I have an appointment with a specialist on August 1st to see if they can determine why I've had 3 miscarriages in the last year.

I need some help. I am trying to figure out what kind of testing I need to request that they do, and I don't want to sound like a moron. Can you guys tell me what they will typically do, what I should have done, that kind of thing? They have not done any kind of testing on me as of yet, except to see if I am RH negative (which I'm not) and what blood type I am (which is O positive). I am trying to research it online, and I'm SO confused.......maybe it's because my brain is going a million miles a minute, or I'm not looking in the right place. So, I'm reaching out to you guys for some direction!

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Okay, well, a lot of ladies have had way more testing than I have, and your new doc will very likely have a standard process for testing. They typically start with CD21 (7DPO) bloodwork, which is a small panel of seven or eight (?) things they check out all at once with one draw, including the progesterone level, which is why they want it at that time.

That's all I ever had done (multiple times), because the progesterone turned up deficient, so we worked on that and retested, and retested until it looked right (on clomid, varying the amount). I should have gone back in, but I held off, knowing that it would be 'this time'. Stupid in retrospect. But I was also on my own with the clomid, never had any supervision. I wish I had snapped to the fact that it gave me a CM problem (it disappeared). But I guess that only became obvious right after I stopped taking it, as the EWCM returned in force as before. I'm babbling at you. This is not helping.

Then there's CD3 b/w...I'll let the other girls who've done all that say more, because I don't know a whole lot about anything else, not enough to explain it.

It's interesting to me that they did the Rh testing and nothing else. Hmmm...you were on progesterone supps, right? They did that with no test? Interesting again. But then again, I think that's happened a lot -- clomid or progesterone without much supervision.

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Jen - There are a number of things they can check on cd3 - estrogen, lh, fsh, tsh, t3, t4, testosterone, progesterone, glucose etc. cd21 (or more accurate 7dpo) is the progesterone check. they may do a u/s, endo biopsy (to give some insight as to what the condition of your lining is). I doubt they'd do a hsg, since you obviously have no problem getting pg. Maybe they will do some additional b/w to check for clotting disorders??

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http://rchiprean.abmp.com/index.html

I think (and I'll have to look at my chart to know for sure) that they've already done the testing for the clot thing. That's the blood work that the doctor did in November that I had to ask the new doctor about because the other one didn't explain anything to me.

I'm going to jot all that down, and just kind of see what the specialist has to say on the 1st....because they've not done much of any testing. Dr. Lowe, the dr who did my d&c, wanted me to have 2 more miscarriages with heartbeats before he would send me to a specialist or do any kind of infertility testing, so at least Dr. Boyd (the new dr) is sending me to someone right away. I'll end up seeing both Boyd and Egley (the specialist) I'm sure. Hopefully I'll get some answers.

Thanks girls!

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Jen - That still blows my mind that your first doctor wouldn't do anything until you had losses with heartbeats. That is just wrong.

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http://rchiprean.abmp.com/index.html

Believe me, it blows my mind too, which is why I switched doctors. I feel much better with this new doctor.

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Jen~Here are some that I was tested for. They're usually done after a stillbirth, but I've read on message boards that some of these things cause recurrent miscarriages too, so you could ask about them. If you had blood clotting ones done, you might already have had some. These are the ones that I can think of...MTHFR, Factor V Leiden, Lupus anticoagulant, Rheumatoid Arthritis (and any other autoimmune diseases). Maybe Anti Nuclear Antibody. I'm not sure what that one was for though. Some of them you might not be able to have done right away-I had to wait six weeks to make sure all of the pregnancy hormones were out of my body, because that could interfere with it. I'm glad that this doctor is finally doing something for you!

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Hello,

I don't post that often - but I am an old timer. We had 2 chemical pregnancies with IVF and our doctor recommended having karyotyping done. Basically they drew blood and tested our chromosomes to see if we carried any genetic mutations that would cause an embryo to stop developing and miscarry.

I do think this was done because of DH's count though...I believe there is a genetic condition as to why some men have low counts. We are pretty sure DH's is related to an undescened testicle (sorry for tmi) and the test confirmed he did not have this genetic mutation.

I am pretty sure they test all 46 of them !

Good Luck!

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Jen

Jen-I am so glad you are comfortable with your new Dr. and will be getting testing done. If you don't mind my asking, have all your m/c been after seeing a heartbeat? (i know this last one was a chemical).
Here is a link to some info on m/c which may help you with the testing
What Causes Recurrent Pregnancy Losses?

