BFP after RPL. Brain dump. Update with question.

[pinkpeony08]

I was planning to test today, but I was going to the ob yesterday for recurrent yeast infection after not having one in years. I thought I might as well test before going. It was positive. At least I was able to have discussion in person about mfm recommendations. Having to sit in the ob clinic without any bad news also was helpful to my anxiety about going in. He also gave me terconazole to get rid of the yeast that didn’t clear with monistat.

I’m feeling nervous about the bfp, feeling like I’m getting right back on the roller coaster emotionally, wondering if this will even work or if I’ll have to go through another loss.

I also felt crummy this am, though I’m not even 4 weeks yet. I’m worried I’ll feel horrendous in a few weeks... or this crummy feeling could be in my head.

He gave me the option of prometrium(I have the rx though I was planning to finish the terconazole before starting). He talked with mfm while I was there and they recommend waiting for heart beat (aka no ectopic) before starting lovenox or baby aspirin. He basically told me the option of which of these 3 (progesterone suppositories, baby aspirin, lovenox) is up to me since there isn’t actually good evidence for any of them. Any thoughts?

My prior losses were at 11w, 14.5w and 12w.

Sorry for the brain dump.

UPDATE:  I go in for my appointment on Monday and should be about 6.5 weeks.  I'm already on baby aspirin and progesterone suppositories.  My OB is leaving the decision about lovenox up to me, and I don't know if I should add lovenox or not.  Essentially, because there isn't good evidence for any of the medications for RPL, he doesn't have a recommendation.  I may talk with MFM more and have them weigh in as well, but wondered if anyone had any insight?  I'm an NP myself, so I know about risks of lovenox, but hard to decide what I should do.  I'm also unsure my insurance would cover it, and I know it's not cheap.  Any thoughts?

[compassrose]

I’m so sorry. I hear you. I’m currently 8 weeks after 3 losses (all d&cs at 9.5 weeks), and I’m dreading my ultrasound at 9 weeks on Weds. because it’s where I’ve heard bad news before. I don’t have any advice for mental health other than staying distracted and telling the people you need for support.
I did a FET this time so I’m on all kinds of meds, but last time my OB had me on prometrium and baby aspirin from my beta, so that I at least felt like I did everything I could. I think there’s some mental health value to that.

[pinkpeony08]

Sept 22, 2018 13:50:24 GMT -5 compassrose said:

I’m so sorry. I hear you. I’m currently 8 weeks after 3 losses (all d&cs at 9.5 weeks), and I’m dreading my ultrasound at 9 weeks on Weds. because it’s where I’ve heard bad news before. I don’t have any advice for mental health other than staying distracted and telling the people you need for support.
I did a FET this time so I’m on all kinds of meds, but last time my OB had me on prometrium and baby aspirin from my beta, so that I at least felt like I did everything I could. I think there’s some mental health value to that.

Thanks for the kind words. Sending good wishes for your 9 week ultrasound- I can imagine there will be a weight lifted off of you after that appointment.

My ob sounds like he would be willing to order lovenox if I asked, but he is less in favor of the lovenox compared to prometrium and baby aspirin. It sounds like that may be makes the most sense. Mfm voiced that there is reason to change something for mental health sake even if nothing actually changes physiological.

[loira]

I'm sorry, it's such a mind fuck. I can't remember - have you already had RPL testing? Are they planning on testing your thyroid levels soon? Mine plummeted in pregnancy, but were totally normal when not pregnant. I had also had an ectopic and was at risk for another, but my RPL specialist didn't seem concerned about the baby aspirin. She recommended I start taking them as soon as I got my BFP.

[luv2rn4fun]

I had two losses (both had heartbeats) before DS1. We did RPL testing and it all came back unexplained. My RE recommended baby aspirin since the follow up appointment (so pre pregnancy) and progesterone supplements (she actually was ok with suppositories but I preferred the shots...I had done the suppositories for #2 and hated them) from BFP through first trimester. I did baby aspirin til 27 weeks.

I did this for both boys. It’s the only difference between them and my first two pregnancies.

((Hugs)). I hope this is your rainbow baby! Being pregnant after loss is so so hard.

[seeyalater52]

I dont have any advice, just wanted to say congrats and acknowledge the complexities you must be feeling right now. I hope things go smoothly for you. Sending so much ❤️ your way.

