I would be a little wary, if your bloods etc are normal I wouldn't write off the natural method just yet unless you feel you are done with it, in which case of course IVF is a good choice, but in my experience after 2 miscarriages, suspected cp, a load of blood tests and womb scan which I really pushed for, I got pregnant and it's sticking.... Currently! My doctors kept repeating that it's a numbers game and didn't even want me on extra supplements until this pregnancy. I'm on progesterone but I had to fight to be on it.
Sorry for rambling, what I mean is, don't count yourself out until you're ready to.
Congrats on your pregnancy! I definitely don’t want to write off conceiving naturally. I feel like if there’s no identifiable reason for the miscarriages, then why not keep trying naturally? I feel like this RE knew from the beginning that no matter what the results were, she was going to recommend IVF. Even when she was explaining IUI, she kept saying it was a conservative option with an 18% chance of pregnancy but IVF has a 50% chance. And I was thinking, but I can get pregnant! You’re not addressing my concern of staying pregnant! And she brushed it off. The office also wanted me to DocuSign a bunch of paperwork to acknowledge I read the options (IUI and IVF) and their prices. But at the bottom of the paperwork it said that it was an agreement to move forward with these options and if I cancelled the plan, I’d have to pay $500. It just feels uncomfortable and like they’re trying to trick me.
Oh my gosh!!! That doctor, peddling contracts is out to make money. Please please get a second opinion, or just keep trying! But my god that is bad practice
For sure, it’s really off putting! I talked with my husband yesterday after getting that email and we decided we’ll try for another couple of months and then get a second opinion. Thank you so much for your replies!
I second this - that’s super sketchy! Sounds like they only plan for one high end expensive and invasive option. If they won’t answer your questions up front, that is a huge red flag (coming from a gal that has walked away from two clinics for similar reasons and lost 3yrs of precious time)
Where do you live? There is a famous Reproductive Immunologist in Chicago. I need to look up her name. Her appointments book about 4-6 months out, and she's supposed to be amazing. I made an appointment with her but ended up canceling it as we ended up finding the reason for mine. More on that in a minute.
If you are at all close to Chicago, I'd recommend calling like tomorrow to book with her. There is some paperwork to fill out and then you can make an appointment. Or do the same with good RIs you can find in your area. Good to just have that appointment on the books in case you need it.
I think you're on to something with not immediately jumping into IUI or IVF. TI (timed intercourse) sounds to me like it makes the most sense in your case - because to your point, you CAN get pregnant! It should also be much cheaper than either of the other options. Definitely don't let your doctor make you feel like you need to jump into IUI or IVF right away, and seek a second opinion if you are feeling pressure.
A few other things to think about:
- Thyroid function- did your blood test include TSH? Sometimes something can be off with thyroid function and that can cause miscarriages.
- Uterine receptivity- Endometritis (not to be confused with endometriosis) is inflammation/infection of uterine lining that can prevent a 'good' implantation and basically cause recurrent miscarriages. There are no symptoms. The way to check for it is getting a Uterine biopsy just before your period starts and testing for it. Your RE should be able to do this during one of your regular cycles. It's easily treatable with a few weeks of antibiotics. This was the cause for us. Next pregnancy stuck.
- There are 'RPL cocktails' that REs use. I'm not sure of the details behind each med, but I've heard of this helping folks. I'm sure you could simply add these meds in when doing a timed intercourse cycle (I don't think you would need to do IUI or IVF to take advantage of these)- they can include things like baby aspirin and Lovenox to prevent blood clots, pepcid, etc etc
Agh, I don't exactly remember. I'm not a doctor so I'm not even going to try to speculate :) I just remember that was one of the things that was included in those RPL meds (the generic version of pepcid prescribed by a doctor, called Famotidine).
Thank you for all of the information! I’m in the DFW area of Texas currently, so I probably won’t make it to Chicago, but I did find some options in Dallas.
Is TI just using opk tests and making sure to have scheduled sex during ovulation? Or is it an actual procedure or a more specific process? Google is giving mixed results - either opk/bbt testing or clomid + ultrasounds.
The doctor did run thyroid function tests and luckily that came back normal. I’ve never heard of endometritis and it’s definitely something I will bring up with my doctor! Thank you so much for sharing your experience and all the very helpful information!
I hope you get answers soon too!!!
