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RECURRENT MISCARRAGES ATTEMPTING FERTILITY TREATMENTS
I have a 4 year old son and was able to get pregnant with him the first month I tried. I had some spotting with him if I did heavy exercise. The dr. said I had a placental lake. I started trying to conceive again about a year and a half ago. It took 6 months to become pregnant. I lost it a 6 weeks after I saw the heartbeat. It did not attach well and there was bleeding at the attach site. This was october 2006. I had a miscarrage 2 months ago at just a few weeks. I saw some mucus tissue pass. The doctor has done several lab tests. all which are normal. He suggests clomid and prometrium pills. I am apprehensive about progesterone pills and birth defects. These pregnancys are by the same father. Do you have any suggestions? Does this form of treatment sound like the next step? My doctor is a obgyn.
It is a little difficult to answer you question without knowing exactly what tests have been ordered. Although the past year has been difficult, the good news is that chances of having a normal pregnancy after two miscarriages are very good, in fact > 75% chance that your next pregnancy will result in a live birth.
My usual approach after two miscarriages is to do the following tests: a karyotype (tests chromosomes) of both you and your husband, either an X-ray test called an HSG or a special ultrasound called a saline ultrasound to make sure your uterus is normal, and some tests for certain blood factors that can increase risk of clotting since this seems to be associated with miscarriages.
If these tests all come back normal, after only two losses, I discuss with my patients the following choices:
1) no treatment, since we have not found anything wrong and the chances that the next preganncy will be normal are so good. If all the testing comes back normal, and you already have a 4 year old with the same father, chances are you have just had some unfortunate luck.
2) Progesterone. If using progesterone, the plan is to use urine ovulation predicition kits, have intercourse the day the urine turns positive and then the day after, and add progesterone three days after the urine first turns positive. The idea is that you want to start the progesterone before you get pregnant, but not too soon so that the sperm are able to penetrate cervical mucous to reach the egg. The case for progesterone is that some people have for many years believed that a condition called luteal insufficiency (not enough progesterone) causes recurrent miscarriages. The case against progesterone is that there has never been a well designed scientific study proving that luteal insufficiency exists or causes recurrent miscarriages, and some studies have suggested that progesterone can rarely lead to an abnormality of a baby boy's penis called hypospadias.
My belief and suggestsions are:
1) If all the testing is done and normal, not use supplement
2) If you wish to use progesterone, I believe it is likely to be safe in the vast majority of instances, and won't hurt
3) Unless your periods are regular, I do not think you require clomid
Good luck!
My usual approach after two miscarriages is to do the following tests: a karyotype (tests chromosomes) of both you and your husband, either an X-ray test called an HSG or a special ultrasound called a saline ultrasound to make sure your uterus is normal, and some tests for certain blood factors that can increase risk of clotting since this seems to be associated with miscarriages.
If these tests all come back normal, after only two losses, I discuss with my patients the following choices:
1) no treatment, since we have not found anything wrong and the chances that the next preganncy will be normal are so good. If all the testing comes back normal, and you already have a 4 year old with the same father, chances are you have just had some unfortunate luck.
2) Progesterone. If using progesterone, the plan is to use urine ovulation predicition kits, have intercourse the day the urine turns positive and then the day after, and add progesterone three days after the urine first turns positive. The idea is that you want to start the progesterone before you get pregnant, but not too soon so that the sperm are able to penetrate cervical mucous to reach the egg. The case for progesterone is that some people have for many years believed that a condition called luteal insufficiency (not enough progesterone) causes recurrent miscarriages. The case against progesterone is that there has never been a well designed scientific study proving that luteal insufficiency exists or causes recurrent miscarriages, and some studies have suggested that progesterone can rarely lead to an abnormality of a baby boy's penis called hypospadias.
My belief and suggestsions are:
1) If all the testing is done and normal, not use supplement
2) If you wish to use progesterone, I believe it is likely to be safe in the vast majority of instances, and won't hurt
3) Unless your periods are regular, I do not think you require clomid
Good luck!
One option that you might want to look into is taking levonox during pregnancy....see a hematologist. There is a really good one in Hackensack,NJ...he specializes in this!
I too my self suffered 2 miscarriages, I was tested for everything under the sun and the only thing that was low was my progestrone level. When I became pregnant the 3rd time my dr. prescribed prometrium and I am happy to say I gave birth to a 10lb perfect baby girl. I am know pregnant again and began taking the prometrium as soon as I got a positive test. I am only 5 weeks but so far so good. It was so hard for me to believe that something so small like a lack of a hormone caused me the months of pain that it did. I only have positive things to say a bout the prometrium and like I said I had a completly healthy 10lb baby. So I hope this helps Good Luck with everything. Oh and I took the prometrium until my 16th week. Natalie
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