4 miscarriages in a row in 15months, looking for help, support, advice

Question

4 miscarriages in a row in 15months. (But I have a beautiful happy healthy 5 year old son with my ex husband)

I had 2 Hysterosalpingogram (HSG) - dye tests and my tubes were “fill and spill” dye, fee of scar tissues and working normally.

I have had 3 Laparoscopy surgeries, I have had minor uteran septum fixed, Had minor endometriosis removed, and two ectopic pregnancies.

My Thyroid is fine, and no diabetes, but I do have low blood sugar

Progesterone and HCG are fine with all 4 pregnancies with my current husband

I have a 14 day luteal phase with normal cervical mucus and a normal cycle of 29 or 30 days.

I tested negative for anything Infectious and no STD’s.

I tested negative for Anti-Nuclear Antibodies

Negative for Chromosomal abnormalities on my husband and myself. They never were able to test the first two miscarriages for chromosomal issues.

This fourth pregnancy (last period was 06/02/08) we made it to 8-9 weeks further than we have ever been with good HCG’s and progesterone of 25 to32. First ultrasound at 7 weeks showed nothing, they thought maybe to soon, but they sent me to have a second ultrasound later that day at the radiologist. The DNC was sent off the pathologist and no fetal tissue found, so yesterday I had my second in a row ectopic surgery and the tube they had just fixed from the last ectopic that was “free flowing” is now gone. They kept telling us the chances of a second ectopic were low, and that my tubes were good. Guess they were wrong.

I feel confident that the last two pregnancy losses were issues with the left tube, now that the tube is gone I feel more confident. But I still had 2 miscarriages prior to the ectopic. We see the best fertility specialist in the area, but i know we can’t afford IVF and I just don’t understand what’s going wrong and what’s left to test on me, and what’s next. Has anyone had any other tests I should ask for? Do I ask for more or trust the specialist is testing for everything?

I’m reading a book called Preventing Miscarriages by Jonathan Scher, M.D. and they said 1 in 300 women will have 3 consecutive miscarriages in a row. I have had 4 in a row, and the last two in a row were ectopic. What are the static’s on this?

Thanks for the help.

Answer 1

There very specific things that you can do with next pregnancy (that my wife did with second pregnancy - after first miscarriage):

1) take progesterone suppositories for the first three month (as soon as you find our that you are pregnant).  In fact, if you know exactly when you ovulate, you can start taking progesterone two days after ovulation (and stop taking if not pregnant).  This is standard protocol with IUI/IVF to maximize chances of implantation and for sustaining pregnancy.    You should do this regardless whether progesterone is an issue for you or not. It doesn't hurt, and it can make all the difference.

It is important to note to take it progesterone for the first 12 weeks, not 7 or 10 weeks.   Placenta takes over production of progesterone starting week 8-10, but not completely till week 13 or so.  So, you may be fine with progesterone count at week 7 but not later.  Taking suppositories of 12 weeks makes sure at least lack of progesterone is not the cause (our first miscarriage at 10 weeks was likely due to this).

2)  take baby aspirin for first three months.  this helps prevent miscarriage due to clotting around the placenta.  also this is standard protocol for most IVF but you can do this regardless.

3) take the medicine metformin for first three months of pregnancy.  this helps with insulin resistance, and reduces miscarriage risk. talk to your doctor since you already have low blood sugar (which is pre-diabetes condition). You can take this even if you do not have have clinical PCOS.  again, need to consult with doctor if you are already taking some other pre-diabetes medication.

The other things you have already mentioned (genetic testing, testing for infections, etc.).  The fourth thing that my wife was take it easy for the first three months - no stress (she went on leave of absence). Now we have a very playful and cute 3 month old.

Good luck.

Added:  Actually, metformin can also used to both treat underlying cause of hypoglycemia and can also indirectly cause hypoglycemia (if not prescribe appropriately), so need to consult with doctor. It depends on insulin response/levels and the reason for the underlying low blood sugar.

Answer 2

I'm sorry that you are going thru this but I really dont hope you take offense to this but have had your husband checked? Like has his sperm count been counted?  

