Recurring Miscarriage

QUESTION

Dear Midwife,
I am looking forward for advice, who can guide me to take the right path. I am 36 years old, had 4 miscarriages in 2 years. First 3 miscarriages, happened within 10 months. 1st pregnancy went up to 12 weeks and miscarriage happened at home.

After 5 months I conceived again, at around 8 weeks I started bleeding and went for an ultrasound, to know that the baby is not viable. They did D&C and tested the cells of my fetus and found that there is chromosomal disorder. Doctor asked both of us to go for chromosomal tests and semen analysis to my husband. They came out +ve. We are not having any family member on both sides facing any child bearing problem.

I became pregnant for the 3rd time, which is unplanned, just 2 months after my 2nd miscarriage. Around 6 weeks of pregnancy I started bleeding which is again a miscarriage. After 3rd miscarriage, we approached a specialist in maternal fetal medicine. He has done HSG to me, and asked me to go for a blood test, to check the blood clottings. Everything came +ve. Doctor advised me to take omega3 tablets 2 per day and one baby aspirin, every day before 1 month of trying to conceive.

We have given a total of 10 months gap from 3rd miscarriage to 4th. I again became pregnant for the 4th time, and this time bleeding started, from 5th week, leading to miscarriage. In my 3rd and 4th miscarriages, doctors noticed progesterone deficiency. But not in the 1st and 2nd.

Please advise me what are the tests that need to be conducted and which doctor and hospital should I approach in New Jersey. I can't think of my life without children.

Kindly understand my feelings.

ANSWER

I am SO sorry for your losses--I can't even imagine.

From what you are telling me, it sounds like you have some of the common problems that come up when women over 35 try to conceive.

Also, if they are noticing the progesterone deficiency after you start to bleed, it may not be that the progesterone is the problem; it will naturally drop if you are miscarrying for another reason.

I would be curious about what your doctor is advising about how you should proceed, since I don't have your full medical history and have not done a physical exam. Is s/he still telling you that you have a good chance for a normal pregnancy? Because just from what you say, I'm wondering if you would be a candidate for in vitro fertilization with a donor egg and your husband's sperm. That might be the best way for you to have a pregnancy and be able to breast feed a child.

I don't know from what you say whether your clotting disorder is serious enough to prevent considering this option. But if that's the route you choose, sooner would be better than later. Good luck, and let me know how it goes.

-- Cynthia, CNM

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