[ohnicole]

Hey everyone. I'm kind of a lurker, but I'm Nicole. I had my first pregnancy last summer, which unfortunately ended in a missed m/c and D&C in September at 12 weeks. I have several issues that make me think I should see a specialist of some sort, and I'm wondering if a RE is appropriate for everything or not. Here is my (unfortunately, long) list:

1. Since my m/c in September of 2009, I have had only 3 cycles (but both complete cycles so far have been ovulatory), 1 70 days, 1 50 days, and am on CD 20 of cycle 3 with no sign of ovulation. My doctor says it can take up to a year to regulate after a m/c (which I'm sure is true, but I've already been TTC or waiting to TTC for almost a year). Also my cycles before m/c were longish and irregular (30-42 days) and she would never do anything about it then. I am especially concerned because I have read that late ovulation can contribute to m/c.

2. My sister was recently diagnosed with thyroid autoantibodies. I got tested for thyroid issues and all the tests came back in 'normal range', but I have 2 concerns. One is that my sister having autoantibodies put me at higher risk of any autoantibody, not just thyroid and my doctor refuses to test me for a whole panel of m/c-related antibodies. Two is that my TSH levels came back normal, but my T3 and T4 levels were both just barely in the normal range on the low end. From what I see online, that can still signal hypothyroidism, which can contribute to m/c.

3. My sister was also recently diagnosed with a clotting disorder (prothrombin/factor II mutation). My test results for that specific mutation haven't come back yet, but my doctor refuses to test me for the whole m/c-related clotting disorder panel (which would include some autoantibody tests that I think I should be tested for anyway).

I just don't really feel comfortable continuing with full-out TTC with all these potential m/c risk factors and I am going to ask to see a specialist. Is a RE the most appropriate for all of these concerns, or should I see an endocrinologist and a hematologist as well? And if anyone has dealt with any of these issues and has any general advice, I would really appreciate it.

[Kary♥RN]

Nicole... I am so sorry for your loss... HUGS.

Welcome to the board...

I started to see an RE after my third m/c... My Regular OB had run tests.. and it came back I have a MTHFR Homozygous Mutation of A1298C.... (Which can be attributed to M/c... and cloting issues)... After my OB really didn't want to do additional testing I went to an RE and Hemetologist on my own. I feel you HAVE TO BE YOU OWN ADVOCATE!!!! You really should go to a specialist since you have these risk factors... Not say YOU HAVE THESE ISSUES... BUT You just don't know if you DO!!!! And You should also follow up with your cycles... How do you KNOW they were Ovulatory?.. The reason I ask this is in October.. I temp, I had my thermal shift (To signal Ovulation).. I use OPK's... Got a BLARING + OPK (Also signaling Ovulation)... I had EWCM..... (again I am thinking I am Ovulating).. I go in for my U/S... and NOT ONE! NODA! ZERO Follicle that would have released a mature egg. So Even though you have all the signs... You really need U/S and Blood work to be 100% sure that you did Ovulate.. And with your cycles being so crazy... I would say just see a RE to be sure.. HUGS!!! KUP what you decide!

[KDD]

Nicole. I'm very sorry for your loss.

I'm seeing an RE because DH and I have been actively TTC since our loss and haven't conceived again yet (currently on cycle #22). I have regular cycles and I ovulate (confirmed with progesterone tests) and all other test have been normal. I don't know why we lost our baby (most likely a chromosomal issue) or why we haven't conceived again.

You have some valid concerns and if your Dr. isn't listening to you then you should seek a second opinion.

[ohnicole]

Thanks for your thoughts. With the way doctors are so reluctant to do anything sometimes it makes you feel crazy for pushing to get tests done. And it's good to get some encouragement, that no I'm not crazy for worrying about these things.

As far as my ovulation goes, I do get positive OPKs and EWCM a couple days before a thermal shift. And on my post-m/c cycle, they did an ultrasound to look for retained tissue and found a 12mm follicle. I ovulated (according to OPK and BBT) about a week later. But no, I have never had an ultrasound closer to ovulation or a progesterone test at 7dpo, so I can't be really sure.

I think it does make sense to get my doctor to send me to a RE and a hematologist. Annoying that they have to make it so hard just to get tests. Hopefully specialists aren't so reluctant to check things out.