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Forum: Recurrent Miscarriage and Pregnancy Loss

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  #1  
August 30th, 2011, 09:57 AM
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How many of you did testing to try and find a cause for your repeated losses? Were you ever able to find an answer?

We had two term pregnancies with live babies and now we're in the midst of my 2nd miscarriage in a row. Last time we were told it was probably some fluke genetic abnormality and that it wasn't likely to happen again. But here I am.

After my daughter was born I was tested for the standard blood clotting disorders (she was anemic and there was a clot in the placenta). But there was nothing there. My progesterone was tested early this pregnancy and was good. I had an ultrasound at what should have been 6w6d by LMP but baby was measuring a week behind and had a heartbeat of 103. So development was already slow by that point. Based on measurements from yesterdays ultrasound (11w3d by LMP) the baby probably stopped growing about 1.5-2 weeks after the first ultrasound.

The doctor suggested that we could test for a balanced translocation, as that could explain how we've had healthy pregnancies and two losses. But my understanding is that if that is the case and we want to avoid another loss, we'd have to do IVF, which we really don't have the money for.

I'm frustrated. And heartbroken. Confused.

And after my doctor saying that after two losses in a row we have a 35% chance of this happening again, I don't know if I have the strength to do this again.
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  #2  
August 30th, 2011, 10:38 AM
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I am sorry for your losses. I don't know anything about the testing your Dr wants to do, sorry. I hope one of the ladies is able to help you.
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  #3  
August 30th, 2011, 11:01 AM
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DH and I've had the karyotyping (which is the name of the test your RE wants to do). Neither of us showed an issue on that but then were told that our RE still thinks there's a genetic issue somewhere along the way.
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  #4  
August 30th, 2011, 12:49 PM
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I haven't had any testing done unfortunately. If there was a clot in the placenta, it wouldn't hurt to take a baby aspirin for 2-3 months before trying again. We had early losses and that seemed to be the miracle pill. I couldn't afford testing that is why we didn't test, but I feel strongly that we need to get me tested after this baby is born.
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  #5  
August 30th, 2011, 01:02 PM
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The clot was a chorangioma in my daughter's placenta (one of the successful pregnancies); we've never had any tissue from my losses tested. Supposedly the clot was not large enough to cause issues such as fetal death. These are the tests my doctor ran after my daugther's birth (about a year before my first loss):
CARDIOLIPIN ANTIBODY
MTHFR
PROTEIN S
PROTEIN C
FACTOR V LEIDEN
FACTOR II GENE MUTATION
ANA (SCREEN)
LUPUS ANTICOAGULANT
ANTITHROMBIN III


Everything was normal for those. Would it be worth asking my doctor about taking a baby asprin even though she tested for all of the above already?
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  #6  
August 30th, 2011, 01:44 PM
geogeek's Avatar Marsi's Mommy
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It wouldn't hurt to ask. Is there any other testing that she wants that haven't been done other than the karyotyping? I feel it is every woman's right to find a reason behind losses regardless of if they are going to try to have another child or not.
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  #7  
August 30th, 2011, 03:25 PM
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She said that if I opt for a D&C they can test the tissue to see if there was anything genetically abnormal about that. Right now I'm going to wait. If that doesn't work I'll try cytotec. So I probably wouldn't be able to get the tissue testing.

She did tests for my thyroid and a she said something about diabetes testing (but I didn't have to fast or drink a sugary drink, so she must have just done a simple blood sugar). There were four vials of blood that they took yesterday, but I can't remember what all we were testing for. I should have results from that by end of the week. I had declined the karotyping for now (I figured I'd talk to my husband about that since he'd need to be tested, too). I think it was hemoglobin, thyroid, blood sugar, and antibodies from being Rh-.

I had good progesterone and good betas this last pregnancy. I'm Rh- but I've never tested positive for antibodies from that. I saw a peri doctor during my last loss (he's the one that diagnosed it) and he didn't see any reason in my medical history to be concerned for another loss or another anemic baby (other than an ultrasound he did not do any testing).