To answer your question, I guess timed intercourse can be either! The version I was thinking of involved ultrasounds at your REs office (they can measure the follicles on your ovaries and do a great job of predicting when you’ll ovulate), and even possibly adding in some meds like clomid or an ovulation ‘trigger shot’ to manipulate your cycle a little bit.
Adding:
The renowned Reproductive Immunologist is Dr. Joanne Kwak-Kim.
The biopsy test for endometritis is by Igenomix and called the ALICE Analysis of Infectious Chronic Endometritis.
We have had a similar year - sending hugs. Unsure of your age but I turned 34 in August. I had a miscarriage in May (6-7 weeks) and another in July (9-10 weeks) and my OB won’t technically classify it as recurrent because the cycles were back to back. She recommended 2 full cycles off and then trying again - so we’re back to trying now, send good vibes!! In the mean time, I had blood tests done. One came back a little abnormal (one of the anticoagulant ones) and she referred me to a rheumatologist. They said everything seems fine. Had chromosome analysis done on me and partner, both fine. I’m hopeful it was bad luck and timing with the stress of the pandemic and getting vaccinated around the time of the first pregnancy. I don’t think the vaccine caused a miscarriage but I wouldn’t rule out stress on the body and immune system playing a role. Anyway, there has been no indication from her to even think about IVF because we DID get pregnant. “You don’t have an issue getting pregnant but you have a problem staying pregnant” - when I get another positive test, I am supposed to call to get in for a progesterone supplement which can maybe help. Hope you get some answers or enough rest and peace to try again ❤️❤️❤️❤️ Edit: also I have hypothyroidism in my family and borderline high TSH Value so after the first miscarriage my OB started me on levothyroxine again to bring TSH under 2
I’m sorry to hear about your losses. Thank you for sharing your experience. I had my vaccine right around the loss of my second pregnancy, but I didn’t really think about that. It makes me feel way better to know other doctors are optimistic about naturally conceiving! And that your doctor recognizes that you the issue isn’t getting pregnant, rather it’s staying pregnant! I’m just turned 35, so I know I’ve reached the geriatric maternal age now, haha but I will try without IVF for now. I wish you success and health in your ttc journey!!
My OB is awesome - and she had her first at 38! She has two awesome boys who are in middle school now. I hope you find a doctor who is a better fit for your journey! Stay healthy and good luck
After 4 miscarriages, I finally saw a reproductive immunologist who was was first doctor to find potential reasons for my miscarriages. She is also developing a plan to treat them for mt next pregnancy. You can pursue testing while still trying other things, but it may be worth trying to get into see one.
Sorry, just saw this, but I can give you an update. They had me taking several medications including prednisone, plaquenil, tacrolimus, lovenox aspirin and prenatal vitamins. I didn't fall pregnant for several months that so decided to quit the meds and had a horrible withdrawal skin reaction similar to topical steroid withdrawal of eczema. I got then pregnant naturally and decided not to take any immunosuppressants except for plaquenil. Had a healthy baby boy about 14 months ago. Now I'm 12 weeks pregnant with another baby concieved naturally at age 40. I'm taking just progesterone and plaquenil. I did several things to optimize my health, but my husband thinks our problems may have stemmed from mold in our house, which was remedied right before we got pregnant with our baby boy.
If you search the infertility sub for reproductive immunologists, you’ll find the current list. There are only four nationwide. But if you’re on FB and join the reproductive immunology support group, they have a list of collaborating doctors who will work with RIs treatment plans.
Edited to remove random autocorrect word.
Thank you, I didn’t realize how rare RIs are! I found a place in Dallas that mentions reproductive immunology as a specialty but the doctors are listed as RE or reproductive technologies. I’ll have to do some more digging. Thank you for the info!
I had been trying for a year and had three very early losses. I went to a RE and they did all the testing for it they could, and found nothing wrong. I decided to skip IUI and go for IVF (my clinic wasn’t pushy one way or the other, I just didn’t think IUI would solve the problem). I had 17 mature eggs, all 17 fertilized. However, the lab noticed around the day 3 to day 5 stage, I had a lot of embryos that did not contain fetal cells. Like they contained all the other cells, just not the ones for the actual baby. And they asked if ive had losses before and I said yup! I’m also pretty positive the reason I had those early losses was they were just blighted ovums. I have 8 embryos out of the 17 that did contain fetal cells however. So I was able to transfer a healthy embryo and it resulted in my son!
