Infertility vs. Miscarriage

[hellokitty1]

So without getting into much detail, I have MC'd for the third time in three years. I had some non-invasive fertility treatments this year (i.e. non-IVF) but this last pregnancy was all natural. Thew news sucked but by the time you hit three, it begins to seem like the norm.

All four pregnancies occurred with no outside help but only my first one resulted in a textbook pregnancy and birth. So, now I'm beginning to feel like my issue is not infertility but rather the inability to carry a child. In my non-medical brain, these two seem unrelated. So today it hit me,what if I can get pregnant a million times but can't carry the baby. How does infertility support help me in this case? Am I being ignorant? I am not going back to infertility treatments until January when my insurance changes and coverage kicks in. So in the meantime, this is my million dollar question.

Any thoughts?

[lisams]

I'm so sorry you're going through this.

I don't know the details, but I have a friend who was having several m/c and they found out that she wasn't making enough of a hormone (can't remember which hormone it was) to stay pregnant. Once they found out, she started getting hormone injections as soon as she found out she was pregnant and she was able to go full term. So, perhaps a fertility specialist would monitor your hormone levels very early into the pregnancy?

I'm sending tons of positive thoughts your way. I hope things work out very soon for you.

[pb&j]

Being able to get pregnant but not stay pregnant is considered a form of infertility. There are myriad reasons why this might be the case. When you are able (emotionally and financially), your best bet is to seek out a reproductive endocrinologist (RE). An RE can pinpoint the problem (if there is one) and recommend appropriate treatment.

I'm so sorry for your losses.

-Ry,
mom to Max, age 1.5
and my girl in heaven

http://www.windsorpeak.com/dc/user_files/37124.gif

[janeybwild]

Vivian, I am so sorry for your loss. I hope you find the answers you need.

[hez]

What Ry said. Generally speaking, I understand that 3 in a row is the 'magic' number that will spur a doctor to help you discover the cause.

I'm very, very sorry for your losses.

[kep]

Lisa, are you talking about Progesterone? And big hugs to you, Vivian. I don't have any advice or BTDT, but my heart goes out to you.

Kelli

Proud Mommy to Luke (April 2003)
And Joseph (December 2006)
http://i16.photobucket.com/albums/b27/kellip/Pictures/IMG_3229.jpg

[tarabenet]

Vivian, I am so sorry for all you have been through.

To echo Ry, difficulty carrying a pregnancy to term definitely is a form of infertility. That is *not* bad news for you, though. It means that you are not alone in this experience. It also means they have developed tests to help pinpoint causes. There are treatment options.

"Infertility support" may or may not be useful to you, depending on the group you find. But infertility treatment? Very likely to have answers for you. Low progesterone is one very likely culprit, and can be pretty easily supplemented. (Not exactly fun, but far from impossible.)

When you are ready to try again, know that you have every reason to be positive and hopeful about your chances of growing your family. Every reason!

Benet

[Radosti]

After 2 miscarriages, I cornered my doctor and asked for progesterone. I was on it for my DS as well. I don't make it, or not enough to sustain a viable pregnancy early on. So, the point is to test as early as possible (I tested 5 days early because I miscarried at 3.5 weeks both times), and immediately get on progesterone. Then stay on it for the first trimester. So far, it worked beautifully... same as it did with DS. Good luck. I hope this helps.

[SASM]

Vivian,

I am so sorry to hear of your news. HUGE hugs to you. I cannot offer any advice other than asking if you've tried Prometrium (synthetic progesterone). I am sure that you've probably already gone that route but I am sooooo certain that is why I have DD1 and DD2. I had m/c's before and after DS. After M/C #2, I met with a CNM and she thought that I should just try Prometrium. I had two DC's while on it and, for me, it is a miracle "drug". HTH.

HUGE HUGE (((((hugs))))) to you. Good luck. If you have any ?s feel free to email me.

ETA: You've probably already had this explored as well since you've had seen someone re: infertility but my girlfriend has antiphospholipid antibody ~ from what I understand, her body attacks the fetal tissue and/or clots form as well. Anyway...she probably had at least 6 m/c's before this was diagnosed ~ now she is super fertile and blessed with a large family. :) She injects heparin and takes something else as well.

Sorry...I am normally very good with details, and I normally know her treatment, etc, but I am exhausted. This is the sign to sign off.

ETA #2: I was going to copy and paste part of my response to this thread b/c I thought that it might help you cope BUT here is the thread. The entire thread might help you. HUGS! http://www.windsorpeak.com/dc/dcboard.php?az=show_topic&forum=37&topic_id=449291&mesg_id=449291&page=3

[lisams]

Yes, that's it, she had to get progesterone injections for like the first trimester. I couldn't remember which one it was - it's just too late for my brain!

[o_mom]

Infertiilty specialists (reproductive endocrinologists) look at both problems conceiving and problems carrying a pregnancy to term. They are absolutely the right specialist to help with this. As others said, progesterone supplementation is one very common treatment, but certainly not the only one.

