Assisted conception w/ miscarriage?

I have just had my 3rd miscarriage in a row, 6th miscarriage overall. I know I have antiphospholipid syndrome and am treated accordingly but we are still having zero luck, with 18mths TTC. We have other children, so a) I know my body CAN do the whole pregnancy thing if it so chooses and b) its clearly a miracle we have the kids at all.

I just dont know where to from here. Im starting to wonder if its not a chromosomal abnormality or something with either/or both Dh and I. We have a child with special needs.

Is IVF/PGD worth a look? The only Drs up here who know anything at all are the Queensland Fertility Group specialists. Has anyone here had to seek out assisted conception for miscarriage issues?

Thanks.

There was some discussion about this relating to another member with recurrent miscarriage. Sorry i can't be more help, but i think the upshot was that unless the miscarriage was related to a genetic problem with the embryo/baby, then there was nothing to be gained by using AC.
There is however ways which fertility specialists can help after conception with drugs to help you in the early stages after conception.
PGD is very expensive, but if your miscarrying is related to something chromosomal, then that would be the way to skip that hurdle.

Hope someone with more info (i.e. not as vague as me!) can help out.

I'm really sorry about your loss x

I was told after my third that 3 is kind of the magic number, in that once you've hit that, they start doing more tests. You can ask your FS for a chromosome test, which will test your compatability with your husband and also for any genetic abnormalities.

The other thing I've learned - if you have PCOS this is - is that Metformin and Clomid can increase the chances of a successful pregnancy. Obviously you need to be monitored while taking the Clomid, as it can lead to multiples or OHSS, but it might be helpful for you.

That's about the limit of my knowledge, but I hope you get something out of it :hug:

ETA - Just remembered something Rouge told me, about taking an aspirin a day. Apparently it thins the blood and makes it easier for bub to stick....you'd hafta PM her about it though :)

Thanks for the replies!

I took clomid for sticky baby #2 and it seemed to do the trick then. I have been taking asprin daily from before this last miscarriage and was on clexane from +hpt onwards but it didnt help :(

So an FS would atleast be able to rule out chromosomal issues?

Its quite possible I have PCOS. Ive never really been tested for it but on the scan from this miscarriage I noticed a heck of alot of "bubbles" on my ovaries; and I have had a few burst cysts.

Definately think I will head to QFG for some testing and go from there.

Really sorry to hear of your loss Freya :(

It's not a problem that I have but from what I know about Assisted conception, I think it would be really helpful to at least have a chat with a FS. I am assuming you have had some testing but there might be some tests you could undergo to get to the root of the problem.

Good luck, and take care x

Eta: yep, there are a whole barrage of tests for chromosomal issues.

Definitely get tested for PCOS then darl, because the Metformin may be just what you need. It's not a big deal, just a blood test and an ultrasound.

I'm so sorry you've had another loss. I dont know abou then ART side of things.

Have you been tested for MTHFR? It's a genetic condition relating to not being able to methylate folate properly. Some people are non-methylators, some over methylate. They can currently test 2 genes for it (out of over 40). It basically means that some people need activated folate instead of normal folate acid. MTHFR can cause clotting, leading to repeat miscarriage or stillbirth. As folate is not absorbed properly, it can also increase the risk of neural tube defects.

There is also some link to autism, heart problems, increased risk of Down Syndrome and many other things. I know Medicare provides a rebate for testing one of the genes. I don't know about the other gene.

Mthfr dot net is a good place to start research.

Have you had karotyping done? A balanced translocation in either parent can result in repeated miscarriages.

When I saw a specialist in Sydney about the miscarriage issues he did a fair few blood tests (about 16 vials) but Im not entirely sure which ones he did apart from the main clotting disorders (anti-phos, anticardio, Factor IV etc). The Mthfr would definately be one of interest if it hasnt already been done, as Ds2 has autism and people often mistake him for having down syndrome (he has a very flat nasal bone and big brown eyes, I can definately see what they see esp with his autistic traits). No karyotyping as far as Im aware.

Better start writing a list of things to bring up with the FS. Id rather go through all this testing, even if Ive had some done already, before we TTC again than go through another miscarriage.

