miscarriages/dr question
3 Replies
Karen P - April 25

I am a 32 yo with a 3 year old daughter conceived naturally and quickly, carried with an uncomplicated pregnancy, and delivered quite easily, vaginally. My husband & I tried for a year to get pregnant w/ #2 w/o success. We had a natural cycle IUI and miscarried at 5-6 weeks, 3 unsuccessful drug cycles with IUI, an unsuccessful fresh IVF cycle (5 eggs retrieved, 4 fertilized, 2 transferred on day 3 and 1 frozen), a frozen cycle (with the 1 frozen one) and miscarried at 9 weeks (genetic abnormality dx by D&C), a natural cycle IUI and miscarried before 5 weeks, and just completed a successful IVF cycle (25 eggs retrieved, 8 fertilized, 3 embryos transfered on day 3, and 2 frozen), with a "questionable looking embryo" - irregular sac and no clear ring around it on US yesterday. My betas were 140, 350, 677, and 4600 with some intermittent spotting. With my history, my pessimism is overwhelming, so I assume I will not get good news tomorrow at my next visit. My RE says that eventhough I am 32, I have an abnormally large number of genetically abnormal eggs and I just can't believe this. Could there be any other explaination for these miscarriages (I had the recurrent miscarriage lab work up which was negative and a endocrine work up and have been on synthroid 50 mcg for a while now with a TSH of 2.11).........is there something we are missing??? I sure hope so. Thanks.

 

Dr Smith - April 25

From what you've posted, I tend to agree with your doctor that, for your age, you have an abnormally high number of genetically abnormal eggs. If this cycle ends in miscarriage, you could consider IVF with pre-implantation genetic diagnosis to identify genetically "normal" embryos for transfer.

Did the recurrent miscarriage workup include immune and clotting testing?

 

Karen P - April 25

I'm sure the work up included clotting testing but I'm not sure about immune testing - there was a whole long list of tests that I didn't really research. I guess I'll just have to swallow the fact that my eggs are botched...We were going to do PGD with the 2nd trial at IVF but my RE said he didn't think there would be enough embryos - I only had 3-4 the first time. But, with the change in meds, I had 8. I'm not sure if that is even enough, but it was too late to plan for the PGD - apparently that needs to be done in advance. And, it's $5,000. Probably worth it to prevent these roller coaster pregnancies. I just find it so hard to believe the botched egg theory since I got pregnant 3 1/2 years ago so easily and I find it hard to believe the 6 eggs that were retrieved and fertilized in my IVF cycles are all bad (not to mention the 2 IUI cycle eggs that I miscarried too). What are the chances that all my eggs are bad? Should we just give up? Thanks.

 

Dr Smith - April 27

It is unlikely that [i]all[/i] your eggs are "bad". However, it may take several cycles to obtain a "good" one. I would recommend the PGD, even if there are only a few embryos to head off the roller coaster pregnancies. Also, look into the immune testing. For more information about the immune testing see www.repromedix.com

Best of luck.

 

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