Intro

[vmars]

I am not sure if this is the right place for me, but over NYE I experienced my second loss since September. I am 33 and DH is 34, and we have a 5 year old son. We had no issues TTC DS. We started trying in June for #2. We waited so as not to have to worry about paying for 2 kids in full time daycare.

In September I had a miscarriage around 4 weeks, about a week after I found out I was pregnant. This time, on Sunday night I woke up with terrible cramping and bleeding. I was about 4 weeks along this time too. My hcg came back as a 4 and progesterone as a .3 from my test on Monday. My doctor said once the bleeding stops to call and make an appointment for testing for me and my DH.

Not sure everything they are going to do yet....my best guess is my hormones could be out of whack. Most of the women in my family have thyroid problems. My sister had to have her levels perfect in order to get pregnant. I have had mine tested but it’s been over a year since my last test.

[G22]

I'm sorry for your losses. I hope that with the testing, you can get some answers for moving forward.

[pinkpeony08]

I'm sorry to hear of your recent losses. I also have been struggling with recurrent pregnancy loss after 2 healthy, term pregnancies. I have had 4 losses now between 11 weeks and 14 weeks with no answers. I hope you can get some answers.

[seeyalater52]

I know I already responded to your other post on Getting Pregnant, but I wanted to say welcome to the board and I’m so sorry about your losses. I’ve had two very early losses as well, although we had to do IVF to get pregnant in the first place.

As I mentioned, some fertility specialists have theories that bringing down thyroid levels if they’re borderline or even normal but above the average can be helpful for those having difficulties conceiving and/or maintaining pregnancies. Your doctor may or may not be familiar with that line of thinking since I know a lot aren’t necessarily specialists in this area.

I’m super glad to hear they’re taking it seriously and willing to try to investigate a cause. Obviously it could be a fluke but as someone who has been there it was important to me to do everything possible to identify a cause in the event that something needed to be fixed. Good luck.

[fairfax]

Welcome! I’m so sorry about your losses, it is so difficult. This board has been an incredible source of support and information for me so I am sure you’ll find it helpful no matter what your path.

To second others above, my thyroid levels were on the higher end of the normal range and my RE put me on a lose dose of synthroid. It’s lowered my levels several points (4 point something to 1 point something - I forget the details). I was hoping it would help me lose weight as well but I’ll take what help I can get!

[chocolatepie]

vmars I am so sorry for your losses. I hope you are able to find some answers soon and that this board can offer some suggestions, insight, and support as you journey to a solution.

[pickel]

I’m sorry for your losses. I hope you’re able to find answers and find some comfort in this board.

[landmermaid]

I'm very sorry for your losses. I came here after my third MC in the last year and a half. The board is a great resource for information and support. Best wishes to you.

[vmars]

Thank you everyone. Does anyone have any insight on what tests are typically done in the beginning? My doctor mentioned blood work, a scan of my uterus and testing my husband (I am assuming he would be blood work and a sperm sample?) I am going to call next week to set up an appointment, but when she called I was busy at work and wasn’t able to really ask too many questions.

[seeyalater52]

Jan 4, 2019 14:17:15 GMT -5 vmars said:

Thank you everyone. Does anyone have any insight on what tests are typically done in the beginning? My doctor mentioned blood work, a scan of my uterus and testing my husband (I am assuming he would be blood work and a sperm sample?) I am going to call next week to set up an appointment, but when she called I was busy at work and wasn’t able to really ask too many questions.

Have you had RPL testing done? Plus they will likely do a full thyroid panel I’d guess if you haven’t had one already.

For fertility bloodowork they typically do a “cd 3” panel that includes FSH, AMH, estradiol, and prolactin.

For uterine they may do an internal ultrasound but will likely want an HSG or SHG to image your uterus and tubes.

For your husband they will probably do a sperm analysis and possibly some bloodwork as well (I have no husband so not sure what is standard beyond SA.)

[vmars]

Jan 4, 2019 14:30:15 GMT -5 seeyalater52 said:

Jan 4, 2019 14:17:15 GMT -5 vmars said:

Thank you everyone. Does anyone have any insight on what tests are typically done in the beginning? My doctor mentioned blood work, a scan of my uterus and testing my husband (I am assuming he would be blood work and a sperm sample?) I am going to call next week to set up an appointment, but when she called I was busy at work and wasn’t able to really ask too many questions.

Have you had RPL testing done? Plus they will likely do a full thyroid panel I’d guess if you haven’t had one already.

For fertility bloodowork they typically do a “cd 3” panel that includes FSH, AMH, estradiol, and prolactin.

For uterine they may do an internal ultrasound but will likely want an HSG or SHG to image your uterus and tubes.

For your husband they will probably do a sperm analysis and possibly some bloodwork as well (I have no husband so not sure what is standard beyond SA.)

