After second miscarriage/ stress & miscarriages

[Jenifer__0]

  To give you my background... My husband and I have been trying to get
   pregnant for a year and a half now.  We have been successful twice,
  but both ended in miscarriages at 6 and 8 weeks respectively.  The
  second miscarriage occurred 21 days ago.  I am 29 years old and we
  would like to have 2-4 children.  Other than the two miscarriages,
  I have never been pregnant before.  I have had all of the standard
  blood tests for thyroid, lupus, progesterone, etc. and each test came
  out normal.  My husband and I are in the process of having the
  chromosome(?) blood test.  
  1) From what I have read, testing for recurrent miscarriages
  is not usually performed until the 3rd miscarriage.  Should my
  case be treated differently becuase of my age, the fact that I
  have never had a successful pregnancy and because it takes us
  on average 7 months to get pregnant?  That is, are there any
  other tests that I should consider at this point?
  2) I had 6 days of heavy bleeding/cramping with my current
  miscarriage and the last 15 days have been light to heavy,
  dark brown spotting.  My doctor examined me at about day 12
  of the miscarriage and said that my uterus (cervix?) is closed
  and we can start trying again even before my next period.  
  I read in previous postings that most doctors recommend at
  least one normal cycle before trying again.  Emotionally I
  am ready to try again, but are there any health considerations?  
  Also, should I be getting HCG tests?
  3) What is your opinion on stress as a factor in miscarriages?  
  I have heard different things.  Mostly that it does not effect
  miscarriages.  I can tell though that my cramps got worse or
  spotting occurred when I felt stressed.  Why is this?
Dear Jennifer:
The definition of recurrent miscarriage and the point at which the likelihood of having a successful pregnancy becomes less that for a woman who has never had a miscarriage is 3 pregnancies. Hence, this is the point at which medical studies are recommended. In our "hurry up society", testing is started earlier for all the reasons you set out in your history.
Investigations include hormone measurements, imaging of the uterine cavity for scar or congenital anaomalies, immune tests (women reacting against their own body), cultures or blood tests for infection, and genetic studies.
Following miscarriage, the uterine lining must be shed away, the menstrual cycle must reset to initiate ovulation, and then a new lining capable of supporting a pregnancy is formed. Until the menstrual cycle is re-eastablished, there is not an ovulation to "try again". If once conceives before the first normal menstrual period, there is no point from which to date the pregnancy: hence, the meaning of tests such as ultrasound is confusing. Thus, I have written several times in this forum that one should wait until the first normal menstrual period before attempting pregnancy.
hCG testing shows that the trophoblast (pregnancy associated tissues) have been completely cleared by the body. These levels are followed if there is a specific reason, if bleeding persists, if menstrual periods have not resumed in 2 months.
Stress is difficult to measure. Available information does not support stress as a cause of infertility, miscarriage, pre-term birth. We do not know how "being upset or worried" really works. Most people who report physical effects of stress describe muscle contractions: tension headaches, migraine headaches, difficulty catching one's breath, nausea, cramps, diarrhea, urinary frequency. I presume the uterus can participate in such activity, but the uterus is, like every muscle, continually adjusting its tone and it is unclear that this has any role in miscarriage.
Keywords: recurrent miscarriage
This informatin is provided for education purposes only and is not amedical consultation. If you have specific questions, please contact your physician.

[LUV__ME]

A related discussion, Repeated Miscarraiges was started.