point to more than just very bad luck. I truly understand wanting answers, but unfortunately many times there still aren’t any after thousands of dollars in blood tests or invasive procedures. It’s little comfort, but take heart that you’ve had healthy pregnancies in the past- many conditions would have affected those as well. 
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  • char245char245 member
    @olivemomma don’t worry, it’s not just a small town answer. I live near a major city and I got the exact same response as you. I totally get how you are feeling!
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  • zamoraspinzamoraspin member
    @olivemomma If you are concerned I would recommend getting a referral to an RE. Regular OB's don't have much training in these issues and they are likely to brush off even multiple losses. It sounds like you had a couple of the most common tests, but RE's will run a recurrent loss panel which is more comprehensive. Beware, they do take a lot of blood, and often they don't learn anything from the tests. 70% of all mc's are due to genetic abnormalities, and when you get to 35+ that figure goes higher. However, in some cases there is another issue - like uterine scarring, septum, a parent is a carrier of a genetic condition, clotting disorders, etc.

    There is a woman who has posted on the mc board that had successful pregnancies and then 15 (!) losses, followed very recently by a successful but extremely high risk and problematic pregnancy (it turned out she did have a clotting disorder if I remember correctly), so, not to scare you, but even if you have had successful pregnancies, there is a very very small chance that there could be an explanation other than genetic. 

    The most commonly accepted "treatment" for RPL is actually expectant management - translation, we'll do nothing and eventually it will work out for you when you get a good embryo. As we age that may not be such an appealing option.
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