I am not sure, both times they used the speculum and took some sort of sample and also did a vaginal ultrasound. I don’t think they did any genetic testing. My last thyroid panel was over a year ago.

[seeyalater52]

Jan 4, 2019 15:13:11 GMT -5 vmars said:

Jan 4, 2019 14:30:15 GMT -5 seeyalater52 said:

Have you had RPL testing done? Plus they will likely do a full thyroid panel I’d guess if you haven’t had one already.

For fertility bloodowork they typically do a “cd 3” panel that includes FSH, AMH, estradiol, and prolactin.

For uterine they may do an internal ultrasound but will likely want an HSG or SHG to image your uterus and tubes.

For your husband they will probably do a sperm analysis and possibly some bloodwork as well (I have no husband so not sure what is standard beyond SA.)

I am not sure, both times they used the speculum and took some sort of sample and also did a vaginal ultrasound. I don’t think they did any genetic testing. My last thyroid panel was over a year ago.

Repeat loss testing is a panel of bloodwork to test for various underlying issues. Your doctor may or may not feel it is warranted after 2 CPs. Mine did, but I recognize that doing IVF adds another layer to things. 

Definitely re-do the thyroid panel if possible and if your provider isn't familiar with the best practice guidelines around lower thyroid levels for TTTC maybe flag that for them too. It may not be enough that it's "normal."

[vmars]

Jan 4, 2019 15:34:57 GMT -5 seeyalater52 said:

Jan 4, 2019 15:13:11 GMT -5 vmars said:

I am not sure, both times they used the speculum and took some sort of sample and also did a vaginal ultrasound. I don’t think they did any genetic testing. My last thyroid panel was over a year ago.

Repeat loss testing is a panel of bloodwork to test for various underlying issues. Your doctor may or may not feel it is warranted after 2 CPs. Mine did, but I recognize that doing IVF adds another layer to things. 

Definitely re-do the thyroid panel if possible and if your provider isn't familiar with the best practice guidelines around lower thyroid levels for TTTC maybe flag that for them too. It may not be enough that it's "normal."

My last test was August 2017 at that time my levels were...

TSH 1.58
T4 1.23
T3 143
Triiodothyronine 3.3

Are these good numbers? Per Labcorp they are in the normal range.

[seeyalater52]

Jan 4, 2019 16:05:39 GMT -5 vmars said:

Jan 4, 2019 15:34:57 GMT -5 seeyalater52 said:

Repeat loss testing is a panel of bloodwork to test for various underlying issues. Your doctor may or may not feel it is warranted after 2 CPs. Mine did, but I recognize that doing IVF adds another layer to things. 

Definitely re-do the thyroid panel if possible and if your provider isn't familiar with the best practice guidelines around lower thyroid levels for TTTC maybe flag that for them too. It may not be enough that it's "normal."

My last test was August 2017 at that time my levels were...

TSH 1.58
T4 1.23
T3 143
Triiodothyronine 3.3

Are these good numbers? Per Labcorp they are in the normal range.

They're well within the normal range, and actually my RE is shooting to get my TSH around 1.5. That said, I've had my thyroid tested multiple times this year and it's been creeping upwards (not super clear what is causing this) so a lot can change in over a year, especially if you've had brief pregnancies during that time period. 

[landmermaid]

Jan 4, 2019 14:17:15 GMT -5 vmars said:

Thank you everyone. Does anyone have any insight on what tests are typically done in the beginning? My doctor mentioned blood work, a scan of my uterus and testing my husband (I am assuming he would be blood work and a sperm sample?) I am going to call next week to set up an appointment, but when she called I was busy at work and wasn’t able to really ask too many questions.

I'm currently going through all of this. For CD3 blood work they had me do a karyotype (my husband as well), some genetic markers, thyroid levels, immune panel, AMH, FSH, LH, Vitamin D, and a few others. There had to be 20 tubes for the draw. I also had an ovarian ultrasound for follicle count on CD3. A different cycle on CD8 I had a saline sonogram to check for any abnormalities. I am opting out of the HSG. My follow-up isn't for a few more weeks so I don't have any results yet, but I feel like it's been very thorough. It's very overwhelming in many ways, it's a lot of information.

[vmars]

Jan 5, 2019 11:24:25 GMT -5 landmermaid said:

Jan 4, 2019 14:17:15 GMT -5 vmars said:

Thank you everyone. Does anyone have any insight on what tests are typically done in the beginning? My doctor mentioned blood work, a scan of my uterus and testing my husband (I am assuming he would be blood work and a sperm sample?) I am going to call next week to set up an appointment, but when she called I was busy at work and wasn’t able to really ask too many questions.

I'm currently going through all of this. For CD3 blood work they had me do a karyotype (my husband as well), some genetic markers, thyroid levels, immune panel, AMH, FSH, LH, Vitamin D, and a few others. There had to be 20 tubes for the draw. I also had an ovarian ultrasound for follicle count on CD3. A different cycle on CD8 I had a saline sonogram to check for any abnormalities. I am opting out of the HSG. My follow-up isn't for a few more weeks so I don't have any results yet, but I feel like it's been very thorough. It's very overwhelming in many ways, it's a lot of information.

