# Second miscarriage in a row-now what?



## MisaGoat (Jul 10, 2006)

I just found out that I have an empty gestational sac at what was supposed to be 11 weeks. My progesterone and HCG levels were fine earlier. I am healthy, young, no family history, no indications at all that I should have trouble having another baby.

I had a miscarriage in July also at 11 weeks. There was a heartbeat at 9 weeks and at 11 weeks I started bleeding. There was no heartbeat and it looked like it had stopped growing about 2 weeks prior to the bleeding.

I had my son in September 2006. I had a completely healthy pregnancy, no complications, everything was normal.

Now what?
1) What do I do about an empty sac? I will get HCG results tomorrow and my midwife is getting the full radiology report later today. She will call me later this afternoon.

2) What do I do for the future? I could accept that miscarriages happen sometimes and we don't know why as the explanation for the first miscarriage. Now that I have had two in a row I really need some sort of explanation. What should I ask? Is there testing I should do? What next? My hormone levels were fine. I didn't have low progesterone.

I am just frustrated, angry, sad and disappointed. Thanks for reading this.


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## shantiani (May 9, 2008)

Ugh. I'm so sorry. It really sucks, doesn't it?
Like you, I was able to explain the first one away with bad luck... and even the second because it was very early... but when a third one happened my whole world turned upside down as I realized that is too much for coincidence.

So far, I've had blood drawn (no results yet, it feels like it's taking FOREVER). There are a few things they test for like hypothyroid, some immunological clotting issues, physical abnormalities of the uterus, and I'm sure I'm forgetting a few others. My doc said that the most helpful information in tracking down a root cause comes from testing tissue samples of the fetus. Did you have a D&C (they often(?)/always(?) save samples) or did you m/c naturally? (I m/c naturally all 3 times, which I preferred but now I wish I had saved the fetus for testing so I could just KNOW if it was random chromosomal errors or not.)

Statistically they find a cause for about 50% of recurrent miscarriages and the other 50% they just don't know. The good news is, the ones they can diagnose are often treatable, and in the idiopathic cases (unknown cause) women go on to have healthy pregnancies with almost the same success rate as if they'd never had the m/c (the chance of m/c goes up about 4% with each subsequent one, according to one rather large study, which I can send you if you want).

There is also a camp that believes the cases which are not chromosomal but have unknown causes are due to subtler lifestyle/health effects such as stress and diet. In my own case, I'd have to agree that the stress of grad school was effecting me physically.

I know all of the information in the world doesn't make it easier. It's a pretty helpless feeling, and I'm very sorry you're having to experience it now. Good luck!


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## catballou24 (Mar 18, 2003)

we just went through our second in sept. at almost 12 weeks. the first was in april at 8 weeks. i know how you feel in regards to why. i have 3 healthy kids, had healthy pregnancies with all of them, normal births. nothing out of the ordinary. this time i can't seem to hold onto a baby..







i think it's my age to be honest. i'm 43. but there are many people in their 40's who have perfectly healthy pregnancies. all my bloodwork came back normal with me being super healthy. af is normal as well. so i am stumped...

i hope you can find out and/or have another healthy pregnancy soon! i'm very sorry for your loss...


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## Prism (Apr 28, 2008)

I don't know either, but I've had two in a row as well. the first m/c was at 13weeks, the second only 4 months later I spotted at 8wks and found out I had two empty sacs but didn't miscarry until again at 13weeks. I agree with you that two in a row doesn't feel coincidental anymore.

I am healthy, have 2 healthy kids and pg's with them, nothing adds up. I also "did everything right" the 2nd pregnancy and still miscarried.
I don't have any answers but just wanted to send hugs and tell you that youre not alone in this.
And it really does suck.


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## usmcwfe (Aug 17, 2006)

I been there too. I had a healthy baby, normal delivery, normal pregnancy. Then I had two mc's. Then I had another normal pregnancy and delivery. And then I lost another at 14wks. We were not able to do chromosome testing because this last one was amissed mc and they said that bc the cells were no longer dividing that they were unable to look at the chromosomes. So, we have NO clue happened. They want to test my blood for clotting issues but my dr is very sceptical that I have issues like that. These mc's are just so strange, especially when you are able to carry and deliver a baby.
We've examined our diet, lifestyle and we can't find much that would cause this. I hope you can find some answers and peace. Its frustrating to not know why this keeps happening.


