Factor V Leiden

I forgot to mention that I finally got my blood results back. Needless to say that it was a major Odyssey to retrieve the results. It was meant to take 4-6 weeks for the results to come back and from week 4 I called the surgery every week to see if they were in. Finally, after 8 weeks I insisted they track the samples and at least confirm that they had been sent. Yes, they had been sent and the results had been sent to the fertility clinic, not my GP (leave alone me, the patient!). The fertility clinic didn’t bother to tell me the results were in so next I had to chase them. I am glad I have some project management skills or I’d never get anywhere with the NHS.

The test for factor V Leiden was positive – everything else negative. I have read up on it again and (as always) the role of factor V Leiden in pregnancy complications is controversial. It seems there is an increased risk for pregnancy loss in the second and third trimester, preeclampsia, fetal growth retardation and placental abruption.  The treatment: mini Aspirin from positive pregnancy test and heparin from the first scan at 8 weeks. I read that mini aspirin also helps in the implantation phase because it helps blood circulation in the uterus.  I am surprised that there aren’t any definite and conclusive clinical studies on thrombophila and pregnancy less or the prevention of pregnancy loss.  There are so many women pregnant at any given time, they should have super accurate statistics by now. How come all these studies show contradictory results?

For more information on mini Aspirin  http://www.conceivingconcepts.com/learning/articles/aspirin.html

Very basis factor V Leiden reading: http://miscarriage.about.com/od/thrombophiliadisorders/p/factorvleiden.htm

And a comprehensive overview on pregnancy complications caused by factor V Leiden with references to medical publications  http://www.geneclinics.org/profiles/factor-v-leiden/details.html

when will things return to normal?

The last time I miscarried I had my period 31 days after the D&C but I wonder if it will be the same this time. I checked my temperature and for a week the temperature was still at 36.7 and then dropped to 36.4. No  changes since then. I guess, that also means I didn’t ovulate as the temperature would go up to 36.7 again.  But: if I didn’t ovulate I won’t have a period, right? And without period no trying for a baby again.

Apparently one does not necessary ovulate in the first cycle after a D&C. Some reassuring words on www.pregnancyloss.info/waitingforaf.htm.

back to square one

On Monday I went back to the JR for a scan. Although I knew for a fact that I had miscarried I still managed somehow to find hope for this situation, thinking of scenarios where my baby naturally only would have been so small and that this scan would show it had grown properly and had a heart beat.  Of course that was all wishful thinking. The embryo was still only 3mm without heart beat. The embryonic sac was still quite large though. Obviously my body hadn’t noticed that the embryo was dead.  The doctor who explained the results to me must have been only 22! He looked quite forlorn in his chair, with a really bad posture and a very insecure look on his face. I almost felt like I had to explain the situation to him. He couldn’t offer any information I didn’t already have. I wonder why they don’t let the nurse give you the final results. At least she has seen the scan and probably has seen thousands of them before. I could imagine that she has a much better grip on what’s normal and what’s not.

He referred me to the day surgery unit for a d&c. I must say all the nurses where absolutely lovely and very caring. The d&c is a very short procedure done under full anesthesia where they basically scrape out what is left of the embryo and the placenta. Before you even know you are asleep you wake up and all is done. They kept me on the ward for about 2 hours afterwards and then send me home. One of the nurses suggested that I asked my GP to be referred to the “recurring miscarriage clinic” at the JR run by Tim Childs (who is also a doctor at the fertility unit ). Normally they would wait until I had 3 miscarriages but she said if I asked for it they would start investigating now. Excellent tip. I am so glad she told me.

I am back to square one now with no end in sight. All I can do is to hope that next time I get pregnant again as easily and that the baby will be ok. Where I will get the confidence from that it will be ok I don’t know.

miscarriage again

I knew that I had miscarried. I called the fertility unit on Monday to ask them to move my scan forward and see me the same day. The nurse who spoke to me said that they wouldn’t see me earlier, they don’t like to scan women who are bleeding because it could be ok one minute and change half an hour later (essentially making the scan a waste of time!). She gave me the advice to do a pregnancy test on Thursday morning and call them in case it was negative.  I don’t have much expectations any more to get any compassion or empathy from NHS staff but had thought that the Oxford Fertility Unit, who I pay out of my own pocket for their treatments, would be a bit more interested in their patients. I felt let down, still do.

Then I called Beards Mill Clinic which is a private clinic for pregnancy scans. The doctor was so wonderful. Finally somebody who took her time to do a scan, explained what she saw, listened to me and genuinely offered me her sympathy when it was obvious that I had miscarried again. That’s all I wanted. Someone to properly check and then tell me what it is. The embryo was only 2.7mm long and there was no heart beat. Since I was so sure of the conception date there was no chance that I had miscalculated the date and was only 5.5 weeks pregnant. My baby should have been about 10mm with a strong heart beat.  I am devastated and really, really worried that this will happen again.  What if there is something wrong with me and I will never carry a baby to term? 

