RPL Testing Etc. After a LC?

[inaya]

Hey all. Tldr: talk to me about REs and RPL.

This might be more of a loss after LC question or maybe it's just AL... idk. Anyways, the thing is, I need more info on RPL testing and deciding if I should look for an RE, what kinds of tests to be considering, etc.

I'm currently going through my third miscarriage, but we have one rainbow (we had two losses, live birth, loss). I know that having a LC kind of rules out some scenarios, and we have one known genetic issue, but it's still fairly unexpected to have repeat losses like this (not unexpected to a PgAL brain but you know, statistically.)

I know that many, many couples never get any diagnosis, but I was wondering what others have done and what the process has been like for RPL testing. There used to be info on the TTCAL blog but the new one didn't have anything I could see.

Just hoping that if there's something treatable we can treat it, I guess, but not wanting to deal with unnecessary stuff or stress out over things that wouldn't be applicable, I guess. Any and all info and opinions are appreciated!

[Deleted]

Oh no, I'm so sorry for your loss. *Hugs*

I got most of my testing since through an RE, then had some more through another RE that specialized in RPL, then saw my MFM to set a plan for future pregnancies.

Nothing was ever found on my testing (except PCOS, but that doesn't explain all my losses), but I'm still glad I got it all done. I would definitely get the referral to an RE, totally worth it. Good luck.

[glb30]

I'm so sorry for your losses.

My testing was done through an RE. As I remember, he gave me 5 different reasons for recurrent losses and then we tested for each- genetic, hormonal, infection, structural (like issue with uterus) and like clotting disorders. There may have been more, this was just 4 years ago now.

My issues were hormonal. (Low progesterone produced naturally) They also found a blood clotting disorder (MTFHR).

With that being said, they never seemed 100% confident that either of these actually caused the losses. For example, my sister has MTFHR and has no losses, one baby. And progesterone is somewhat of a chicken and egg scenario. (Is it low bc it's the pregnancy is not viable, or is the pregnancy not viable bc it's low?) Regardless, we treated both and I have my rainbow!

[briarrose]

inaya, I had my August baby 1st, but then I just had my two back-to-back losses, so I just had an appointment on Monday. I am seeing a wonderful OB who I am so happy with. He is 70 years old, and I was terrified to see him because I am still nursing. He was so cool and wonderfully supportive. After I get my period back, I will be going in for a progesterone check on day 23 or so. Then, first week of June, I am having a blood draw to check my clotting factors and thyroid, and possibly a couple things I cant remember, so that is what's going on for me.

He was so great and so ready to do testing right away rather than wait for me to have 3 losses to be considered "recurrent". I was so lost on where to go and am so happy to have a direction to go in after having a hard time at my old practice of being dismissed because my losses were so early.

He wont check genetic issues for us until we have ruled out the other stuff, and it isn't something that we are necessarily concerned with at this point.

[gratefulgirl]

As you might remember, my DD1 was born before I had any losses. Then I had my 3 early losses. My OB ran some testing and my RE. My fuzzy diagnosis was wonky hormones/weak ovulation that may have been post-nursing or post-pill or just lifestyle related - it was unknown. It was also unknown if DD1 was a rare good cycle and the issue predates her.

Just being with an RE helped for DD2, especially the TLC method of treating RPL. For DD3 I religiously followed ideas from the book It Starts With the Egg recommended by several ladies here. It was an entirely different experience than my journey to DD2, but again it could have been a fluke. But my cycles seemed much closer to ideal before DD3 than before DD2.

[eliz77]

Sending you many ((hugs)). am so sorry to hear of your loss.

Like previous posters, my testing has been done through an RE. After my 2nd loss, my o/b had written me a script to have CD3 blood work done at their lab, but when I lost my tube (ectopic), she recommended going straight to an RE.

I actually just finished my second time going through CD3 blood work and an HSG. It's been three years since last round of testing was done, one living child in between. The only thing that came up in round one was 2 copies of MTHFR gene so I was placed on baby aspirin and lovenox during pregnancy. Whether that made the difference or not...who knows...but I liked having a plan. This last time, after 8 months no pregnancies, we just wanted to check how things are, and everything came back normal.

For me, because I am AMA (40 years old), this was more for peace of mind than anything else. And for closer monitoring when pregnant due to 3 losses and one remaining tube. Also started a Clomid cycle, so that makes me feel like we are being proactive.

Good luck! Some ladies seem hesitant or afraid to take that step. But honestly, the RE's job is to get you pregnant and figure out why you may be having losses or not getting pregnant. I think for loss moms, it really helps figure out a plan to go forward with.

Again, ((hugs))

[inaya]

Thank you all for sharing! I've kind of been under the assumption that our disorder carrier status is to blame for everything, but talking it over with MH and then reading through all of this is really pushing me to make sure there's not something else going on, *especially* something treatable. My MW was on that same track, too, although her plan was to sort of look things over at her office with the OBs and go from there. gratefulgirl, I've heard of that book just recently (maybe from you!) and I'm going to read it.

Now I just have to figure out how to get a referral to an RE, which so far is requiring a ton of phone calls and has revealed that my PCP is on an indefinite leave of absence. Being with this HMO has been the most frustrating thing. FX we can get things moving.

[eliz77]

I never actually got a referral to either RE I saw. My o/b gave me a list of REs in area and I saw one. Did not like them and went to another practice based on a friend's recommendation. Since my insurance was accepted, all they asked me was who my o/b was.