20 tubes in one draw? I have a feeling I would pass out.

Were the cd3 and cd8 tests done when you had your period after your miscarriage? Is a saline sonogram painful? What is HSG? Sorry for all the questions!

[seeyalater52]

vmars an HSG is a dye test to check your uterus and tubes. The saline sono (SHG) is similar so many practices prefer one or the other. You have it sometime in the first half of your cycle, I can’r think of any reason why you couldn’t have it during the cycle following your CP although I haven’t done that personally since I did it way back when we first started with the RE.

Your doctor may want to wait to draw CD3 tests in a new cycle post CP, as they’ll want your beta levels to be all the way down. If they’re down again on CD3 it won’t be an issue but sometimes it doesn’t work out that way.

A lot of the tests the previous poster mentioned like immune, genetic markers, karyotype, thyroid, vitamin d don’t have to be drawn at any particular time in your cycle. They are part of recurrent loss testing and whether your doctor runs them basically just depends on how aggressive they are about your early losses. Some doctors seem to take that more seriously than others, who chalk it up to bad luck. I think you have a living child as well so that may impact how aggressive they choose to be on the genetic side.

[landmermaid]

Jan 5, 2019 11:43:40 GMT -5 vmars said:

20 tubes in one draw? I have a feeling I would pass out.

Were the cd3 and cd8 tests done when you had your period after your miscarriage? Is a saline sonogram painful? What is HSG? Sorry for all the questions!

They had to use both arms to get all the blood they needed. I laughed that I used to give blood in college, so I should be good. They looked at me and said it probably was close to a pint that was taken. I'm not at all squeamish for blood draws, so it wasn't too bad. But sadly there was no cookie or juice box for me afterwards 😂

For my testing I believe I had gone one or two cycles after my miscarriage. I called the office after my third miscarriage and it took a few weeks to get an appt, then waited for the right time. Like seeyalater said, some of the blood tests didn't necessarily have to be on CD3, but it was easier for me to get it done all at once.

The saline sonogram was not painful at all. I felt a little pinch when they put the tube to administer the saline, but that was seriously it. My pap smears are more uncomfortable. And I hadn't taken any ibuprofen. I had no cramping during. No spotting after. It was quick and was definitely the right choice for me.

Feel free to ask away!

[seeyalater52]

I took 800 ibuprofen before my saline sono and it still hurt a lot, but paps are painful for me due to the speculum, which they also use to insert the catheter through the cervix for the procedure, so that accounted for some of it. The cramping during was very intense but I felt ok almost immediately afterwards, no spotting but I needed a pad because the saline solution continued to drip out for a few hours. I’d recommend the ibuprofen just in case because people have a wide range of experiences with how painful it feels for them but try not to worry too much about it.

[landmermaid]

seeyalater52 I'm so sorry that your's was so uncomfortable. Thank you for sharing your story too.

[vmars]

Jan 5, 2019 13:35:54 GMT -5 seeyalater52 said:

I took 800 ibuprofen before my saline sono and it still hurt a lot, but paps are painful for me due to the speculum, which they also use to insert the catheter through the cervix for the procedure, so that accounted for some of it. The cramping during was very intense but I felt ok almost immediately afterwards, no spotting but I needed a pad because the saline solution continued to drip out for a few hours. I’d recommend the ibuprofen just in case because people have a wide range of experiences with how painful it feels for them but try not to worry too much about it.

Thank you for the ibroprofin tip. I am not great with the speculum stuff either. My doctor told me I can call to set up my appointment as soon as the bleeding stops. I am planning to call on Monday and see when they can fit us in.

[ilovecandy]

Just wanted to say I am so sorry for your losses. I think everyone else covered the testing questions.

[Jalapeñomel]

Sorry to see you here vmars. I hope you get some answers.

The HSG may be pretty easy for you if you’ve had a vaginal birth. Overall, the emotional aspect of this process far outweighs anything physical. Good luck!

[vmars]

Jan 6, 2019 14:39:22 GMT -5 Jalapeñomel said:

Sorry to see you here vmars. I hope you get some answers.

The HSG may be pretty easy for you if you’ve had a vaginal birth. Overall, the emotional aspect of this process far outweighs anything physical. Good luck!

I had a csection. But yeah I agree the emotional is much worse.

[vmars]

So I got an appointment for 8:15 am tomorrow morning. The receptionist was less than helpful. I asked if I’d be able to return to work afterwards and she said I could only discuss it with the doctor and she couldn’t even discuss the types of testing to be performed. Doctor is going to call me back, but I don’t know when. Is a sperm analysis something they do in the office or is it the kind of thing he can do at home and drop off later? Bc man that’s kind of awkward lol.