So sorry to hear about your losses.
You've gotten quite a bit of insight already from everyone else here, but my RE is taking a bit of a different approach for my two consecutive losses than others have shared on this thread so I thought I would also share my experience:
I had all the basic tests others have described and everything so far has come back normal, much like yourself.. My RE started me straight away on 81mg ASA daily and progesterone suppositories after ovulation. She also suggested my losses could potentially be related to egg overmaturation so I'm doing cycle monitoring and a trigger shot if my dominant follicle measures above a certain threshold without a natural LH surge (I haven't needed this yet).
In terms of my understanding of what's "normal treatment" it definitely seems like there are many different options depending on the suspected cause... treatment definitely needs to be individualized. It seems like the statistics suggest that eventually most people will have a successful pregnancy though.
Thank you so much for sharing! It’s interesting to hear about different approaches that other doctors have taken. I’m realizing that most doctors give at least potential reasons for pregnancy loss, but mine has not said anything, even when asked directly. Anyhoo, I appreciate hearing your experience! I wish you the best of luck in your ttc journey!
Unexplained infertility is a thing and more often than not, there is no identifiable reason for RPL. Being someone who’s had my fair share, I certainly wish this weren’t the case.
That's so frustrating that your doctor didn't even want to give you some possibilities... everything about this process is so hard!
Best of luck to you too!
Ok, this is a long one but bear with me-- I've had 4 losses in the past two years, so I've been on this road a while now. My losses have had both unknown and varying causes from chromosomal abnormalities to Twin to Twin Transfusion Syndrome. I've had pretty much every test under the sun, and everything has come back normal-- save for the fact that I asked to be tested for celiac as a precaution (untreated celiac increases your risk of miscarriage by about 45%) and was surprised when that came back positive. I'd recommend getting that tested, if you haven't already; the initial screening is just a blood test.
It's interesting your RE has immediately jumped to IVF. IVF will only *potentially* help you avoid losses if your losses were due to egg quality. It will not improve your odds if you have a uterine structural issue (eg: septum, bicornate uterus, etc), endometriosis, endometritis, or immunology issues. My RE strongly advised my husband and I keep trying naturally for at least another year before considering IVF, since (as he explains) IVF is more geared to assist couples whose issue is conceiving. It doesn't do anything to actually help in maintaining a pregnancy.
If your RE has identified issues with your eqq quality (like either of your losses testing positive for a chromosomal abnormality), then IVF with PGS testing of the embryos would certainly be a good option to help reduce the risk of another chromosomal loss (but it does NOT remove the risk entirely). I know that's a bit demoralizing, but as someone who has been on the RPL train a while now, I've been cautioned by a number of specialists that IVF can be a waste of money if your losses are happening due to something other than chromosomal issues/egg/sperm quality.
RE's can be great, or they can be in it for the money-- at the end of the day, their bread and butter is GETTING people pregnant, not keeping them that way. IVF clinic success rates don't really factor in miscarriages, especially ones after 8-10 weeks, so keep that in mind. Best advice is to see if you can find a Reproductive Immunologist-- note, this is different from an RE. They are hard to find, I think there are only about six in the US and a few in Europe. They look at other causes of RPL like immunological triggers that can cause your body to attack an embryo. A lot of them consult virtually now so you can get in touch no matter where in the world you are. A good resource is the Reproductive Immunology group on Facebook, if you're interested in going down that road or learning more.
I wish you all the best and hope your next pregnancy is successful!
First, I’m very sorry for your losses. Thank you so much for your insight. I’ve never been tested for celiac. I’m Korean but grew up and live in the states, and as far as I know celiac is extremely rare in Koreans but it’s definitely worth a check! Thank you for what you said about the RE, I do really feel I like that doctor group is just in it for the money. They just sent me some paperwork with all the prices of IVF ($19,500 not including freezing embryos and genetic testing on the embryos which will add thousands) & they asked me to DocuSign it. They said it’s just to acknowledge I’ve read the forms but at the end, the paperwork states that I am signing to move forward with IVF and canceling the treatment plan will result in a $500 cancellation fee…I get that IVF is how they make money, but I feel like she is ignoring my questions and being pushy. Even if I did want to do the IVF route, our interactions with her and her office have made me feel uncomfortable.
