Investigations after two consecutive miscarriages

[mackoo0524]

Hi! I'm a long-term lurker and first-time poster. Hope I'm in the right forum.

Just wanted to start a thread for anyone going through investigations for miscarriages... Strictly speaking, I'm not a recurrent miscarrier as I've 'only' had two miscarriages in a row.

A quick history: DH (now 37) and I (now 28) started our TTC journey in March 2013, naively expecting to get PG within a month or two. After what felt like a few long months, I got my first BFP in July 2013 (4th cycle) and we were elated. Everything seemed to be going well - strong pregnancy symptoms from week 5, no bleeding, everything was normal. We were just waiting for our first ultrasound scan at 12 weeks. A week before that, we went to Greece for a holiday and I started spotting on our third day there. I was horrified and mentally prepared for the worst. Our fears were confirmed the next day, when ultrasound scan found an empty sac (I think they saw a fetal pole, but definitely no embryo/fetus, so it was possible that the embryo died very early on and had been reabsorbed). We flew back to the UK two days after that. Long story short, diagnosis was MMC. We first tried medical management but this failed. Had ERPC at the end of September and had my first 'normal' period on 1 November. The whole experience was devastating and very, very distressing, but we started TTC straight away

It might be worth mentioning that I had a consultation with Dr Adrian Lower in January 2014 to rule out Asherman's, the tests came back clear. It took us 10 cycles from the ERPC to finally conceive again. We had our second BFP in July - almost exactly the same week as my first BFP. We were cautiously optimistic this time round, but I sort of had a feeling quite early on that it was going to fail. Unlike the first pregnancy, I had very few symptoms this time round. The only symptom I had was sore breasts and enlarged nipples. Anyway, we had to go to Australia for a relative's wedding a week after BFP. The lack of symptoms was worrying but I tried to stay 'cautiously' positive. Sadly, I started spotting and then bleeding at 6.5 weeks. This time we decided to wait till we returned to the UK to see a doctor. The bleeding started off very light but gradually got heavier. At about 7.5 weeks, I had moderate cramps (like bad period pain) and felt a gush of blood come out in the bathroom. Ultrasound scan at EPU that afternoon confirmed that the miscarriage was complete, and blood tests two days later showed that my HCG levels were coming down.

So here we are - 2 pregnancies, 2 MCs. Since the NHS doesn't offer investigations until you've had 3 MCs in a row, DH and I have decided to go down the private route, as we just can't bear to wait ages to conceive again only to possibly miscarry another time.

After doing lots of research online, I've decided on seeing Dr Shehata, and yesterday I gave his clinic a call and was told that the earliest appointment we can get at his Harley Street clinic (I work and live in Central London; Surrey is to far away for me) is in December. I did some more research and decided to consult Dr Gorgy, who also has an excellent reputation. I called his clinic this morning and got an appointment confirmed for September 13/9. It feels good to be taking active steps in an otherwise helpless situation. So far, I've paid £50 over the telephone to secure the appointment, which will cost £200. From what I've read online, I expect the tests to cost around £2,000.

Will update this thread as I progress with the investigations. Hope this will help someone in a similar situation!!

Meanwhile, if you have any experience with Dr Gorgy (or MC investigations in general), please share with us.

Thank you and good luck to all of us TTCing! xxx

[Wadsy]

Hello!

I'm so sorry to hear about your losses Mackoo. How devastating - and I'm not surprised you'd like to avoid going through this again. I'm not sure how helpful I'll be to you but I'd like to join the thread to learn more about this topic.

I have an 18 month old. We tried for for him for two years and in that time we had an ectopic pregnancy (I've still got both tubes) and a miscarriage at 5 weeks. I was about to have a laparoscopy to check my tubes when I got pregnant with DS. Now we'd like a sibling (greedy I know!) We've been trying for 6 months and in that time I've had another miscarriage at 5 weeks. I'm over 35 so we've been to the GP and are having fertility tests done at the moment. I've been given a choice of a referral to the infertility clinic and the recurrent miscarriage clinic on the NHS. Not really sure what to go for. There are good reasons to go to both. We don't get pregnant very quickly and I've had an ectopic pregnancy and never had my tubes looked at (Infertility clinic) but I've also had three losses (Miscarriage clinic). Just don't know what to do! x

[mackoo0524]

Hi Wadsy, apologies for the late reply! I don't logon very often :) Sorry to hear about your ectopic and MCs and wishing you best of luck with fertility tests.

I just got back from my first appointment with Dr Gorgy. We spent a good half an hour going through my medical and pregnancy history and he explained to me the tests needed. It was A LOT to take in, but basically the tests cover a few main areas: immunology, uterine cavity, chromosomal and a couple of other things (sorry, he spoke very fast and I don't remember everything he said exactly!)... He recommends getting all of the available tests done, which includes blood tests (he mentioned getting tests sent to Chicago), a 'water scan' (the term he used for a specific type of ultrasound scan that involves injecting some liquid into the uterus), menstrual blood tests (for 'microorganisms' I think), sperm fragmentation tests for DH etc. So basically the full works!

I asked about costs and he said that it will not be cheap - he put the estimate at £3,000, which is quite a bit higher than I expected from reading on Mumsnet, but we're okay with that. Treatment costs will really depend on the type of treatment we need. He said that it would be worth asking our GP if they would cover genetic testing and thrombophilia - no harm in asking. But DH and I decided we'd just do all our tests with Dr Gorgy to save time and hassle.

I asked if we could TTC before getting test results and he said that's entirely up to us, whether or not we want to take the 'risk'. It's something DH and I will have to discuss...

I asked if I had to wait for a normal period before getting the tests done and he said that's not necessary. He said only the 'water scan' has to be done immediately after a period.

So our next step would be to arrange the funds and book an appointment for the tests - that's it! He actually said an appointment is not needed and we can just phone on the day and come in to have blood samples taken. I'm looking at the week after next - by then I should have the necessary funds ready then.

In terms of the clinic and Dr Gorgy himself, my impression was very favourable. He had a straightforward, no-nonsense manner, but not rude or abrupt at all. I was worried that we would be rushed but he actually went through everything with us very patiently and in great detail. My husband and I definitely feel like we're in good hands.

Will keep you updated!! Do keep us updated on your fertility testing progress as well

Mackoo xx

[mackoo0524]

Sorry, I think the term he used was 'aqua scan'. Just looked it up, I think it refers to this procedure: Saline sonohysterography/ HyCoSy/ Aqua scan

So many technical terms!!!!