Two is not enough

You have to wait until you had three miscarriages before anyone will investigate the possible cause. Two is not enough. The person who set that rule must have been a man. Not enough of what? Pain? Heartache? Not enough self doubt that maybe you weren’t meant to have children? Not enough money spent on fertility treatments? Not enough life time lost on trying to conceive?

Two is not enough, is what the doctor at the fertility clinic told me when I saw him last week. It is all down to bad luck. How tired I am to listen to that. Would he accept that when it was his wife miscarrying? Would he help her to find out if there is an underlying cause that may be treated or let her miscarry again?

I mentioned to him that in the past I had been tested positive for protein c deficiency. The moment I mentioned it he sat up and said that I really needed to be on a mini Aspirin as soon as I test positive in a pregnancy test and then inject heparin for the duration of the pregnancy. And yes, protein c deficiency can cause miscarriages by forming blood clots and reducing blood flow to the embryo.  Gee, I am glad I mentioned it. I am glad I had recently talked to my friend, 33 weeks pregnant, who also has protein c deficiency and is now on heparin. She wasn’t until last week so I didn’t think it could be an issue in early pregnancies. So, I am to get tested for protein c and protein s deficiency, factor V Leiden, antithrombin III just to make sure.  Off to the GP.

It really gets me that nobody every asks if you happen to have been tested for any of the problems associated with recurring miscarriages. I mean, at least in a setting like a fertility clinic they could sit down and say “Here is a list of factors that can cause miscarriages, please tick boxes if appropriate, if you don’t know don’t worry for now”.  How is the average woman supposed to know what can cause a miscarriage? Why don’t doctors ask! Why do I feel I need to be smarter than them to get a decent treatment?  Everything I know about miscarriages and causes of miscarriages and chances of conceiving at my age I have learnt by reading information on the internet. That includes web sites like the ones below but also medical research articles and blogs. Often the more helpful information came from blogs because they put medical facts into a context I can relate to.  None of my – I am sure limited – knowledge comes from doctors I have spoken to. What is it with them that they don’t want to have informed patients? Or do they simply believe we are all too stupid to understand?

For any smart woman out there here is a list of possible causes of miscarriages. Take a look at the web sites to read in more detail how they can be treated. If you have been tested for any of those  let your doctor know, even if he dosn’t ask. The list is taken from two web site that I found very helpful www.ivf1.com/miscarriage-cause/ and www.miscarriageclinic.co.uk .

Embryo chromosomal abnormalities (sadly, this is the most common cause in early miscarriages and nothing can be done about it – that’s where the bad luck comes into it)

Parental chromosomal abnormalities (can’t be fixed, you may want to opt for egg or sperm donation)

Thrombophilias (can be treated with Aspirin and heparin)

Immune causes (can be treated)

Uterine abnormalities (can be treated, surgery)

Progesterone deficiency (doctors don’t believe progesterone supplements have an effect, strangely enough the women who use it and subsequently carry their baby to term instead of miscarrying again do believe in it……….make up you own mind)

Environmental causes (smoking, drinking, diet, infections (listeria, toxoplasmosis, cytomegalovirus, rubella…. – can be avoided and/or treated)

 

 

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.