More than one chemical pregnancy- what now

[rangie]

Can you share your story about having more than one CP? I had one in September and I'm pretty sure one in October also. Prior to that I had a healthy son.

I'm seeing the midwife tomorrow to run labs, though they said they don't consider it to be 'recurrent' loss until you've had 3 CPs/miscarriages. They said they'd run a thyroid panel, Vitamin D, progesterone. I want to be proactive, I'm 35+ and a bit of a Type A.
Anything else I should ask about or be aware of?

Thanks.

[Rama]

Oct 19, 2016 15:52:31 GMT -5 rangie said:

Can you share your story about having more than one CP? I had one in September and I'm pretty sure one in October also. Prior to that I had a healthy son.

I'm seeing the midwife tomorrow to run labs, though they said they don't consider it to be 'recurrent' loss until you've had 3 CPs/miscarriages. They said they'd run a thyroid panel, Vitamin D, progesterone. I want to be proactive, I'm 35+ and a bit of a Type A.
Anything else I should ask about or be aware of?

Thanks.

Why do you think you had a CP in October? Did you get a positive test?

[rangie]

Rama, @pineappleoranges, I had implantation cramping then a positive pregnancy test on 12DPO in October. Got a negative test 2 days later, followed by a period that started on CD33 (then 16DPO). I tend to get insomnia with even a droplet of HSG, and I had that too. Initially I thought it was a false positive test but the wise internet tells me that it was more likely a barely detectable CP.

In September, I had a positive test from 9DPO for about 2 weeks, then negative, got my period, and confirmed with labs that betas were 18 when I should have been 5 weeks along. Definitely a CP that time.

Thanks for any thoughts.

[rangie]

*HCG

[Deleted]

Some insurance companies are switching to cover loss testing after 2 losses, so it might be worth it to check your plan.

[rangie]

Thanks @led, hadn't thought about insurance coverage. I'm sorry you know that. Love to you.

[Rama]

Oct 19, 2016 16:09:28 GMT -5 rangie said:

Rama, @pineappleoranges, I had implantation cramping then a positive pregnancy test on 12DPO in October. Got a negative test 2 days later, followed by a period that started on CD33 (then 16DPO). I tend to get insomnia with even a droplet of HSG, and I had that too. Initially I thought it was a false positive test but the wise internet tells me that it was more likely a barely detectable CP.

In September, I had a positive test from 9DPO for about 2 weeks, then negative, got my period, and confirmed with labs that betas were 18 when I should have been 5 weeks along. Definitely a CP that time.

Thanks for any thoughts.

I'm so sorry for your losses. That's awful, especially being back-to-back. @led had the best answer to your OP. Unfortunately, without insurance to back you up, you kind of have to go at their pace. :(

[thechickencoop]

I'm sorry for your losses. I had three early losses last year and we went through a lot of (inconclusive) testing this year. There is a RPL check in over on 3T that has some fantastic info.

Likes LED and Rama said, insurance will usually cover RPL testing after 3 losses. Tests can include general bloodwork, cd3 bloodwork, 7dpo bloodwork, karyotyping for you and your SO, autoimmune testing, HSG, possibly cervical cultures, endometrial biopsy, etc.

Insurance coverage may also depend on how your RE codes it so always ALWAYS double check. My lab invoice for all of my karyotyping/AI testing was for almost 3000; luckily we only owe like 140 ish.

[thechickencoop]

Also, just an aside, how long have you been TTC? At 35 you would be considered AMA which, if you have IF coverage, will usually cover your visits to an RE usually after the 6 month TTC mark.

I would 100% go to an RE over a midwife/gyn. An RE is specifically trained to GET you pregnant whereas a midwife/ob will pick up after you're KU. It's not a bad idea to just start the discussion there (and you might need a referral per your insurance) but theyre not going to have the same level of knowledge that an RE would.

[doodler]

First of all, I am very sorry for your losses. Secondly, I want to echo what others said. First, I would confirm insurance coverage. Then I would get myself to the RE. They are the experts in this area.

As far as insurance goes, I had one hell of a time dealing with my insurance and trying to figure out what exactly they would cover when it came to my repeat loss testing. It turned out that everything was covered, but I spent hours on the phone trying to figure it all out and still walked into testing not sure if it was covered or not.

Also, this is anecdotal, but when I first went to the RE for my testing, I had an 11.5 week loss, an 8.5 loss and a CP. They did not consider the CP as a "documented loss" so technically I only had two losses at that time. My insurance still covered the testing though.