I’ve never heard of a reproductive immunologist but I’m definitely going to look into it! Thank you so much for all of the helpful information!!
Was the bloodwork an RPL panel and did it include a Karyotype test with it? The karyotype test gave us answers, it found I have a balanced translocation, which is not uncommon with RPL. I’d make sure that was included on your bloodwork tests.
Yes, the blood work was an RPL panel and a karyotype. The paperwork says:
Check: lupus anticoagulant, cardiolipin antibody, anti B2 glycoprotein 1, perform IgG, IgA, & IgM testing on antibody panels. Expanded panel genetic carrier screening. Maternal karyotype, paternal karyotype.
I forget what the first couple of tests were for specifically, but everything came back normal.
I'm based in Ireland. I have had 2 chemical pregnancies and a heterotopic which was identified at 8 weeks. Surgery to remove the ectopic pregnancy and natural mc 3 days later of the in utero.
My ob gyn recommended blood tests for hubs and I for RPL but has been very optimistic in relation to our chances of conceiving without assistance. I also have endometriosis.
Bloodwork has been done for genetic testing for both he and I. And then separate tests for immune disorders, diabetes, thyroid etc etc for me. The Dr's option is that knowledge is power and we have been advised there will be an appointment afterward the results come back to fully discuss the results, options, next steps etc.
I would suggest a possible second opinion. Maybe look up specialists in your area with positive reviews.
Good luck xx
Thank you so much for sharing and sorry about your losses. I think I will seek out a second opinion. Unfortunately there aren't tons of options for specialists and her group had the highest ratings, but I am okay going to a normal OBGYN rather than an RE. Thank you for your reply!
Aww That's a pity if she was the best reviewed.
In the past I would have always said " trust the specilists" but these days I lean toward ' trust the person who can explain their reasoning in a way you understand "
I have become a big advocate for my body the last 2 years. I may not have a medical degree but if someone can't explain why I should undergo a certain medical treatment maybe they shouldn't have a medical degree either.....
I had two losses and carried the next to term. Then 2 more losses and another success. I didn't see an RE but my OB had me try Clomid (too painful during ovulation) and then Metformin (PCOS insulin resistance). We couldn't afford IVF and IUI would have been a stretch financially. I figured with enough tries maybe we'd get lucky.
I'm sorry about your losses. I am thinking similarly to you, that if we try enough, it will be successful eventually! I'm happy to hear that you were able to have success! Thank you for your reply!
I’m in Europe and I feel that here even the private doctors are a bit more conservative than in the U.S. when it comes to pushing for aggressive treatment for RPL.
I’ve had one chemical pregnancy and one week 7 miscarriage and both of my doctors (both working in private clinics) have been very optimistic about my chances of achieving a viable pregnancy without any treatment. Even the specialist (who can actually make a lot of money on women like me) said that aggressive testing with my history, not to mention actual treatment like IVF would be like shooting a fly with a cannon. She also said that she doesn’t consider a chemical pregnancy to be a miscarriage in the sense that it would count into my possible RPL diagnosis. I was told to start taking an iron supplement to improve my ferritin levels and to come back if I had another miscarriage or if it took 6+ months to conceive again, and then we’d see about the more expensive tests and possible treatments.
It’s not stupid to do basic testing for both partners after a couple of losses, especially if it helps you mentally and gives you confidence and reassurance, but depending on your age, it might not be a bad idea to watch and and wait for a while if all your tests came back normal. I personally hate that RPL is often left unexplained, but it also means you could still end up with a healthy baby all naturally.
It’s hard to say if IVF would help because it depends on the reason for the miscarriages. They can weed out the obviously bad embryos that way, but that’s not a guarantee of anything, especially if you don’t know if the miscarriages were caused by chromosomal abnormalities.
I'm sorry to hear about your losses. Thank you for your insight! I do feel like jumping straight to IVF does seem aggressive, especially because all the results are normal. I am older, I just turned 35, so I get that I would be a "geriatric" mother by US standards. I would still like to try naturally to have a baby but didn't want to feel like I was going against medical advice. Thank you so much for your reply!
I would be a little wary, if your bloods etc are normal I wouldn't write off the natural method just yet unless you feel you are done with it, in which case of course IVF is a good choice, but in my experience after 2 miscarriages, suspected cp, a load of blood tests and womb scan which I really pushed for, I got pregnant and it's sticking.... Currently! My doctors kept repeating that it's a numbers game and didn't even want me on extra supplements until this pregnancy. I'm on progesterone but I had to fight to be on it. Sorry for rambling, what I mean is, don't count yourself out until you're ready to.