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## MisaGoat (Jul 10, 2006)

I don't really know why this happened. I can't find any risk factor that would make sense. I'll probably get some blood work done to rule out thyroid issues and I guess look at clotting issues. I was diagnosed with hypothyroid about 10 years ago but I am not sure it was an accurate diagnosis since I was only on medication for about 6 months and my blood work came back good even after I stopped the medication and I haven't had any symptoms. I've never been told that my uterus was abnormal but I could ask about it. I am still waiting to hear from my midwife. I will probably call soon to check in.

I started bleeding like a period today and have some cramps. I had a little bit of brown spotting on Friday and Saturday but none on Sunday. I had more spotting yesterday after the trans-vaginal ultrasound and some this morning but it has picked up now and is like a period.

What does a miscarriage of a blighted ovum/empty gestational sac/anembryonic pregnancy look like? A heavy period? There won't really be much to pass like my previous miscarriage right?

Thank you for your support and ideas. It really helps to try to work it out in my head. Strangely I don't feel as upset today. I am not really pregnant but in away I never really was. The egg was fertilized but never grew. I think also I was pretty apprehensive about this pregnancy since I had a miscarriage last time. I was waiting to see the heartbeat to get attached and to get past the miscarriage milestone.

I think I may wait a couple months before trying again. I've been pregnant/miscarrying/recovering/ttc and repeating that since May. I need a break. I have to live in the life I have and not in the future or the past. I have a lot of other things going on now that will be easier not being pregnant. I am sad that my son will be at least 3 years older than his younger brother or sister. I always wanted to have my children close together.

Thanks again for reading and replying. Let me know what testing you would recommend or diet/lifestyle changes before I ttc again (I am thinking maybe in the spring I would try again).


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## shantiani (May 9, 2008)

Apparently eating a lot of fruits and vegetables is a biggie- of course we all already know that!- but this study says it decreases m/c risk by half. That's pretty significant. It also mentions white meat, fish, dairy, vitamins and chocolate as beneficial factors.
http://www.dailymail.co.uk/news/arti...iage-risk.html

I've also read that it's best to start eating really well before TTC. I've never heard an explanation, but I suppose if these foods are repairing our immune systems or something, it takes time to reach peak performance.

Alot of studies site stress as a big lifestyle factor (but that might be more about cortisol released during pregnancy, not so much in preparation for ttc).

There are a bunch of books out there on diet and miscarriage but I haven't read any so I wouldn't know which ones to recommend. This one keeps coming up on my searches though...
http://www.amazon.com/Infertility-Di.../dp/1893290395

Let me know if you do read any good ones! I'm not exactly waiting to ttc but I am trying to be very mindful of my lifestyle during the whole process now, not just post bfp.

Good luck!


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## no5no5 (Feb 4, 2008)

Quote:


Originally Posted by *MisaGoat* 
I'll probably get some blood work done to rule out thyroid issues and I guess look at clotting issues. I was diagnosed with hypothyroid about 10 years ago but I am not sure it was an accurate diagnosis since I was only on medication for about 6 months and my blood work came back good even after I stopped the medication and I haven't had any symptoms.

I just want to address this thyroid issue. After being diagnosed a few months ago with autoimmune thyroiditis (Hashimoto's), I have learned a lot of things that it seems many doctors don't even realize. If you were diagnosed with hypothyroidism, it probably means you had a high TSH level at one point. With Hashi's (what I have), your TSH levels fluctuate, sometimes a lot. So that could explain why your TSH went back down without treatment. If I were you I would absolutely insist on testing BOTH of your thyroid antibody levels. If you do have autoimmune thyroiditis (or even if it's just subclinical hypothyroidism), that can absolutely cause miscarriage and/or infertility. I mentioned subclinical hypothyroidism, which is when your TSH levels are only very slightly high. Some doctors may not be aware that the levels of TSH that are considered "normal" have been lowered. And TSH in pregnancy should be a lot lower than when you are not pregnant. Some women find that they need thyroid meds during pregnancy but not otherwise.