[cherryvalance]

I just wanted to offer hugs and commiseration. Honestly, after losses, I feel like a lot of pregnancy feels like just waiting for the other shoe to drop. I'll keep everything crossed that this is your take home baby.

[pinkpeony08]

Sept 22, 2018 15:21:20 GMT -5 loira said:

I'm sorry, it's such a mind fuck. I can't remember - have you already had RPL testing? Are they planning on testing your thyroid levels soon? Mine plummeted in pregnancy, but were totally normal when not pregnant. I had also had an ectopic and was at risk for another, but my RPL specialist didn't seem concerned about the baby aspirin. She recommended I start taking them as soon as I got my BFP.

Thanks. I met with RE, had a ton of RPL testing done, which at first came back looking like a protein C deficiency.  Then I met with hematology, and they did more testing confirming my protein C is just fine.  I'm now on a baby dose of thyroid med.  They ruled out autoimmune thyroid issues, but will be checking my thyroid with my pregnancy labs, which I plan to do around 6.5-7 weeks when my first OB visit will be.  

Interesting that your RPL specialist wasn't worried about the baby aspirin.  My OB said he would worry if I started bleeding with an ectopic and wasn't clotting as I should.  As MFM, the goal is to get me through the 10-15/16 week period because that's where things seem to be going wrong.

Thanks, a mind fuck is about the best description.

[pooh8402]

FX for a sticky baby!

I don't have personal experience with rpl, but a friend of mine with 5 miscarriages, all in first tri, was finally able to carry a baby then she started lovenox on the day of her BFP. I know there are posters here who carried once they started blood thinners too.

My opinion, and what I would do, is to do the prometrium AND the baby aspirin. You have the script, the baby aspirin is OTC and cheap, and they don't hurt, but could definitely help. I don't see a downside to starting meds.

I also did baby aspirin for my current pregnancy and my first one, and those were the only cycles I've conceived on. #anecdotes

[pinkpeony08]

Sept 22, 2018 19:33:21 GMT -5 pooh8402 said:

FX for a sticky baby!

I don't have personal experience with rpl, but a friend of mine with 5 miscarriages, all in first tri, was finally able to carry a baby then she started lovenox on the day of her BFP. I know there are posters here who carried once they started blood thinners too.

My opinion, and what I would do, is to do the prometrium AND the baby aspirin. You have the script, the baby aspirin is OTC and cheap, and they don't hurt, but could definitely help. I don't see a downside to starting meds.

I also did baby aspirin for my current pregnancy and my first one, and those were the only cycles I've conceived on. #anecdotes

Thanks. We both remember RE saying starting the baby aspirin at positive pregnancy test, so I will just pick it up.  I looked at the either the prometrium or terconazole side effects, and I thought there may be an interaction.  I just looked it up - no interaction, so will go ahead and start the prometrium tonight.  

And ha, starting a pregnancy with terconazole is a change too?!  My OB counseled it is safe in pregnancy despite what I'm reading not recommending in the first trimester, ugh.  

I keep trying to remind myself that I don't KNOW the outcome, and my body is capable of this - carried two babies to term without issue before this.  

Thank you all for your kind words and support. SaveSave

[loira]

pinkpeony08, I think in my case, once they knew I was at risk for ectopic, I was unlikely to have another that would rupture my tube. I had ultrasounds at 5, 6 and 7 weeks to ensure IUP, and they would have likely found an ectopic before rupture became an issue.

[woowoo]

Popping in to say congrats and offer hugs.

[scm1011]

Congrats and fingers crossed for a sticky baby. I'm sorry you've experienced so much loss; I hope this is your rainbow baby.

[mpc]

Pregnancy after loss is so hard. I also had 3 losses in a row. I don't know that I have any good advice for getting through 1st trimester after that. It was rough. I did start baby aspirin and prometrium right away with subsequent BFPs. I've gone on to have 2 successful pregnancies after my losses, and i wanted to pass along my very best wishes of the same for you.

[stellelinds25]

I don't have any advice, but I wanted to send along some congrats and lots of sticky baby vibes! (((hugs))

[blt08]

Congrats and all my love dealing with all the complexities that come with PGAL.

[pinkpeony08]

Thanks all. I sent a message to my ob this am and asked him to connect with re and mfm and get consensus on a plan, including the baby aspirin.

[pinkpeony08]

Bumping up the thread with update/question in original post.