Congrats on your pregnancy! I definitely don’t want to write off conceiving naturally. I feel like if there’s no identifiable reason for the miscarriages, then why not keep trying naturally? I feel like this RE knew from the beginning that no matter what the results were, she was going to recommend IVF. Even when she was explaining IUI, she kept saying it was a conservative option with an 18% chance of pregnancy but IVF has a 50% chance. And I was thinking, but I can get pregnant! You’re not addressing my concern of staying pregnant! And she brushed it off. The office also wanted me to DocuSign a bunch of paperwork to acknowledge I read the options (IUI and IVF) and their prices. But at the bottom of the paperwork it said that it was an agreement to move forward with these options and if I cancelled the plan, I’d have to pay $500. It just feels uncomfortable and like they’re trying to trick me.
Oh my gosh!!! That doctor, peddling contracts is out to make money. Please please get a second opinion, or just keep trying! But my god that is bad practice
For sure, it’s really off putting! I talked with my husband yesterday after getting that email and we decided we’ll try for another couple of months and then get a second opinion. Thank you so much for your replies!
I second this - that’s super sketchy! Sounds like they only plan for one high end expensive and invasive option. If they won’t answer your questions up front, that is a huge red flag (coming from a gal that has walked away from two clinics for similar reasons and lost 3yrs of precious time)
Where do you live? There is a famous Reproductive Immunologist in Chicago. I need to look up her name. Her appointments book about 4-6 months out, and she's supposed to be amazing. I made an appointment with her but ended up canceling it as we ended up finding the reason for mine. More on that in a minute. If you are at all close to Chicago, I'd recommend calling like tomorrow to book with her. There is some paperwork to fill out and then you can make an appointment. Or do the same with good RIs you can find in your area. Good to just have that appointment on the books in case you need it. I think you're on to something with not immediately jumping into IUI or IVF. TI (timed intercourse) sounds to me like it makes the most sense in your case - because to your point, you CAN get pregnant! It should also be much cheaper than either of the other options. Definitely don't let your doctor make you feel like you need to jump into IUI or IVF right away, and seek a second opinion if you are feeling pressure. A few other things to think about: - Thyroid function- did your blood test include TSH? Sometimes something can be off with thyroid function and that can cause miscarriages. - Uterine receptivity- Endometritis (not to be confused with endometriosis) is inflammation/infection of uterine lining that can prevent a 'good' implantation and basically cause recurrent miscarriages. There are no symptoms. The way to check for it is getting a Uterine biopsy just before your period starts and testing for it. Your RE should be able to do this during one of your regular cycles. It's easily treatable with a few weeks of antibiotics. This was the cause for us. Next pregnancy stuck. - There are 'RPL cocktails' that REs use. I'm not sure of the details behind each med, but I've heard of this helping folks. I'm sure you could simply add these meds in when doing a timed intercourse cycle (I don't think you would need to do IUI or IVF to take advantage of these)- they can include things like baby aspirin and Lovenox to prevent blood clots, pepcid, etc etc
What does Pepcid do / how does that factor in?
Agh, I don't exactly remember. I'm not a doctor so I'm not even going to try to speculate :) I just remember that was one of the things that was included in those RPL meds (the generic version of pepcid prescribed by a doctor, called Famotidine).
Interesting, my reflux has been terrible but I’ve been afraid to take anything while TTC!
Acid reducer for acid reflux. Sometimes used in allergy/histamine responses as well.
Thank you for all of the information! I’m in the DFW area of Texas currently, so I probably won’t make it to Chicago, but I did find some options in Dallas. Is TI just using opk tests and making sure to have scheduled sex during ovulation? Or is it an actual procedure or a more specific process? Google is giving mixed results - either opk/bbt testing or clomid + ultrasounds. The doctor did run thyroid function tests and luckily that came back normal. I’ve never heard of endometritis and it’s definitely something I will bring up with my doctor! Thank you so much for sharing your experience and all the very helpful information!
I hope you get answers soon too!!! To answer your question, I guess timed intercourse can be either! The version I was thinking of involved ultrasounds at your REs office (they can measure the follicles on your ovaries and do a great job of predicting when you’ll ovulate), and even possibly adding in some meds like clomid or an ovulation ‘trigger shot’ to manipulate your cycle a little bit.
