multiple miscarriages - baby aspirin

[michkatz]

Hi All,

I am about to miscarry for the second time in 2 years.

History: I have a beautiful daughter who will be four this June. I got pg with her right away and basically a perfect pregnancy.

2 + years later we try again and can't seem to get it right, it takes a few months. Finally, after learning all I could from this site and the taking charge of your fertility book, we get pg. Unfortunately, it doesn't make it past 6 weeks.

We take some time off.. try again.. It takes about 6 months and I am pg.

I had implantation bleeding while suffering through a fever, taking antibotics and too much tylenol. I had a serious flu/respiratory infection.

I had high hopes for this one since it clung on through all that! But we're at the 6 week mark and its not looking good.

My questions are: multiple miscarriages.. what do they mean? especially after a sucessful easy pregnancy? ( I am now 38 going on 39 in a few months but could it be just age?)

I did a blood test and all looked basically normal. Even did an ultrasound.. looked good (before latest pg)

And I see lots of people mention baby aspirin. What does that do?

I used to have a fabulous OB in the states but am now in England awaiting word from NHS about getting fertility counseling.. but it doesn't seem to be getting pg that's the problem, does it?

Thanks for any advice

[Macabe]

Oh my, I'm really sorry about your losses. I'm not quite sure where to begin with this post. First off, 2 miscarriages is not really considered out of the realm of "normal." What I mean is, something like a quarter or a third of all pregnancies end in miscarriage, so having two m/c doesn't necessarily mean there's anything wrong with you. In my case, my midwife wouldn't even consider additional testing until I had 3 m/c in a row. At that point, she sent me to a reproductive endocrinologist, which I understand you're trying to get in to see. However, I do think an OB could perform many of the tests you can get throuh the RE, but you might have to ask.

My point is, there may not really be anything "wrong" with you, and your next pg might be completely healthy.

I think the basis of the "baby asprin" thing is that there are some people with clotting factors, and the clotting factor increases the chance of miscarriage (while allowing for a healthy baby, sometimes). There's someone on the board who has this condition who might chime in at some point.

OTOH A university near me is currently doing a research study on women who have had 2 miscarriages and whether a baby asprin a day would help them carry to term. I know because a few people mentioned it to me, not realizing I'd already had 3 (or 4) m/c. So I didn't qualify for the study. But they're not limiting the study to women with the clotting issue, so I guess there's a theory that it could help other women, as well. I'm not sure.

I think an OB could order the test for Factor V (five) clotting issues. It's a blood test, IIRC.

It's so frustrating after you've had a successful pregnancy--I had most of my miscarriages after my son, Gabe, was born. Right now we're going on the working theory that I had very low progesterone. I was tested during one of my pregnancies and it was 5.5, which is extremely low for a pregnancy. But I was already on my way to a miscarriage for that pg, so I don't know if the low progesterone was a result or a cause of the m/c. I got pg again a few months later, and I started on progesterone supplements right away.

I think an OB could order the test for progesterone too--it's just a blood test that's done at 7DPO or CD21. An OB could prescribe the progesterone, if necessary, too.

There are also some STDs that can have an affect--chlamyidia in particular, I think, so I had my midwife check for that even though I've been happily married for many years. I figured it couldn't hurt to have one more check.

But it's still very possible after 2 m/c that it's just a fluke, and your next pg will be fine and healthy. I know how hard it is to go through this. :hug:

[kohlby]

Hi. I'm sorry for your loss. I recently had my second miscarriage over a course of only 5 months. I've had five miscarriages total and have two kids mixed in there. My pattern is mc, mc, DS, mc, DD, mc, mc. I requested testing after my 4th miscarriage. Due to having healthy babies, my OB didn't really think I needed it but she listens to me so she did it. I did end up as heterogenous for factor V lieden. However, due to my healthy babies, neither my OB, nor my RE (reproductive endocrinologist), nor my RE's panal of specialists think that FVL caused my losses. I'm not on heparin/lovenox since no one thinks it caused my miscarriages. But, I am on a baby aspirin a day as a "just in case" measure. Baby aspirin works differently than lovenox/heparin. So, it's not a cure all if someone's clotting disorder is causing miscarriages. There are other clotting disorders out there too. I *think* the treatment for one is baby aspirin and extra folate, but someone can correct me if I'm wrong.

I then requested to see a specialist, who did all sorts of testing. I had read that if they're going to find a reason for a miscarriage that they find it almost as often after 2 losses than after 3. So, it is something that you may want to look into. I found going to the RE for all the testing stressful. I think part of me still didn't think I needed it. It was found that I have insulin resistance, which means I'm on a diabetic diet for the rest of my life. When I got pg, I saw the RE for weekly ultrasounds,starting at 5 weeks. I miscarried again at 8 weeks- after seeing the heartbeat for two weeks in a row. They're supposed to have the results of testing on the fetus by now so I'm anxiously awaiting the results.

My OB puts me on vaginal progesterone suppositories when I get pg as a just in case. The RE does the same. All testing has shown my progesterone fine. However, it's a "just in case." I was on progesterone for the last pg, as well as the two that did make it.

Depending on the results of the latest miscarriage, I may be requesting metformin to help with the insulin resistance. My RE also mentioned that clomid sometimes reduces the miscarriage rate too, but she's hesistant to put me on it while bf. (I've been pg 7 times and it's never taken me more than 4 months. So, it's not to help me get pg!) I still need to talk to my RE to see if anything is going to be done differently this time.

Age can be a factor. But that doesn't mean that it doesn't hurt to get checked out. I'd ask about doing some basic testing and then deciding if you want to go through more - and if so, then get referred to a specialist. Some women find the testing helpful and calming - but note that a reason is only found in 40% of cases so you may not find answers. I found the testing stressful and annoying. However, now that I've had yet another loss, I'm glad I went through all that testing.

[amyamy1973]

I'm so sorry for your losses. I just wanted you to know that my story is so similar to yours. I had a beautiful healthy daughter after an uneventful pregnancy in 2004. And then two miscarraiges in row, both at 7 weeks. When I saw the bleeding the second time I thought "what is wrong with me?" But blighted ovums, which is what I had, are really common. It seems terrible twice in a row but it didn't mean that I wouldn't be able to have another baby.

Also, are you saying that at six weeks it's not looking good because you're bleeding again? I ask because with my last pregnancy, my fourth, I had bleeding at 6 weeks and just assumed I was losing the pregnancy again. But when I went in for an ultrasound we had one healthy fetus and had lost his twin. My son was born perfect and healthy in February.

Again, so sorry for your losses but don't lose hope.

----Amy
Mom to Phoebe, Simon and three angel babies.

[michkatz]

Hi all,

Just wanted to update. I went in for an ultrasound and there was tiny bean with a heartbeat. I didn't have any more spotting after that for about a week and half. Today, I got some more but I am not rushing to any conclusions, just trying to be positive. I am almost at 8 weeks.. hoping to reach that magical 12 weeks where the risk drops.

THanks for all your replies.

[amyamy1973]

Congratulations! I've heard that once you see a heartbeat you have more than a 95% chance of staying pregnant. I'm so happy for you. Do update us again in a few weeks.