Beards Mill Clinic referred me to the JR for another scan on Monday and a d&c the same day.  I am glad I have a few days to come to terms with this before they do the d&C. I am not ready to let go of my baby.

back to normal?

Never thought I’d be so happy to have my period, just 4 weeks after my miscarriage. I am glad that my body is getting back to normal so quickly.  At the same time I still cry over the loss of my baby. Emotionally I haven’t caught up with the speedy recovery of my body.

I haven’t gotten used to the idea either that I will never have that perfect family and that from now on I will have to go through everything on my own. There won’t be anyone to come along to the scans,  nobody to want to feel the baby kick, nobody to help me through the delivery. I am frightened of being alone for the rest of my life.  I need affection and attention, too. But will I be alone? I will have a child. That’s not alone at all.

And there is the Donor Conception Network, a UK organisation with local groups of parents and their donor conceived children. http://www.dcnetwork.org/ That’s not being alone! I had no idea how many children have been conceived that way and I am glad to hear that they don’t turn out emotionally distressed over it either. The recommendation is to tell them early on so it never becomes a problem.

I started charting my temperature again like I used to when I tried to have a child with R. I find it enormously reassuring to see my body functioning like a clock work. It gives me confidence that I will conceive again. Tomorrow, on day two, I am off to get my first hormone blood test done and again on day 25. Then my GP can refer me to the clinic. Maybe by Christmas I can have my first go?

planting a tree

How do you get over losing the baby you were hoping to have for such a long time? It’s devastating. Maybe because there is nothing you can do. Your body does and you watch. It makes me feel like I can’t do the most basic thing in life: having children. Nothing anyone says seems to make a difference. All of a sudden you hear all these stories of women with miscarriages. Stories you never heard before because nobody likes to speak about it. If I had know all this before (including the fact that 1 in 4 pregnancy end in miscarriage) I could have prepared myself better for the loss. Why is it such a stigma? And why all this fear of not telling anyone you are pregnant until you are 12 weeks? All you do is to deprive yourself of the shared joy about your pregnancy and the shared grief when something goes wrong. Believe me, even if I find it hard to be consoled at the moment by hearing about other women’s miscarriages, at least I don’t feel I am alone in this misery. I can’t thank my friends and my sister enough for their support which I really, really need now.

I planted a tree in memory of the baby. It’s a paper bark maple, a small tree with beautiful red leaves in October.

losing a baby

I lost the baby.  I flew to Basel for a business meeting on the 24th of Sept in the morning. As soon as I arrived in the hotel to drop my bags I saw that I had been bleeding. I was just shocked and couldn’t think straight. How could I not even have noticed it? No cramps, no pain. Just blood. I cancelled all my meetings and went straight to the emergency services. A modern hospital building that instilled the immediate impression of good medical care available in a wealthy country. Art work on the walls and leather benches to sit on. I had to wait about an hour but then a friendly nurse looked after me. She did an ultrasound scan and showed me the little beating heart of my baby. I was lucky, at 6 and 1/2 half weeks one can at least see something.  That was the first time the somewhat abstract concept of pregnancy translated into a real baby. My baby. I was bleeding more now and they showed me the source of all that blood. A 1×2 cm hematoma; blood that collects between uterus wall and the placenta. They said that I didn’t need bed rest and could do anything normally but obviously shouldn’t run a marathon! They looked a bit concerned though when I said that I was going to take the train to Frankfurt tomorrow. I was starting to be really concerned when they gave me a prescription of painkillers and said I might need these. Were they really that convinced that I would miscarry and be in a lot of pain? Anyone up for some hope and encouragement? The bleeding stopped and by the next morning I felt good enough that I could take the train. No more bleeding all day.

When I arrived at my mom’s house in Frankfurt I told her that I was pregnant. She was so happy for me. Just like everyone who I had told. I didn’t plan to tell her that early but I was worried the bleeding would start again and I would need to go to hospital. When I woke up on Saturday morning I again had been bleeding. Again, no pain, no cramps. We drove to the hospital and this time they kept me there. The hematoma had grown to 2×3 cm and that is “very large” according to the doctor who did the scan. All I could look at was the heart beat. So beautiful and so reassuring. He said that they would keep me there until the bleeding stops and the hematoma shrinks because there is a risk that the blood can pull the placenta off the uterus wall. He also said some women had gone on to carry their baby full term. 7 days is hospital without being allowed to get up unless to go to the toilet. Luckily, since I was close to my mom’s place, I had a lots of visitors who brought books for me to read. I was quite happy lying still in my bed if that helped the baby.  They showed me the baby every two days, well, they monitored the hematoma, but for me it was an opportunity to see that little heart beat again. Until the 4th of October, when there wasn’t a heartbeat.

The women who shared my room were very supportive. Surprisingly one can be very close to total strangers. At the end of the day we are all the same and share the same worries and feelings.

They did a d&c and kept me overnight. The next day I flew back to Oxford.