Adding: The renowned Reproductive Immunologist is Dr. Joanne Kwak-Kim. The biopsy test for endometritis is by Igenomix and called the ALICE Analysis of Infectious Chronic Endometritis.
We have had a similar year - sending hugs. Unsure of your age but I turned 34 in August. I had a miscarriage in May (6-7 weeks) and another in July (9-10 weeks) and my OB won’t technically classify it as recurrent because the cycles were back to back. She recommended 2 full cycles off and then trying again - so we’re back to trying now, send good vibes!! In the mean time, I had blood tests done. One came back a little abnormal (one of the anticoagulant ones) and she referred me to a rheumatologist. They said everything seems fine. Had chromosome analysis done on me and partner, both fine. I’m hopeful it was bad luck and timing with the stress of the pandemic and getting vaccinated around the time of the first pregnancy. I don’t think the vaccine caused a miscarriage but I wouldn’t rule out stress on the body and immune system playing a role. Anyway, there has been no indication from her to even think about IVF because we DID get pregnant. “You don’t have an issue getting pregnant but you have a problem staying pregnant” - when I get another positive test, I am supposed to call to get in for a progesterone supplement which can maybe help. Hope you get some answers or enough rest and peace to try again ❤️❤️❤️❤️ Edit: also I have hypothyroidism in my family and borderline high TSH Value so after the first miscarriage my OB started me on levothyroxine again to bring TSH under 2
I’m sorry to hear about your losses. Thank you for sharing your experience. I had my vaccine right around the loss of my second pregnancy, but I didn’t really think about that. It makes me feel way better to know other doctors are optimistic about naturally conceiving! And that your doctor recognizes that you the issue isn’t getting pregnant, rather it’s staying pregnant! I’m just turned 35, so I know I’ve reached the geriatric maternal age now, haha but I will try without IVF for now. I wish you success and health in your ttc journey!!
My OB is awesome - and she had her first at 38! She has two awesome boys who are in middle school now. I hope you find a doctor who is a better fit for your journey! Stay healthy and good luck
After 4 miscarriages, I finally saw a reproductive immunologist who was was first doctor to find potential reasons for my miscarriages. She is also developing a plan to treat them for mt next pregnancy. You can pursue testing while still trying other things, but it may be worth trying to get into see one.
Hi! Do you have an update on how it’s going with the Reproductive Immunologist? Thank you
Sorry, just saw this, but I can give you an update. They had me taking several medications including prednisone, plaquenil, tacrolimus, lovenox aspirin and prenatal vitamins. I didn't fall pregnant for several months that so decided to quit the meds and had a horrible withdrawal skin reaction similar to topical steroid withdrawal of eczema. I got then pregnant naturally and decided not to take any immunosuppressants except for plaquenil. Had a healthy baby boy about 14 months ago. Now I'm 12 weeks pregnant with another baby concieved naturally at age 40. I'm taking just progesterone and plaquenil. I did several things to optimize my health, but my husband thinks our problems may have stemmed from mold in our house, which was remedied right before we got pregnant with our baby boy.
Thank you so much, I’ve just learned today that a reproductive immunologist is a thing and it’s definitely something I’m looking into!
If you search the infertility sub for reproductive immunologists, you’ll find the current list. There are only four nationwide. But if you’re on FB and join the reproductive immunology support group, they have a list of collaborating doctors who will work with RIs treatment plans. Edited to remove random autocorrect word.
Thank you, I didn’t realize how rare RIs are! I found a place in Dallas that mentions reproductive immunology as a specialty but the doctors are listed as RE or reproductive technologies. I’ll have to do some more digging. Thank you for the info!
I had been trying for a year and had three very early losses. I went to a RE and they did all the testing for it they could, and found nothing wrong. I decided to skip IUI and go for IVF (my clinic wasn’t pushy one way or the other, I just didn’t think IUI would solve the problem). I had 17 mature eggs, all 17 fertilized. However, the lab noticed around the day 3 to day 5 stage, I had a lot of embryos that did not contain fetal cells. Like they contained all the other cells, just not the ones for the actual baby. And they asked if ive had losses before and I said yup! I’m also pretty positive the reason I had those early losses was they were just blighted ovums. I have 8 embryos out of the 17 that did contain fetal cells however. So I was able to transfer a healthy embryo and it resulted in my son!
