5 miscarriages any hope?

Adoruhbul

3 Posts
Reply Posted on: May 14, 2012 at 4:34am
Hi Dr. Braverman--

I was referred to you by a fellow forum member on a different forum who is now 16 weeks pregnant after 4 miscarriages. After my most recent loss she said that I should contact you as youve made her far more pregnant than she's ever been so far! I looked into details on you're website and unfortunately it pains me to say this but it doesn't look like I can afford both you and my RE at this point in time. I am disabled after a head injury and unfortunately doing IF treatments and RPL treatments at this time is unattainable on a single salary :(.

At this point in time I figure we will give it one more shot and if we miscarry again save until you can possibly help us. I figured before I make that leap I should tell you my story and see if you think there is any additional testing that we should have done or try anything different or simply whether or not you think you can help us!

I am 23 years old my husband is 28. As previously stated I had a TBI in 2008. I was one Depo-Provera for 2 years and ceased in August of 2010. I never got my period back so we went to an RE in June of 2011. Oral medications were ineffective so we used FSH and it was effective in finally growing follicles. After multiple failed TI cycles we moved on to IUI. We've done 5 IUIs with my RE with FSH and all have been successful in achieving a pregnancy.

This is my loss history-

September '11- 1st beta was 6, 2nd was 9, consecutive ones did double in the 72-96 hour range which was deemed slow. At my first ultrasound at 6 weeks my hCG was very low at 366. As a result of the low hCG nothing was seen on ultrasound, RE deemed it to be a chemical pregnancy, I naturally miscarried 3 days later. I was originally on Crinone, after beta progesterone came back at less than 1 so I was put on PIO ever since.

November '11- 1st beta was 12, 2nd was 23, third was 35 at 5.5 weeks I started bleeding and went to ER because I had severe pain. I had an hCG of 488 and ultrasound showed nothing in uterus or tubes. It was deemed a possible ectopic by the ER and a chemical pregnancy by my RE. I naturally miscarried the next day.

January '12- 1st beta was 25, second beta was 75, third was 180. I had a doubling time under 48 hours for all betas. At 5.2 weeks I had my first ultrasound, hCG was 2900 and a gestational sac with yolk sac was found and measured 4.6 weeks. 3 days later I went to the hospital with a pink bleed. I had an hCG of only 4400 and the ultrasound showed a large SCH. The sac still only measured 4.6 weeks. At 6.3 days my RE saw me again and at this point the sac only measured 5.2 weeks and the fetal pole measure 2cm however the SCH was getting much large. At my 7 week ultrasound no new growth was seen and the SCH was over 4cm large and they told me even if there had been growth there was really no chance. The baby never had a heart beat. I miscarried with Cytotec at 9 weeks after a missed miscarriage was diagnosed. I was on PIO, Delestrogen, Dexamethasone, high dose folic acid and baby aspirin.

March '12- I had 13 follicles before triggering that were mature. Before this cycle I never had more than 6. My RE was hoping that more than one would implant which would increase my chances. It was a chemical pregnancy and my hCG never made it over 10. I naturally miscarried 4 days after my beta.

May '12- 1st beta was 13 at 11dpIUI. 2nd beta at 14dpIUI was 39 and it continued with a 48 exact hour doubling time. At 5 weeks we did another beta which came back at only 750. At 5.2 weeks we went for another beta and ultrasound. Ultrasound found an empty sac measuring 4.5 days, beta came back only 150 higher at 950. At 7 weeks we went for our viability scan which showed a sac measuring 9mm which was I think 5.2 weeks measurement and a small fetal pole, no measurements given with a beta of only 1900. We were told the pregnancy was not viable and I naturally miscarried today, Mothers Day of all days at 8.1 weeks. I was on PIO, Deleestrogen, Heparin, high dose folic acid, and Dexamethasone.

My hCG numbers have always been considerably low, and the 2 times we've seen a sac on ultrasound it's always measured small. We haven't had much testing done aside from thrombophilias and thyroid. Antiphospholipid antibodies, TSH, ANA, and ALA were normal. We haven't done NK cells or karyotypes at this point. No RH issues. He didn't feel the need to do much more testing because he says he's treating me for anything we would find with the Dexamethasone, Heparin, and next cycle adding Intralipids. He says that we can do the karyotype but since there's no treatment he's not sure it's necessary that we just have to keep trying.

Do you also think this all sound chromosomal? First 2 losses were chemical than another loss right before we got to heartbeat, another chemical and then another loss now which again was right before heartbeat. We've gotten so close twice!

Please if there's any advice you can give I'd really appreciate it. I know I'm really young but unfortunately I can't work because of the injury and this has been my dream since I knew all of my other personal goals could no longer be met. Not being able to have a family either would tear me apart. I really need to find a way to make this work and get this much needed happiness and purpose. I've dealt with the fact I will likely physically suffer and have to be on pain meds the rest of my life because of the chronic headaches I can't also deal with the emotional pain of losing more in life. Please help/advise if you can.

Thank you so much, I'm sorry this was so long!

Amanda S.

Dr. Braverman

2004 Posts
RE: 5 miscarriages any hope? Posted on: May 14, 2012 at 6:07am
I dont agree that you are treating with all that you could , as there are other and better treatments should significant immune issues be found, and certainly from you history that needs to be addressed.
We do offer discounts for hardship cases and I would be happy to help guide you . Call my office and schedule a short consultation so at least we can figure out what the real problem is, lets leave finances for later once we determne what you actually need. Sometimes it can be quite simple and if not then we can put all the options in front of us and figure something out. I understand where you are right now and I hope I can help you enjoy life a little more than you have been.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Adoruhbul

3 Posts
Reply RE: 5 miscarriages any hope? Posted on: May 14, 2012 at 6:35am
Thank you so much for your reply. Are you able to share on here how much it would cost for the consult? I would have to see if we can make it work before I waste your time.

If you don't mind let me just ask you one more question. I know without the immune panel you cant really say anything for sure but in your expertise based on my history does it really scream chromosomal to you? My RE is saying he's very sure and that IVF with CGH is the answer.

And lastly I sorta touched on this in my initial but I am on daily OxyContin and oxycodone for the pain problem and wanted to disclose before I schedule anything as I've been turned away from an RE before because of it. Pain management has given there clearance but if you're uncomfortable with treating someone on daily opiates I understand.

Thanks again. Sorry again for the long one.

Amanda S.

Dr. Braverman

2004 Posts
RE: 5 miscarriages any hope? Posted on: May 14, 2012 at 6:44am
I will treat you , my job is to educate not to dictate. You just have to know all the risks involved. You wont waste my time , best is to call the office and I will speak to you and assess what we can do and whats necessary then my staff will review the fees if you want to continue.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Adoruhbul

3 Posts
Reply RE: 5 miscarriages any hope? Posted on: May 14, 2012 at 7:01am
I will call later today, thank you for your kindness. Your website has already given me so much hope. I know everyone cannot be a success story but I really thought short of Intralipids or IVIG, or PGD/CGH we were out of options. I now realize that my treatments likely weren't adequate, I was on a minimum dose of Dexamethasone. If it turns out to be immune that wouldn't have cut it. Speak to you soon!

Thanks again,
Amanda S.