[wannabmama]

My RE did most of the relevant testing well before I had three losses, and it was mostly covered by insurance (I paid maybe $500 total for a couple tests, co-pays, etc.) I had the full battery of blood testing (including the chromosomal test, can't remember the name) and an HSG. I had an SHG later. She also had MH do an SA (then a follow up bc the first was terrible...and then one a year later bc a lot of the testing, including mine, needs to be redone every year for my insurance). Anyway, none of it was specifically geared toward repeat losses, but it sounds like it overlaps a lot with what people get for RPL testing, so I would echo what others say and see an RE to get the testing started.

I've had three cp's, one from an IVF cycle, two on my own.

[rangie]

wannabmama, doodler, thechickencoop, Thank you all. I'm sorry for each of your losses. This is really helpful info.

I saw the midwife today and they took blood, said they'd run the thyroid panel and Vit D, and might have me do progesterone after ovulation if this cycle is a no go. Honestly she seemed to not really know much.

I've been TTC for only a couple months, and I'll be 36 in a few weeks. My first pregnancy was a healthy son, 3 years ago. I *think* that I have gotten pregnant every time I've tried with decent timing, which is great. The 33% baby to pregnancy rate is not. I'll see how this round of labs comes back and this cycle. Then on to the RE.

[Deleted]

rangie - I recall seeing you post in a few different threads. Is this cycle 3 or 5 for you?

[doodler]

Oct 20, 2016 20:36:42 GMT -5 rangie said:

wannabmama , doodler , thechickencoop , Thank you all. I'm sorry for each of your losses. This is really helpful info.

I saw the midwife today and they took blood, said they'd run the thyroid panel and Vit D, and might have me do progesterone after ovulation if this cycle is a no go. Honestly she seemed to not really know much.

I've been TTC for only a couple months, and I'll be 36 in a few weeks. My first pregnancy was a healthy son, 3 years ago. I *think* that I have gotten pregnant every time I've tried with decent timing, which is great. The 33% baby to pregnancy rate is not. I'll see how this round of labs comes back and this cycle. Then on to the RE.

My story is similar to yours.  I had my son 3 years ago and then 5 unsuccessful pregnancies.  I am now 35.5 and trying to decide next steps.  I think the best advice from me is to be proactive and advocate for your own health.  My OB's attitude after the first 3 losses was "Well, unfortunately you have just been really unlucky.  If you were 40 and in this position I would be more concerned but you have plenty of time."  She didn't want to do any testing and mostly justified it by saying that I had carried my son to term and he didn't have any issues so she knew it was possible for me.  When I pressed her about it, she said....well, if you really want me to I will but I think it is unnecessary.  I told her in no uncertain terms that this wasn't about a race to the finish line for me and that I wasn't going to continue having miscarriage after miscarriage until one finally stuck.  I made an appointment with the RE that day and haven't looked back. 

As far as the progesterone, my RE suggested not starting the progesterone until after I actually got a positive test.  I don't remember the reasoning exactly, or if he even explained it, but I seem to remember him saying something about it potentially making my cycles longer and he prefers for patients not to start right after ovulation.  I honestly don't know which is better. 

[rangie]

@wallflwr926, it is cycle 5.  I wised up as to timing after the first two cycles, so looking back I'd call June and July NTNPs. We were having unprotected sex during the fertile window per the tracking app that I thought was on target. I wasn't using OPKs then. Now I am, and I understand that the actual fertile window ends on O day and I know when that day is.  I think we were actually too late those first two attempts. But who knows, I don't have the precise info about the past. I'm still pretty new to all of this so I don't know what "counts". 

I don't even know if the positive test I had for one day this month "counts" as a CP. This is all so hard. I appreciate the feedback here. 

[Deleted]

Oct 21, 2016 8:58:01 GMT -5 rangie said:

@wallflwr926, it is cycle 5.  I wised up as to timing after the first two cycles, so looking back I'd call June and July NTNPs. We were having unprotected sex during the fertile window per the tracking app that I thought was on target. I wasn't using OPKs then. Now I am, and I understand that the actual fertile window ends on O day and I know when that day is.  I think we were actually too late those first two attempts. But who knows, I don't have the precise info about the past. I'm still pretty new to all of this so I don't know what "counts". 

I don't even know if the positive test I had for one day this month "counts" as a CP. This is all so hard. I appreciate the feedback here. 