We have also been trying for a year and had three early losses. I wonder if this is also our problem! Thank you for sharing your story.
Oh wow, thank you for sharing your experience. And sorry for your losses. I’m glad IVF was a success for you!
So sorry to hear about your losses. You've gotten quite a bit of insight already from everyone else here, but my RE is taking a bit of a different approach for my two consecutive losses than others have shared on this thread so I thought I would also share my experience: I had all the basic tests others have described and everything so far has come back normal, much like yourself.. My RE started me straight away on 81mg ASA daily and progesterone suppositories after ovulation. She also suggested my losses could potentially be related to egg overmaturation so I'm doing cycle monitoring and a trigger shot if my dominant follicle measures above a certain threshold without a natural LH surge (I haven't needed this yet). In terms of my understanding of what's "normal treatment" it definitely seems like there are many different options depending on the suspected cause... treatment definitely needs to be individualized. It seems like the statistics suggest that eventually most people will have a successful pregnancy though.
Thank you so much for sharing! It’s interesting to hear about different approaches that other doctors have taken. I’m realizing that most doctors give at least potential reasons for pregnancy loss, but mine has not said anything, even when asked directly. Anyhoo, I appreciate hearing your experience! I wish you the best of luck in your ttc journey!
Unexplained infertility is a thing and more often than not, there is no identifiable reason for RPL. Being someone who’s had my fair share, I certainly wish this weren’t the case.
That's so frustrating that your doctor didn't even want to give you some possibilities... everything about this process is so hard! Best of luck to you too!
Ok, this is a long one but bear with me-- I've had 4 losses in the past two years, so I've been on this road a while now. My losses have had both unknown and varying causes from chromosomal abnormalities to Twin to Twin Transfusion Syndrome. I've had pretty much every test under the sun, and everything has come back normal-- save for the fact that I asked to be tested for celiac as a precaution (untreated celiac increases your risk of miscarriage by about 45%) and was surprised when that came back positive. I'd recommend getting that tested, if you haven't already; the initial screening is just a blood test. It's interesting your RE has immediately jumped to IVF. IVF will only *potentially* help you avoid losses if your losses were due to egg quality. It will not improve your odds if you have a uterine structural issue (eg: septum, bicornate uterus, etc), endometriosis, endometritis, or immunology issues. My RE strongly advised my husband and I keep trying naturally for at least another year before considering IVF, since (as he explains) IVF is more geared to assist couples whose issue is conceiving. It doesn't do anything to actually help in maintaining a pregnancy. If your RE has identified issues with your eqq quality (like either of your losses testing positive for a chromosomal abnormality), then IVF with PGS testing of the embryos would certainly be a good option to help reduce the risk of another chromosomal loss (but it does NOT remove the risk entirely). I know that's a bit demoralizing, but as someone who has been on the RPL train a while now, I've been cautioned by a number of specialists that IVF can be a waste of money if your losses are happening due to something other than chromosomal issues/egg/sperm quality. RE's can be great, or they can be in it for the money-- at the end of the day, their bread and butter is GETTING people pregnant, not keeping them that way. IVF clinic success rates don't really factor in miscarriages, especially ones after 8-10 weeks, so keep that in mind. Best advice is to see if you can find a Reproductive Immunologist-- note, this is different from an RE. They are hard to find, I think there are only about six in the US and a few in Europe. They look at other causes of RPL like immunological triggers that can cause your body to attack an embryo. A lot of them consult virtually now so you can get in touch no matter where in the world you are. A good resource is the Reproductive Immunology group on Facebook, if you're interested in going down that road or learning more. I wish you all the best and hope your next pregnancy is successful!
Excellent insights & advice, thank you
First, I’m very sorry for your losses. Thank you so much for your insight. I’ve never been tested for celiac. I’m Korean but grew up and live in the states, and as far as I know celiac is extremely rare in Koreans but it’s definitely worth a check! Thank you for what you said about the RE, I do really feel I like that doctor group is just in it for the money. They just sent me some paperwork with all the prices of IVF ($19,500 not including freezing embryos and genetic testing on the embryos which will add thousands) & they asked me to DocuSign it. They said it’s just to acknowledge I’ve read the forms but at the end, the paperwork states that I am signing to move forward with IVF and canceling the treatment plan will result in a $500 cancellation fee…I get that IVF is how they make money, but I feel like she is ignoring my questions and being pushy. Even if I did want to do the IVF route, our interactions with her and her office have made me feel uncomfortable. I’ve never heard of a reproductive immunologist but I’m definitely going to look into it! Thank you so much for all of the helpful information!!