So...probably way more info than you wanted, but there it is. Definitely get your TSH & antibodies tested, and even if they are in the "normal" range but at the high end of the range, retest in early pregnancy (and then monthly if there ends up being a problem). Basically as soon as you get your BFP. I did not do that with this pregnancy, and did not get my meds increased until about 6 1/2 weeks, which may have been too late. I will definitely do it next time (if there is a next time).


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## MisaGoat (Jul 10, 2006)

Thanks for the links on diet. I eat fairly healthy but there is always room to improve.

Hashimoto's is something I will definitely look into. I will discuss it at my next appointment. I always thought it was weird that I was diagnosed with hypothyroidism that seemed to resolve itself. The diagnosis was made by blood work so it was based on a number and guideline. Every time I've had my thyroid checked since then it has been normal. The last time I had it checked was probably about 5 years. I have been feeling tired, depressed, have dry skin and dry hair. All symptoms I attributed to other things. I thought I was just tired because I was pregnant and depressed because I was tired and felt bad about being lazy and also just waiting for time to pass and things to change. Dry skin/hair I thought that was just me. Thanks for posting this information.

I think I just need something to do. It is difficult to have a miscarriage because you can't really control anything. I can control my diet and rule out all preventable causes. I need something that I can do, rather than to sit back and relinquish control. Does that make sense?


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## no5no5 (Feb 4, 2008)

Quote:


Originally Posted by *MisaGoat* 
I think I just need something to do. It is difficult to have a miscarriage because you can't really control anything. I can control my diet and rule out all preventable causes. I need something that I can do, rather than to sit back and relinquish control. Does that make sense?

That makes perfect sense to me. I definitely felt that way after a year of IF, and I can't tell you how thrilled I was to finally have a diagnosis. Of course, it ended up being a chronic progressive lifelong condition, but I was still happy about it. Weird.

On the other hand, lately I am feeling sort of the opposite. I guess because it has now been over a year that I have been totally obsessing about my uterus and ovaries, and it has not paid off, I feel like I need to get on with my life. I need to stop obsessing, stop worrying, stop thinking, and just let whatever happens happen. If I don't have another one, then so be it. I'm not going to sit around waiting.

I wanted my kids to be about 2 years apart, mainly because my sister & I are 2 years apart and we had a great childhood, but I am starting to accept that my daughter isn't me and she isn't going to have my life. I wanted to plan everything out for her so her life would be perfect, but that's not really possible. So I am working on letting go.

I'm not saying you should do that, I'm just saying that's where I am right now. Who knows how I'll feel about it tomorrow.


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## railyuh (Jun 29, 2005)

You might have to push to get yourself testing. A lot of docs don't want to run tests until you've had 3 m/c in a row. I had one m/c, then DS, then 2 m/c in a row and my OB kept insisting that testing was a waste of time. He claimed that since I had DS it ruled against there being anything wrong. Well, I pushed for a thrombosis/blood clotting panel and he finally agreed for my "peace of mind" and guess what, it turns out something came up on the test (compound heterozygous for MTHFR). Since then I decided to see an RE and also found low progesterone. We tested my thyroid but it was normal. We thought about looking for uterine abnormalities but decided against it (though if I have another m/c I will ask for it).








I definitely think you should ask for some tests. It bothers me that they expect us to just risk it again and go through another loss before they will do anything


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## slowtime (Sep 25, 2006)

Quote:


Originally Posted by *MisaGoat* 
I started bleeding like a period today and have some cramps. I had a little bit of brown spotting on Friday and Saturday but none on Sunday. I had more spotting yesterday after the trans-vaginal ultrasound and some this morning but it has picked up now and is like a period.

What does a miscarriage of a blighted ovum/empty gestational sac/anembryonic pregnancy look like? A heavy period? There won't really be much to pass like my previous miscarriage right?