When you are 35 or older, you meet the criteria to see an RE after 6 months of TTC, whether it's NTNP or active TTC. So in your case, December you could start seeing one or at least make an appointment. As for RLP testing, it will be dependent on the RE and your insurance company. They will at minimum recommend that you have an HSG to ensure there are no blockages and have YH complete an SA.

With that said while it's good that you are being proactive, do not over analyze or think of your pregnancies in percentages rates. Do not rush to the conclusion that because you didn't immediately get KU like you did with your son that it's never going to happen.

Every TTC journey is different. Secondary IF is a very real thing, and from what I understand it is not a fun club to be in. So take a deep breath and see what the doctors have to say.

[Rama]

Oct 21, 2016 8:58:01 GMT -5 rangie said:

@wallflwr926, it is cycle 5.  I wised up as to timing after the first two cycles, so looking back I'd call June and July NTNPs. We were having unprotected sex during the fertile window per the tracking app that I thought was on target. I wasn't using OPKs then. Now I am, and I understand that the actual fertile window ends on O day and I know when that day is.  I think we were actually too late those first two attempts. But who knows, I don't have the precise info about the past. I'm still pretty new to all of this so I don't know what "counts". 

I don't even know if the positive test I had for one day this month "counts" as a CP. This is all so hard. I appreciate the feedback here. 

I think most people count NTNP months when saying how long they've been trying. You stopped birth control with the express purpose of allowing yourself to get pregnant. Counts to me.

Actually doing things like tracking and charting has a learning curve. It's okay to not know what you're doing, especially if it's your first time or first time in awhile. We're here to help. :)

As for counting your loss, I, personally, would. If you could turn a test, you were pregnant. Even if it only lasted 12 hours. But however you want to classify it is your choice to make. For what it's worth, I hope it never happens again. No one deserves this pain.

[ironbaby]

rangie, I am going to be a little blunt here and give you some tough love. First, let me just say that I am incredibly sorry for your CP. I have been there myself and it is HARD. Huge hugs.

However, I think you're jumping the gun here a little bit. You yourself declared that your VVVFP on the FRER was dubious and those tests do have a tendency to give terrible false positives. I am not calling you a liar or implying that you did not experience a loss, but I do think that at this point, the second CP is questionable. Regardless, intervention at this point feels a bit premature. Many women experience very early pregnancy loss and go on to have healthy pregnancies with no issues.

If you pass the 6-month mark of TTC (the AMA threshold), schedule a visit with an RE. I wish you the best of luck.

[rangie]

ironbaby, Thanks. Maybe I need to stay off the forums for a while. A person inclined towards anxiety like myself is going to read others' stories and see the possibilities. I also want to be proactive and not look back wishing I'd done something sooner, as Doodler said. December will be 6 months TTC by whatever measure. If no dice by then, I'll make the appointment. I actually just called the recommended RE in the area and she only books a few weeks out, so that was reassuring.

I think without the CP(s) and it taking some time, I would be just impatient and not worried. It is the conceiving and not staying pregnant that's got my panties in a bundle.

[ironbaby]

Oct 21, 2016 10:42:27 GMT -5 rangie said:

ironbaby , Thanks. Maybe I need to stay off the forums for a while. A person inclined towards anxiety like myself is going to read others' stories and see the possibilities. I also want to be proactive and not look back wishing I'd done something sooner, as Doodler said. December will be 6 months TTC by whatever measure. If no dice by then, I'll make the appointment. I actually just called the recommended RE in the area and she only books a few weeks out, so that was reassuring.

I think without the CP(s) and it taking some time, I would be just impatient and not worried. It is the conceiving and not staying pregnant that's got my panties in a bundle.

I know it's hard to see right now, but CPs (and miscarriage in general) are incredibly common. 15-20% of pregnancies end in miscarriage. That's doesn't mean it's not heartbreaking, but they also don't necessarily mean there is a problem.

I am glad you have a plan going forward. I encourage you to stick around. This community is a wealth of information and can provide some fun distractions while you wait.

[icedtea]

I have no advice outside of what has been said here, but I wish you luck with whatever you decide. Losses are heartbreaking no matter the circumstances, and I'm sorry you've had to go through that twice. I am also an anxiety-ridden type A person, and so totally get the desire to feel like you have a plan, or are addressing possible problems.

It really helped me to have the RE date set—sort of a "the appointment is made, so I can just breathe and wait now." We do what we must to manage our neuroses