Egg quality and recurrent misscarriage

cerniway

2 Posts
Reply Posted on: Jan 20, 2012 at 12:00pm
Dear Dr. Braverman,

I found your website today on the day that I found out I am having my 13th miscarriage. My husband and I are at a cross-roads as to what to do next. We are blessed with 2 little boys who are 5 and 3. We have always struggled with recurrent miscarriage since we started on our journey of wanting a family back in 2002. I am 40 yrs old and had my first miscarriage at 31. Followed quickly by 3 more over the following 3 years. It seems we have had every test known to man We have had HSG followed by laparascopy to look in abdomen and in the uterus for a filling defect that turned out to be nothing, immune panels (heterozygous for MTHFR and Factor V leiden), karyotyping of both mine and my husband's chromosomes for any translocations, and finally for testing for any infectious or hormonal issues, both of which were negative. We also got tested for x-inactivation and found that one of my x chromosomes is 100% skewed, which while they said is very unusual may not have anything to do with recurrent miscarriage.

We eventually were given a protocol for OI with follistim for stimulation, lovenox 40mg/twice daily,81mg aspirin 1/day and IM 50mg progesterone in the hope that we might get more than one egg fertilize, implant and hope for the best. Using this protocol, we went on to have our first boy in March of '06 (pg#5), then had 2 more miscarriages (one w/twins; again using this protocol) and had our second boy in January of '08 (pg#8), whom was a twin as well. We have since had 5 more miscarriages since starting to try for our 3rd child in January of '09. Alright, so after all that, my question is in relation to egg quality. Is there a way to tell if my problem is and always has been egg quality? Is IVF even a reasonable next route for us? We would do the IVF with the newer 24 chromosome pgs and ask to potentially (if based on evidence) only put back in XX embryos to avoid the x-inactivation issue? If do not know what our problem is, is doing IVF a waste of emotional, physical and financial energy? One other thing that we have had done is several karyotyping of our miscarried embryos and of the 4 we have tested they have all been normal chromosomal boys.

I look forward to your answer - I apologize in advance for the complex nature of our case. We should probably get a consult with you, but wanted to know if you thought that was something that would be beneficial for us or just wasting yours and our time? .....Blessings to you, Rachael

Dr. Braverman

2027 Posts
RE: Egg quality and recurrent misscarriage Posted on: Jan 20, 2012 at 2:50pm
there is nothing unusual about your case as these type of cases are very common here. You certainly need more extensive testing to determine if this is only egg quality which at this time you can not make that assumption. Please call me and schedule a consultation by telephone or skype and I can organize this workup for you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

cerniway

2 Posts
Reply RE: Egg quality and recurrent misscarriage Posted on: Jan 20, 2012 at 5:40pm
Thanks for your quick reply. I will get an appointment for a consult with you when we are feeling a little more healed from our current miscarriage. Unfortunately, since we only found out today, we will have to go through the physical issues of miscarrying over the next week or so and then we can re-visit what to do next. ....Thanks again!

Dr. Braverman

2027 Posts
RE: Egg quality and recurrent misscarriage Posted on: Jan 20, 2012 at 11:20pm
ok , please be aware that testing during your loss gives us a lot more information on how your immune system is interacting with your pregnancies. Some of this information is lost as time goes on.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.