Answer 3

OK, first she can't take metformin, it lowers blood sugar, and she is already hypoglycemic (low blood sugar).  Have them look at your A1c (blood sugar over several months).  It is my understanding from school, and the RE that metformin is used to help anovulatory women due to PCOS which is a precursor to diabetes type II to ovulate.  It does not help sustain pregnancy.

And her progesterone level of 25-32 is good, ideal even.  You don't miscarry until it falls around a 10.  When you miscarry due to low progesterone you bleed out, it doesn't sound like this happened.  Have them check the progesterone every pregnancy though.  I have had low levels with OI (clomid, metformin) I agree, the last 2 miscarriages are probably the result of the ectopic.

Test again for the anti nuclear antibodies.  It can change.  I believe this is the same as +lupus anticoagulent, or +ACLA anti-cardio lipid antibodies.  This is the blood clotting issue.  Blood thinners should not effect you if you do not have clotting issues.  Also factor V leiden is another blood clotting issue.  

It doesn't sound like an anatomy issue.  It is possible that you had a blighted ovum, or 1 with abnormal chromosomes.  Very unusual, I say that you are due.  Baby dust.

Answer 4

I had 6 miscarriages before finally having a full term pregnancy.  The "cause" was always "these things happen" or something along those lines... just boiled down to no known cause.

Before my 7th pregnancy, I went to a specialist who did a number of tests on me and my husband.  All came back clear.  Finally, he offered us one last test.  He said that studies have shown that some women do not produce progesterone and that a low progesterone level could be the cause of my miscarriages.  Progestorone is what thickens the uterine walls allowing nurishment for the baby until the plecenta takes over.

The test is a simple blood test.  The draw back is that they can only test your progesterone if you ARE pregant.  It took us a month to decide and even then we were undecided if we wanted to attempt another pregnancy or just proceed with adoption...and then I got pregnant.  The test was done and I scored a whoping .2 (that is point 2)... normal was 20+.  I began progesterone shots 2 times a day for 4 months.  The result, a wonderful 8lb 5oz son.

The only difference between my severnth pregnancy and the others was those shots.

I wished that all doctors would make the progesterone blood test standard procedure with the regular pregnancy test, but they don't.

Answer 5

I'm don't know if this would have anything to do with your situation or not been as you said there was no fetal tissue found with the one misscarriage, but a close friend of mine was having multiple still borns, they found out her blood was thickening up and causing it to basicly clog up the tubes that feed the baby etc (sorry I know that doesn't sound smart but I'm tired and can't think well at the moment) and they gave her 1 asprin a day to thin out her blood and now she has a cute lil boy. Could this maybe be a possibility??  I also apologise for your losses, I too have had a misscarriage and know how hard it can be with one let alone FOUR :S  Goodluck and I hope the next time is sucessful :)

Answer 6

Sorry for your losses hun.  I've only had one miscarriage and I can't imagine what 4 must feel like.  The only thing I do know is a friend of mine has had 3 consecutive miscarriages and they have recently discovered that it is a clotting issue for her.  With her last pregnancy, she was on baby aspirin and everything was going fine, then her "dr" suggested she stop taking it to see "what happens" well, needless to say, she lost the baby and is now with a new dr.  It's just a suggestion.  I wish you all the best and very healthy pregnancy in your near future!

Answer 7

first of all i am really sorry to hear about all the terrible things you have been through.

my mom had 3 stillbirths before me (one a set of twins) but she had a rare skin disease and couldn't carry boys. my cousin has 3 children and been through 10 miscarriages. i have been through one.

unfortunately none of us know why but what really made me strong when going through my loss was to think of my cousin and the fact that she lost 7 babies and was still going strong. she was absolutely determined to have children and nothing could/would stop her or keep her down.

just keep trying and remember everything happens for a reason. ill pray for you that you are blessed with what you want :)

*****BABY DUST*****

Answer 8

I'm sorry that you have to go through all of this. I have no advice to offer you because I've never gone through this. I was lucky to have gotten pregnant very easily. Have you considered adoption or surrogacy? There are plenty of children who need someone to care for them and if you are only interested in an infant, there is always a teenage mother who needs a responsible parent for their child. One of my friends in high school got pregnant at 16 and gave the baby up for adoption. I don't mean to sound insensitive or anything. I'm just stating an option.