Freya, some of the tests I had were -

ANA - Anti-Nuclear Antibody, anticardiolipin ab, antithrombin 111, karyotype, lupus anticoagulant, protein C and S, prothrombin gene mutation, factor V leiden/APC resistance, CA125, Thyroid Stimulating Hormone, Prolactin, Progesterone, Oestradiol, Luteinising Hormone, FSH, SHGB, Glucose (fasting), insulin fasting, DHEAS, 17 hysroxyprogesterone, sensitive testosterone.

As I said, I don't have issues with miscarriage, rather failure to conceive (even though my embryos look fine).

I don't think mthfr testing is common in Australia. The genes have only recently been identified. Often they'll test homosycteine (sp) levels, as elevated levels can indicate a mthfr mutation. However, apparently they can be normal and still have a mthfr mutation.

There are also a multitude of individual genes which your could both be carriers for. Unfortunately, unless they know what to look for, they can't often find it. It may be worth having a micro array done. It's a panel of extended chromosomal/genetic tests they do in addition to standard counting the chromosomes (karotyping).

And as my genetic counsellor pointed out, genetic testing isn't 100% accurate. Sometimes they find things, sometimes they don't. Even with standard tests like cystic fibrosis carrier status, they've only identified 12 possible mutations out of how many unknown ones. But it's better than doing nothing and they're discovering new things all the time.

Have you ever had the babies tested after a miscarriage? Sometimes they can find things, depending on gestation and time since death.

Another things is it is apparently possible to develop an immune response to embryos. I don't know what that's called or if they can test for it, but worth asking about.

So so sorry Freya.

I think it was minnie mouse who contemplated IVF for repeated miscarriages. I went through QFG and they were fantastic. If you can, get yourself into Bob Watson, he is amazing!

Freya: firstly :hug: im sorry you are going through another loss, as Maruschke said i have also suffered multiple miscarriages and i think it was me who Lenny was referring to.
i started a thread asking if ivf was a "treatment" for recurrent miscarriage, my short story is i have had 2 children and then had two 9 week miscarriages and also 2 5 week miscarriages, the 9 week ones we had seen a slow heartbeat both times but bub was measuring behind, to me that seemed to indicate poor egg quality.

i have had lots of testing done and nothing came up in my blood tests, we have also had the chromosome testing done with myself and DH and both was fine, the fs have said seeing as though we already have a boy and a girl it would be unlikely to be some genetic problem

i always said there was no way i was doing IVF (both my children were conceived with clomid) and i didn't think i could put us all through it however i decided i wanted this whole experience to be over and i thought ivf could give us the best chance of that, it will settle this one way or the other for us.

so im currently doing an ivf cycle and i will be having egg pick up on thursday so i guess we will see how many fertilised eggs i get then, i don't know if this is the answer for us but i figure them being able to look at the embryos and hopefully choosing the one that seems the strongest might give us the best chance of having a sticky one. PM me if you want :hug:

I had to have hormone assistance due to repeated miscarriages - I'm now on pregnancy #10. I can fall pregnant at the drop of a hat seemingly but just as easily lose them. I'm 41.5 and last year when I had 4 in a row I was worried it was nature's way of telling me my eggs were too old and it was chromosomal anomalies that were causing them so headed off to a FS. I had the dye test as well as an enormous barrage of blood tests.

Given that I don't have trouble with conception they figured I probably didn't have problems with ovulation so I was monitored for the first two weeks with blood tests, an ultrasound at 9DPO to check on follicle growth, given a trigger shot of pregnyl for ovulation. I then had 1500iu pregnyl injections every three days during the TWW. Following my positive BT I continued with 5000 pregnyl injections three times a week, progesterone tablets 2 x 4 times daily and asprin daily. That regime continued until I got to 13 weeks and from that point only the asprin is continuing.

Their suggested plan had been to start with this regime and if no success within four months then to look at IVF. Fortunately I didn't need to go down that road.

I'm really sorry to hear you've had another loss. Having never experienced difficulty with conception I don't understand that particular road, but I do understand the heartbreak of the rollercoaster that is conception, loss and then finding the strength to start over again. Good luck.