[sheephater321]

hello ladies..okay ..here goes... I've only been to two ob/gyns in my life, but only one of them has ever given me a gynecological exam. I left my original ob/gyn a year ago because she said she was not seeing OB patients anymore and she knew I was TTC. So i left her and went to the one I'm going to now. I've been a patient there for a year and have had two confirmed miscarriages while there. They've never given me an exam. I did have a nurse give me short u/s with one of the pregnancies to look for a gestational sac, but that's it. Does anyone else think this is odd?
They did one bloodwork panel on me and did diagnose me with a heterozygous C67TT MTHFR defect. They told me they didn't know for sure if that's the cause of the m/cs or not. But that is all the have done.
So, In my whole life I've actually only had 3 gynecological exams by one doctor(I waited until after i got married to go to an ob/gyn b/c I was scared and had never had sex...bad I know) Isn't it possible that I could have something structurally wrong or some other visually apparent problem causing m/c's?? Also, I'm debating whether I should contact my ob/gyn about the fact that I'm pretty sure I just had a really early undiagnosed chemical pregnancy. I know some people may think I'm crazy, but I just REALLY feel I had another loss. I'm not in the mood for my doctor to either just tell me im imagining things..or just blow it off some other way. I'm soo mad at myself for not confirming the pregnancy in time because If I had maybe I could've gotten more testing! I'm so mad right now. I'm also mad because I've also had trouble for the past 10 years with chest pains and heart palpitations. I've only convinced one doctor to look into this and I got a basic metabolic panel and a chem20 blood test done. That didn't get me anywhere and Im worried this could be related to the losses.
i've rambled long enough...I'm mostly just venting, but would very much appreciate any idea/thoughts...thank you in advance

[.:Shortcake:.]

Hugs! I do think that you should defiantly have an exam at your new OB. They do test for infections and many other things and I think that if nothing else you need to have a yearly done. As for the problems with chest pains I'm not sure if it would have anything to do with your m/c's but it could. I would talk to your doctor about everything and if they don't listen I suggest looking into other doctors if possible. I hope you get your sticky BFP and some answers.

[zkat]

It is very possible the MTHfR mutation is the cause of your miscarriages. Your OB should refer you to a hematologist for further evaluation. Usually with that particular mutation, most Dr. will put you on a blood thinner while you are pregnant and 6 weeks post-partum to prevent clotting.

I am at work and don't have time to go full in depth, but I will come back and finish my reply this evening.

[ohnicole]

If you are not comfortable with the way you have been treated by your doctors, then you should definitely ask for better care or get a different doctor. I hope you are able to get some answers soon so you get your sticky BFP!

[zkat]

Ok - I am home now and not limited by works 1 hour limit on recreational sites.

First, I am very sorry for your losses. I am also sorry that you are seeking answers and getting help in finding them.

It sounds like in general you are not comfortable with your current OB. Your Dr. should listen to you and not discount any symptoms. Are you limited on OB choices where you live? If you are, maybe you can go back to your old one until you get pregnant and then switch to a different one. I find it very odd that he has never given you a pelvic exam. I had one at my 8 week OB appt. and I had one after my m/c just to make sure all was OK.

As far as the MTHfR mutation. There is a lot of discussion regarding whether the hetero C (which is what you have) can cause recurrent miscarriage. I think most women on here that have been diagnosed with it will tell you they feel it is the cause of their losses because once they were treated, they were able to carry to term. I have the lesser of the mutation, homo for the A. My Ob sent me to a hematologist who then did a full work up and diagnosed me with an additional cloting disorder, protein C/S deficiency. I am on daily blood thinners until 6 weeks postpartum. On my loss panel, the protien C/S was on the low end of normal, but under the influence of hormones, the levels drop further, causing the blood to be very thick and clots to form, particulary in the cord and placenta. My OB did not know this and probably would have only prescribed baby aspirin for me.

MTHFR & Recurrent Pregnancy Loss - Stephen Wells M.D. - Walnut Creek, CA

I hope you find your answers soon.

Kat.

[sheephater321]

Thank you to all of you ladies for your input and good wishes. Zcat thank you so much for your informative response about the MTHFR. And yes, Ob/gyn options and all doctors for that matter are kind of limited where I live. I live in a very rural area. A couple of years ago, I was on Birth control pills and went off of them because I felt like my chest pains got worse while taking them. I mentioned that to my first ob/gyn and she just said ' well..its a good thing you quit taking the pill then I guess'. So even if she was going to see OB patients, I was still looking around for a new doc. I started at my new ob/gyn in november 09, started prenatals, and concieved in january and in april 2010 and lost both pregnancies. They tested for the MTHFR and antiphospholip antibodies. My regular GP doctor did a basic metabolic panel and a chem20 in addition and said they seemed normal. I'm now taking 1 prenate elite and 2 folgard rx 2.2 tabs daily, but no aspirin or anything. I've been doing this since may.
zcat...did you have to push your ob/gyn for a referral to see the hematologist or did they just suggest it? I had to push my ob for any testing after the 2nd m/c. I'm not happy with my current ob/gyn but from what I hear in my local area he is one of the best. And I do think I'm probably getting better care here than I would have at my old one. But yes, I find it odd that I've never had a pelvic exam. To me that just seems like kind a of 'duh' thing but I know im not a doc.
So, I'm not sure what to do. I might make an appointment at my regular doctor and see if maybe he can arrange for more blood tests or refer me to a specialist.(?) I really think I just had a chemical pregnancy, but even if I did I'm not sure how relevant I should consider that. I mean I know that they are very common regardless of a woman's health status. Should I just trust that the MTHFR is the only problem and that the folic acid will work and go for it again? Or harass my docs for more testing first. My ob/gyn said I don't need any blood thinners.
Ohhh... and one more thing that struck me as kinda odd...my ob also said they did a PTT test and that my blood actually took a bit LONGER to clot than normal but that they were not concerned b/c it was minimal and my chem20 looked normal.
Anyways though...I'm typing way too much here....thank you so much. Zcat, It means a lot that you ae taking time out of your day to help me with this. I need to talk to others like me. I'm so glad that you got the testing that you need. I wish you the best. Thank you for your help! =)