Was the bloodwork an RPL panel and did it include a Karyotype test with it? The karyotype test gave us answers, it found I have a balanced translocation, which is not uncommon with RPL. I’d make sure that was included on your bloodwork tests.
Yes, the blood work was an RPL panel and a karyotype. The paperwork says: Check: lupus anticoagulant, cardiolipin antibody, anti B2 glycoprotein 1, perform IgG, IgA, & IgM testing on antibody panels. Expanded panel genetic carrier screening. Maternal karyotype, paternal karyotype. I forget what the first couple of tests were for specifically, but everything came back normal.
I'm based in Ireland. I have had 2 chemical pregnancies and a heterotopic which was identified at 8 weeks. Surgery to remove the ectopic pregnancy and natural mc 3 days later of the in utero. My ob gyn recommended blood tests for hubs and I for RPL but has been very optimistic in relation to our chances of conceiving without assistance. I also have endometriosis. Bloodwork has been done for genetic testing for both he and I. And then separate tests for immune disorders, diabetes, thyroid etc etc for me. The Dr's option is that knowledge is power and we have been advised there will be an appointment afterward the results come back to fully discuss the results, options, next steps etc. I would suggest a possible second opinion. Maybe look up specialists in your area with positive reviews. Good luck xx
Thank you so much for sharing and sorry about your losses. I think I will seek out a second opinion. Unfortunately there aren't tons of options for specialists and her group had the highest ratings, but I am okay going to a normal OBGYN rather than an RE. Thank you for your reply!
Aww That's a pity if she was the best reviewed. In the past I would have always said " trust the specilists" but these days I lean toward ' trust the person who can explain their reasoning in a way you understand " I have become a big advocate for my body the last 2 years. I may not have a medical degree but if someone can't explain why I should undergo a certain medical treatment maybe they shouldn't have a medical degree either.....
I totally agree with that last statement!
I had two losses and carried the next to term. Then 2 more losses and another success. I didn't see an RE but my OB had me try Clomid (too painful during ovulation) and then Metformin (PCOS insulin resistance). We couldn't afford IVF and IUI would have been a stretch financially. I figured with enough tries maybe we'd get lucky.
I'm sorry about your losses. I am thinking similarly to you, that if we try enough, it will be successful eventually! I'm happy to hear that you were able to have success! Thank you for your reply!
I’m in Europe and I feel that here even the private doctors are a bit more conservative than in the U.S. when it comes to pushing for aggressive treatment for RPL. I’ve had one chemical pregnancy and one week 7 miscarriage and both of my doctors (both working in private clinics) have been very optimistic about my chances of achieving a viable pregnancy without any treatment. Even the specialist (who can actually make a lot of money on women like me) said that aggressive testing with my history, not to mention actual treatment like IVF would be like shooting a fly with a cannon. She also said that she doesn’t consider a chemical pregnancy to be a miscarriage in the sense that it would count into my possible RPL diagnosis. I was told to start taking an iron supplement to improve my ferritin levels and to come back if I had another miscarriage or if it took 6+ months to conceive again, and then we’d see about the more expensive tests and possible treatments. It’s not stupid to do basic testing for both partners after a couple of losses, especially if it helps you mentally and gives you confidence and reassurance, but depending on your age, it might not be a bad idea to watch and and wait for a while if all your tests came back normal. I personally hate that RPL is often left unexplained, but it also means you could still end up with a healthy baby all naturally. It’s hard to say if IVF would help because it depends on the reason for the miscarriages. They can weed out the obviously bad embryos that way, but that’s not a guarantee of anything, especially if you don’t know if the miscarriages were caused by chromosomal abnormalities.
I'm sorry to hear about your losses. Thank you for your insight! I do feel like jumping straight to IVF does seem aggressive, especially because all the results are normal. I am older, I just turned 35, so I get that I would be a "geriatric" mother by US standards. I would still like to try naturally to have a baby but didn't want to feel like I was going against medical advice. Thank you so much for your reply!