Part of me worries that it's folic acid related. With my two healthy pregnancies, I had been carefully taking prenatal vitamins for months before getting pregnant. With my two losses I hadn't been as good at taking them every day while TTC. With all four pregnancies the nausea makes it really hard to continue taking anything. I tried taking my kids' chewable vitamins this time and it let me continue to take something for longer than I typically do, but I still had to stop. Is a folic acid deficiency something that they can do a blood test for?
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  #8  
August 30th, 2011, 04:52 PM
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There is a disorder that is abbreviation MTHFR that is a genetic disorder where you don't absorb folic acid properly. You might want to ask for a test for this. If you have it, they would put you on a folic acid supplement.
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  #9  
August 30th, 2011, 05:36 PM
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Quote:
Originally Posted by geogeek View Post
There is a disorder that is abbreviation MTHFR that is a genetic disorder where you don't absorb folic acid properly. You might want to ask for a test for this. If you have it, they would put you on a folic acid supplement.
That should have been tested for in her clotting panel though. It was included in mine.
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  #10  
August 30th, 2011, 05:43 PM
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Yeah, that was one of the ones that was tested for. But I do remember that the results said that although the specific MTHFR mutation tested for was not present, that there can be other causes of hyperhomocysteinemia. I have no clue what hyperhomocysteinemia is other than it's associated with MTHFR.
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  #11  
August 30th, 2011, 05:51 PM
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I don't know much about that, but you can have your homocystine levels checked. Mine were checked because I have two of the mutations for MTHFR.
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  #12  
August 31st, 2011, 06:29 AM
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Okay, I got the results from the lab work on Monday. She ran:
HEMOGLOBIN A1C (the diabetes test she mentioned)
T4,FREE (thyroid)
TSH (thyroid)
CBC AND DIFFERENTIAL (this is the normal blood panel of white cell count, hemoglobin, etc)
and then the test to make sure I don't have antibodies against Rh+ blood

Everything was normal for that.

I think I may call her and ask about the possibility of a folic acid issue.
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  #13  
August 31st, 2011, 02:07 PM
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good luck sweetie. I've got nothing else to add
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  #14  
September 3rd, 2011, 07:41 AM
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Get a list of specific clotting disorders they tested for. I was tested for just a handful at the OB/GYN's office. The RE included 7 more different proteins to test for. And yes, it was another 7 vials of blood. It was not fun!

We did the genetic testing and translocation testing. No issues. If you do decide to do this testing, chances are your insurance wont cover it and it is EXPENSIVE! Check first!! We figured ours were related to genetics, as DD has a genetic related heart defect. They couldn't identify anything. The RE doesn't think that is our problem.

They also were able to test some tissue (I went to the OB and basically passed the baby in the office) with my 2nd m/c. Everything appeared normal.

I would lean more towards making sure there are not any abnormalities with your uterus or tubes since you carried two children to term. Or with the RH factor. I honestly think our problem is a blood issue (not RH, but actual blood types - very, very rare w/ .08% incl. RPL).
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  #15  
September 3rd, 2011, 07:52 AM
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In post #5 I listed all the clotting tests that were run two years ago.

That's good to know that insurance doesn't usually cover genetic testing--my insurance isn't the best right now (they tried to tell me that the rhogam shot I got with my 1st miscarriage was "non-routine"). We'll probably not do that testing as we wouldn't be able to really do anything about it.

It's not the Rh factor causing problems, as I don't have antibodies for that (I was tested before we knew the baby had passed with my 1st loss and at my appointment last Monday with this loss). I know there are other, more rare blood type interactions. I suppose it could be one of those. And that might even be able to explain my daughter's anemia at birth. I'll ask my doctor about it when I go in for my followup.
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  #16  
September 3rd, 2011, 08:23 AM
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I did a quick search, and what I was thinking of was another type of Rh sensitivity besides what Rhogam protects against. My daughter is Rh negative as well, so that shouldn't be the issue (or at least I didn't develop a sensitivity in her pregnancy and a sensitivity didn't cause her anemia).

My son is Rh+, so I suppose it's possible that I developed this other sensitivity then, it didn't affect my daughter, but maybe these last two babies were Rh+?

The test results just said "antibody screen -- negative", it didn't say if it was only testing for RhD (the most common type of Rh incompatibility) or if it tested for all of them.
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