[Pennylane]

I went through 3 miscarriages before my ob did blood work on me to look for the problem. It ended up being something that 10 days of medicine cleared up. I can't remember what they called it but after doing that, I was pregnant 2 months later. It really made me mad that they did not run those simple tests after the first mc.

Ann

[brittone2]

ITA w/ the others. If you aren't seeing an RE, get to one and get some answers. You might even want to get more than one opinion.

I also agree there are many potential causes...and many of those causes have treatments, which is the good news.

I think after 3 m/c it isn't unreasonable to have them do genetic testing on the tissue, etc. I believe the 3rd is when they begin to look into that more extensively.

[alexsmommy]

So sorry for your multiple losses - not a club I want anyone to join. I only have a minute and didn't read the other responses, but multiple miscarriages is considered a form of infertility and an RE will treat this as well as the inability to become pregnant. You need to have a full work up including an HSG to make sure there are no structural issues in your uterus (ie a partial septum which may not have bothered you in your first pregnancy b/c implantation was on the walls, not the septum. Often implantation on the septum results in loss due to not enough lining/blood flow.) You also need bloodwork to check hormone levels (day three or five of your cycle). It could be many things, you could have a clotting issue causing tiny clots to form in the umbilical cord. There are several forms of this, ANA, Anticardiolipin, Factor V Leiden, MTHFR etc. It could be an egg issue, where some of your eggs are aging faster than your chrological age and you may need genetic testing or possibly IVF to do pre-implantation testing to only implant healthy embryos. In other words, there may be a clear, treatable reason which could lead to progesterone or anticoagulant therapy to help or more traditional "infertility" treatments to help you sustain a pregnancy. I'm so sorry you are going through this, but I would call and schedule an appt with an infertility dr. for January so you can begin bloodwork on the first day of your first cycle of the new year. Best of luck.
Alaina
Alex Feb '03
Zachary July '07

[alexsmommy]

Sorry

[annasmom]

I am so sorry for your loss. It does really suck.

In my non-medical mind infertility and miscarriage or the general inability to carry a child are different, BUT, the doctors who treat these different problems can be the same, if that makes any sense.

Without going into too much detail, I had a problem that resulted in a very high mc rate (80-90%), and inability to carry to term. When I was finally diagnosed (correctly), I was referred to an resproductive endocrynologyst (sp?) at a "fertility clinic." I had to call twice before they actually gave me an appointment, they just couldn't get passed the fact that I had already given birth. But that is excactly where I belonged. The same doctors who were helping hundreds of women get pregnant, also helped me stay pregnant.

If I were you, I would contact your doctor to get more info. Good luck! And lots of peace and healing vibes!!

ETA: I just wanted to add, and this is really important and kind of echoes what the PP have said - I would go to an RE. I was misdiagnosed by my OB, a very capable doctor. An RE is very specialized and will perform the correct tests. I went through several tests that were a complete waste of time because the people performing the tests had NO idea what to look for.

[NancyJ_redo]

Vivian - check your email.

[JenaW]

I am so sorry for your losses. I have had more miscarriages than I care to number. You are right...after a while you just get numb to them. I am probably the person SASM is referring to. After several losses in a row, I FINALLY got referred to an RE and got all of the testing done. Like the others mentioned, I think this should be your first step. RE's are very well versed in ALL forms of infertility, including recurrent pregnancy loss (which IS a form of infertility). There are many reasons why you could get pregnant but not carry to term. Nearly ALL of these can be managed medically. My RE did not think anything would come back on my tests, but I was found to have a positive Anti-nuclear antibody (ANA) - often associated with Lupus, and positive anticardiolipin antibodies (aCL). Those, with my history of multiple losses and a funky platelet count and clotting times gave me the dx of Antiphospholipid Syndrome. Once we got the 'reason' figured out, my RE developed a plan. I take heperin injections (twice daily) as soon as I get a positive HPT. THis continues through the pregnancy, up until 24 hours before I am induced, then resumes 12 hours after delivery for 6 weeks. I take baby aspirin every night (pregnant or not). I also used prometrium while pregnant the first 3 times. (I took progesterone injections during my last pregnancy because the one before it was extremely preterm). It seems to be working, because I have had 4 kids in 3 1/2 years!

My best advice is to get a proactive OB or get a referral. Most OBs SHOULD know what tests to order, but I personally think you are still better off with an RE. They tend to be more aggressive with treatment, as they see more patients with these issues. Feel free to PM me if you hvae any questions. I am an OBGYN Physician Assistant (in my pre-child life), so I have some medical background, and I have done a TON of reading and research on recurrent pregnancy loss.

