4 miscarriages & some hope

rarch

0 Posts
Reply 4 miscarriages & some hope Posted on: Jan 3, 2011 at 6:56pm
hello Dr. Braverman,
I am wondering if there is something more I can do. After having one successful pregnancy (and a healthy baby boy, 6 years old), I have subsequently suffered from 4 miscarriages over the past 4 years. Each time, I get to 5 or 6 weeks, and then lose the pregnancy. in only one of the pregnancies had we seen a heartbeat. In 2 of the pregnancies, there was only a yolk sac seen. I have had every test known to man--not kidding! Everything came back normal--no anticoagulation problems, normal kareotyping for my husband and I, no structural uterine or tubal problems, no killer cells, etc. I have also had testing on 2 of the miscarriages and both were found to be normal chromosonally, (one male & one female). Most recenlty, we went through IVF, only to have the same outcome, another miscarriage. Frustrated and confused, I recently went to Dr. Mary Stephenson at the University of Chicago (I live in Philadelphia) for further testing. She performed an endometrial biopsy and sent it to Dr. Harvey Kliman at Yale. Dr. Kliman performs The Endometrial Function Test (EFT) on the sample, and it was discovered that I had high levels of cyclin E. Dr. Stephenson prescribed Prometrium 2 times per day, 3 days after my Peak fertility day. Are you familiar with the EFT done by Dr. Kliman? I am wondering why my bloodwork levels of progestrone were always normal, so it's odd to me that more progesterone would help. Any thoughts? Thank you so much!

Dr. Braverman

2004 Posts
Re: 4 miscarriages & some hope Posted on: Jan 3, 2011 at 11:43pm
Hi Rarch

Its hard to answer your questions without seeing all the testing you have had done. Yes I know of Dr. Kilmans lab and he has done excellent work in endometrial testing for implantaion issues and we are setting up to use his lab as well. With that said I do agree that this one finding makes it difficult to begin another treatment cycle without all else being explored. "all tests known to mankind" is a common phrase among patients who are referred to my center, and most have not had all the testing I would look for. I do agree that this is not genetic and most likely an implantation issue. There are HLA genes that are HY restricting as the women who have them have a higher chance of miscarriage only after a first male child . This would be treated differently . You may also be a candidate for our neupogen program.
Please call my office and ask for Kim, let me get a chance to go over all your records then I can give you the best advice or treatment options. Lastly dont despair, it is very unusual once you've had a child that we wont figure out how to get you another.
I hope I can be of service to you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.