[missya0002]

ok so just thought id add a reply to what you said about the MTHFR. i have that too and had miscarriage before going on lovenox (heparin) shots as soon as I know im pregnant and progesterone. It is crucial you take blood thinners if you have MTHFR while you are pregnant. After i did that i went on to have a healthy little boy. So there is hope if you have any questions at all let me know i been through it all and all the fustration

[AmyLM]

I wrote out a long response and something happened to it! Anyway, I have a clotting disorder, too. It's different but similar to yours but none the less, it's a clotting disorder. I am on blood thinners all the time, pregnant or not, and will be for the rest of my life. When I was on bc pills, I had a dvt and then a pulmonary embolism. I'm lucky to be sitting here at all, alive. IMO, you need new doctors. period. a new ob, a new gp and they need to send you to a hematologist. Demand it. Please. We all have to be our own advocates, especially when the doctors are so blase about our treatment or they just don't know what it is. Your doctor should have been scared s-less about your chest pain and on bcp, not have the response of "well it's a good thing you stopped taking them." These clotting disorders are not something that can be ignored and they can have horrible, horrible results. I don't mean to scare you but, please, do what you can to find new doctors.

[sheephater321]

Thank you to everyone who is posting on here. Amy..thank you SO much for sharing your story and for your concern. I'm glad this forum is here, but I wish that none of us needed to be here. I want to share a couple more things about my experience with all of this. I've had 2 doctors now tell me that since I've had trouble with the chest pain/palpitations for 10 years, that it must not be anything too critical. I guess the theory is that if it was critical I'd be dead by now(?!) Also, my current ob/gyn told me that i don't need the blood thinners b/c raised levels of homocysteine is what causes blood clots and folic acid lowers homocysteine, thus getting rid of any clot danger.
I'm definetely getting a lot of help and ideas from all of you ladies..thank you all so very much...

[Celena]

You could start by taking 1 baby asprin starting 1dpo *jic* since you do have a clotting disorder.

It might be a good idea to go to your general practitioner to have him run a a few simple blood tests which can see if you have a higher probability for an autoimmine disorder/disease as well. I'm sorry that I don't have a ton of experience in the MTHFR mutation. My best advice is to see if your OB would refer you out to an RE as well as a hematologist. Or start with a reproductive endocrinologist who knows more about the mutation, can analyze your results then decide whether to refer you out to a blood specialist. RE's can also treat for that as well... but for now a baby asprin a day post ovulation might help prevent m/c due to clotting disorder if you were to get pregnant before getting everything taken care of.

I would definitely question these people, but a regular OB/GYN generally do not have tons of experience with abnormalities outside of their general scope if that makes sense. Like a family doctor treats general things like colds, immunizations, etc... well an ob/gyn does yearlies, b/c, uncomplicated pregnancies obstetric care and so on.

[zkat]

Your OB is ill informed on the MTHfR mutation. You should def. be on super high doses of folic acid to decrease homosystine levels. I am currently on 4 MG a day + prenatal with folic acid + sublingual b complex. I will stay on these doeses until I deliver and then decrease the folic acid to 2 MG. The other point your OB is ill informed on is that slightly long clotting time is 'not a problem'. Estrogen and Progesterone cause your blood to become thicker, so your clotting time will get worse the further you go in your pregnancy. My clot times were not drastic, but my blood is super thick.

I was on depropreva shot for years. My hematologist looked at me and said "God really, really loves you. I don't understand how you didn't have stroke or clot all those years" I can never go back on hormone birth control again.

To answer your question - My OB freely referred me to my endocrinolgist and my hematologist, BUT I am very blessed to live in a large metropolitian area and I have been through my share of terrible doctors over the past decade. I have learned to be vocal and my own advocate. I did not even have to push for the testing. It was ordered after my first loss because my endocrinoligst was looking for Lupus markers.

Even if it requires you to travel into a large city, it is worth it to get into a good hematologist. I would request a copy of your test results and take to your Gen. Practiner and ask if he/she will refer you to a hematogist.

Feel free to PM anytime you need info. I had a lot of these ladies here for me when I was going through this, and it is my turn to pay it forward.

Kat.