~Jera

Mom to C ~ 05.13.03
M ~ 09.28.04
N ~ 09.17.05 (born at 25 weeks!!)
A ~ 11.03.06

[aidansmommy]

I'm really sorry for your losses. My story sounds similar to yours so I'll share my experience with you. My first pregnancy ended in a 20 wk loss. Second pregnancy was normal and ds was born. We began trying again for our second baby when he was about 1 year old. We got pregnant two more times, both ended in early miscarriages around 7 and 9 weeks. At this point my doctor knows that after 3 losses I'm beginning to become discouraged and I felt like I'd try once more and if that failed I may call it quits and be happy with my family of 3. So he ran some infertility tests on me, even though technically I was always getting pregnant very quickly but not carrying them to term. Some simple tests showed that I had a blood clotting disorder that for unknown reasons was not a factor in my first two pregnancies but now likely caused my 2 early miscarriages. Thankfully my doctor did the testing because had I not been treated I likely would have miscarried once again. Instead I was put on lovenox injections after I got pregnant with dd and the pregnancy and delivery were normal and healthy. So even though you're getting pregnant there are certainly things that can be done to help you carry your pregnancy to term. I know it's a tough road and I hope you find answers to why your having these losses.


Heidi
Mommy to Aidan 11/03 and Amelia 12/06

[hellokitty1]

Wow. I was somewhat hesitant to post about this initally for fear of being told I needed to go to an Infertility board. But I am so glad I did. I certainly feel less alone in this.

Some more background on what I have done...my first MC was deemed a partial molar pregnancy so since this cause was determinable, it wasn't deemed a "mystery" MC. This information was deemed through a D&C. When I got pregnant the next time, I called the doc early on to see if I should come in early based on the previous MC. He did an US and had a progesterone test done. The numbers were low so he prescribed prometrium taken via mouth. I went in a week or so later I learned I had MC'd again. I had a D&C again and the doc performed some tests including chromosome testing. They were negative but progesterone was noted as low. Although I had only had 2 MC and one was technically diagnosed, my doc recommended I go to an RE.

After trying to get pregnant again and it seemingly taking longer than usual, I went to see an RE earlier this year. He thought my case was simple based on my background. In hindsight he probably wondered why the heck I was there so he recommended somewhat basic treatment and seemed to think this was all I'd need.

First I just took Femara (which is like Clomid, I believe), did the wild thing on the prescribed days and then took prometrium (but this time not orally). I did this for about four months and it did not work. We did some additional testing include an HSG and DH took his test and his swimmers passed with flying colors.

I then did two months of gonadotrophins - giving shots to produce more eggs and then a final shot to drop them at the right time. Although I produced multiple eggs, both times, only one egg was at the right size so I don't think I got much out of that. At that point, the doc recommended that further testing or IVF be next.

I had been paying for everything out of pocket bc my insurance did not cover infertility. I am changing insurance as of January so this is why I'm not starting back up with the RE until then. In the meantime, DH and I just decided to relax and stop living off the calendar. Of course I still counted and magically, I got pregnant. On my own, I started taking my prometrium and called my regular OB. I did not think to call the RE since he had nothing to do with it. In hindsight, I regret that. I told them I was taking prometrium as a suppository and the nurse actually called me back to question if I was sure I was taking prometrium bc the doctor said you can only take that orally. WTH! I know OBs aren't specialists but seriously, you did not know you could take it any other way than orally??? I told her I was staring at the bottle. Then she called me back later to say the dr stood coerected and that I should continue to take it and come in for porgesterone test. She told me it was "almost normal" and to keep taking progesterone. On my first vist at 7 weeks, they said I needed to come back in a week and that the sac was not the size it should be but my 35 day cycle may be the cause. When I went in the following week, they said there was nothing developing in the sac and confirmed a MC. I chose a D&C again thinking that I could find answers that way. I go tomorrow for my follow-up and to see if anything is uncovered.

I am armed with a lot more questions this time, especially after reading all of your wonderful posts. I feel better now that I have reassurance that my RE can still help me.

Thanks again everyone for well wishes and sharing your story. It gives me some hope that I was in desperate need of.

[pastrygirl]

I'm so sorry for your losses... I know you didn't specifically ask about this, but I found this website really, really helpful after my loss. I haven't read it in a while, but there are women with multiple losses. (It's not all about misdiagnoses, but about everything regarding m/c -- some are the lucky few to have been misdiagnosed.)

http://www.misdiagnosedmiscarriage.com/

Cristina
mom to Toby, 6/10/06

[jk3]

I'm so sorry for your losses. It is not easy. I would recommend getting a few opinions from different RE's. Doing so made all of the difference for my family.

Jenn
DS 6/03
DS 5/07

[wolverine2]

So sorry for your losses, and hope that you do get some answers.

I had 2 miscarriages last year, and went to an RE who had a whole series of tests specifically for recurrent losses, which involved a series of blood tests looking for clotting disorders, etc, as well as some other procedures. There was never any reason found, and my RE didn't feel comfortable prescribing progesterone without any indication for it, so we just tried again, knowing that we at least had ruled out a lot of things. Thankfully, I'm now pregnant and due in a month, and for some reason this one was fine. (As was pregnancy #1).

resolve.org has a fact sheet about multiple miscarriages I found helpful, and it helped me know what questions to ask. If you haven't had all of the testing specifically related to pregnancy loss, it seems like you should!

[MelissaTC]

Vivian-

If you are still in the area, PM me and I can recommend a fabulous RE.

Wishing all the best.