I had an ultrasound yesterday that confirmed that my miscarriage completed itself naturally. They weren't able to tell me for sure, but based on my emergency room ultrasound a week ago, it looks like my pregnancy was a blighted ovum. I was 10 1/2 weeks.

I had 2-3 days of light brown spotting before I went to the emergency room. At first it just looked like a little brown in my discharge, but it kept getting heavier. Last Monday it looked like the brown bleeding I usually get on the last day of my period, and was accompanied by minor cramping. When I woke up on Tuesday the cramps were worse, and the bleeding was thick and dark red, with clots. I went to the emergency room, where their ultrasound showed an empty gestational sac. They couldn't tell me for sure whether there had ever been a baby - they wouldn't even officially diagnose the miscarriage.

I saw my midwife the next day. No new information. I was still bleeding, but not heavily. Immediately after my appointment, I started having heavy cramping. I spent the next 3 hours in the worst physical pain of my adult life. I couldn't sit, stand, walk, or even lie down. During that time, I had very little bleeding. It was confusing and very scary. I kept moving back and forth from the bedroom to the bathroom, hoping that I would start bleeding so the pain would go away. I called the clinic, and the nurse said I could take ibuprofen. (They had said before that I should only use Tylenol because they couldn't officially say I wasn't still pregnant.) Either the ibuprofen worked, or 3 hours of agony was enough. Either way, the cramping let up. I bled more that evening, but still only in the bathroom.

It's been exactly a week since the worst of that cramping. I bought some pads, but I've barely needed them. I've had some bleeding and some cramping every day since last Tuesday, but I've never bled enough to fill a pad. I don't know when I passed the sac - I never saw or felt anything that I could identify. With the exception of the pain I felt last Wednesday, the miscarriage was physically like a very light period.

I hope this helps. I think I'm going to cross post it in the sticky about what happens in a miscarriage.

I'm so sorry for your losses. I wish you luck in your search for answers.


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## shantiani (May 9, 2008)

Quote:


Originally Posted by *MisaGoat* 
I think I just need something to do. It is difficult to have a miscarriage because you can't really control anything. I can control my diet and rule out all preventable causes. I need something that I can do, rather than to sit back and relinquish control. Does that make sense?

OMG I know exactly how you feel. It really helps to have something to DO about it or else you just end up feeling helpless, and like it's going to happen again.
I wrote almost the exact same post after my last mc. But, I feel much better after taking the blood tests and focusing my attention on factors within my control.


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## MisaGoat (Jul 10, 2006)

A friend of mine stopped by this evening and brought me starbucks and just hung out and talked and played with my son which was really nice. I just took it easy on the couch. It was good to have someone to talk to and distract me. We also talked about diet and exercise and possibly about working out together. So that would be cool to have a workout buddy.

As far as diet/exercise/testing-I don't think it all necessarily has to be to prep my body for ttc but just to be healthy in general. I really haven't worked out regularly since I was pregnant with my son. So almost 3 years ago now. I do need a break from this pregnancy/miscarriage/ttc cycle. 7 months is enough for now. I need to just feel normal, get in a routine and be healthy.

I have a lot of changes that are going to happen in the next couple months so in a way it is easier to not be pregnant (not that I didn't want to be pregnant but being pregnant is exciting and stressful). I am graduating next month, need to pass my boards/get my license and get a job. So hopefully after I get a job and get enrolled in insurance through my job we will start ttc again. That will probably be in May. And then our lease is up May 25 so we need to decide if we want to stay here or move. And my husband graduates in May and will be getting a job then. Really where we both end up getting jobs will decide if we move or stay. The other upside to waiting to have a baby is that I might be able to have a homebirth. Right now we don't have out of network benefits so a homebirth would be out of pocket and we really can't afford that now. Hopefully our next insurance will have out of network benefits (because I am not counting on homebirth midwifes being in network). If not we will be able to pay the out of pocket cost when we are both working. So that is my long update of my thoughts and miscarriage.

Thanks again to everyone for reading and your support. It is really helpful to be able to tell someone what is going on.


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