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Thanks for the info girls! You are all SO helpful!

No, Bina, all the miscarriages were not after seeing a heartbeat. The very first one when I was married to my ex was after a heartbeat, the 1st one with Joe, and this most current one were chemicals, and then the one in November was after a heartbeat.

I am going to request that he do the karyotyping....just to make sure that there is nothing genetically mutating or whatever....to be sure that we are even compatable to produce a baby together. And then we'll just go from there.

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Well...let's see if I can remember everything I've been tested for. I think the ladies covered most of it.

tsh, E2, fsh, prolactin, glucose, homocysteine, Lupus, mutations (MTHFR and Factor V), endometrial biopsy, HSG, and testing for translocations in my chromosomes.

We did not do Karyotyping on him. Besides the fact that he has already produced children, there is no treatment other than donor sperm, which we are not prepared to do. It is also not covered by most insurance policies and it is expensive (think $1000). Yours MIGHT be, but it really depends on how the doctor codes it.

All my results came back normal.

The one reason they may want to do an HSG is to see the shape of your uterus. An abnormal uterus can hinder implantation.

The testing I did not do - a laparoscopy, and a hysteroscopy. My RE suggested neither were necessary. We also never did a semen analysis, which the RE also seemed to think was unnecessary given that my DH had produced children, and we were getting pregnant quickly.

My RE (who I dislike these days) said that in most cases of recurrent miscarriage, you will not get a definitive answer. From what I've seen on boards, the most probable diagnosis, if there is one other than unexplained, is a clotting disorder or a MTHFR gene mutation, which has to do with the way the body metabolizes folic acid.

The blood tests can all be done on the same day (usually CD3 to catch your FSH and Estrogen levels) with the exception of progesterone, which would be done at 7 dpo.

You should probably check with your insurance before you get all this testing done though. If my insurance didn't cover it as "miscarriage follow-up" the cost of all these tests would have been well over $3000. Oh, and this might be embarrassing, but if there is any chance you've had an STD, most specifically chlamydia, you should be tested because it can give you pelvic inflammatory disease. Your doctor may give you a round of heavy antibiotics. There are also issues with ureaplasma which can be treated with antibiotics.

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Thanks for all the help girls. I will have to check with the insurance....I do believe that there is like a section of the policy that covers infertility testing, but I can't remember for sure. I need to find out. My brain is just all sorts of all over the place with all of this. Joe keeps telling me to relax and let the doctor run whatever tests he is going to run, but I want to be sure that we have EVERYTHING covered. I don't want to miss ANYTHING. And I know that there is a very real possibility that we will not get any kind of concrete answer, and I'm trying to find a way to be okay with that.

This is just so NOT how I saw my life panning out.........and I know that none of us ever imagine that we would be in this situation.....it's just really difficult for me to deal with at this point. All of my IRL friends have kids....it seems like almost everyone around me is knocked up or has kids already or something. Everywhere I look when I'm shopping or whatever, there's another pregnant woman.........it just drives me insane.

I still haven't figured out how poor Joe is putting up with my insanity. He is SO wonderful, and I'm SO thankful for him......I don't know what I would do if he were any different than he is.......

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Jen, I'd still make sure to ask that Karyotyping is covered before you do it, unless you guys have the money to pay for it out of pocket. Then you have to ask yourself if you are prepared for an answer you might not like. Since you can't change your chromosomes, there's not necessarily any benefit to doing this test, other than your own peace of mind.

Even though I got no answer for my recurrent miscarriages, I am glad I did the testing. It was not particularly a fun process, but at least I felt I did everything I could do to prevent another one. If I do get pg again and miscarry, at least I won't have to wonder if it was something that could have been avoided by having done a blood test and getting diagnosed.

It took me awhile to come to grips with the fact that my infertility is unexplained. It's bittersweet to learn that there is nothing wrong with you as far as current medical science is concerned, but to know that there is still definitely something wrong with you.

I do wonder if my weight has had an impact on my miscarriages, since extra fat does produce extra estrogen and could throw off the balance I suppose. Keep trying to lose, but keep failing.

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Jen - I found this for you: FertilityPlus: Recurrent Pregnancy Loss Testing

Its pretty much what everyone else already said but its nice to see some kind of detail on everything. I also wouldn't go by the prices listed since I don't think they've been updated in awhile.

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