Repeat Miscarriage

Posted by Juno on June 01, 2011



In the last five years I had multiple miscarriages.  After each one my obstetricians would just tell me “keep trying.” So I did, with considerable heartbreak and failure.
You have to understand, miscarriage was not part of my family history. It wasn't supposed to be my baby story. My mother has five children. My two oldest sisters each had three children in five years and warned me over the years: Beware. We are a fertile bunch...or so I believed.

So at 33 years old, when my first miscarriage occurred at about 6 weeks, I was shocked. But... I grew up a little bit. I absorbed and accepted the statistics that one in four pregnancies will end this way. And after the recommended wait, I tried to get pregnant again. Roughly two months later, I got pregnant again but at eight weeks, I lost pregnancy number two. This one required medical intervention, a D+C, and so it felt like more of a loss than the first.  But a few months later, the third time was the charm; I had a successful pregnancy and gave birth to my son in 2006.

A few years after our son was born, we wanted to give him a sister or brother. But I miscarried several more times. Most of these pregnancies were thankfully very brief, all within the first trimester. But not the last one:  it was the most emotionally painful because it occurred after four months of pregnancy. I had gotten to know that baby in my sonograms. She was doing very well, had a strong heartbeat.  And then she was gone.

I went in for an amnio but during the exam leading up to the procedure, an ultrasound revealed that the baby had no heartbeat. Without going into any disturbing details, suffice it to say that I had to have another D+C, which was even more traumatic than the last one.  After that episode my gynecological team told me: "Miscarriage is usually just bad luck." In other words, keep trying…but I was too traumatized to move forward. I needed time to absorb my situation.

Over the next few months I got lots of advice and support from friends, friends of friends, and family -- everyone seemed to think it was time to see a specialist. And so I booked the appointment with a fertility clinic. It was a tough hurdle -- I didn’t want to acknowledge any maternal medical issues on my end. I wanted to be relaxed and stay positive, but it was the best decision I ever made.
After a month of pinpricks and prodding, the doctors discovered that I had two very common and very treatable blood-clotting issues.

The first MTHFR or "Thrombosis" is a gene mutation that was preventing me from metabolizing folic acid efficiently.
The second issue, known as PAI, was attacking my placenta and triggering early miscarriages.

30% of pregnancies, I was told, can survive all this. I guess that's how I was blessed with my firstborn.  In a nutshell, nutrients had a hard time reaching the baby because my blood would coagulate. My new doctors also found a cyst in my ovary and polyps in my uterus, and when they removed those they learned that I had extensive endometriosis.

If I wanted a second child the solution was a host of medications:  two blood thinners, one called Lovenox (40 mgs) that I injected myself with daily for 9 months and a pill called Metformin, commonly given to diabetics. In addition, I took a daily baby aspirin and daily Metanx ...extra folic acid.  Eight months later I was pregnant again.  This time I took progesterone suppositories for the first trimester. One year and five months later, thanks to the demanding regimen of medications, I have a beautiful baby boy.

So I urge you, if you suspect a problem, go to a specialist. Don't make my mistake of waiting until you've had multiple miscarriages. Obstetricians generally won’t refer you to a high-risk specialist until you have had three miscarriages! That is too long to wait. If I had sought the advice of a high-risk fertility team sooner, I might have had the little girl I lost or a larger family. The "what ifs" haunt me. So pick up the phone and call a specialist if you can. Take control of your own baby story.