Recurrent Pregnancy Loss

fondren82

0 Posts
Reply Recurrent Pregnancy Loss Posted on: Nov 15, 2010 at 9:41pm
I am so happy to have found this site. I am 28 and my husband is 31. We are both healthy and neither of us drink ETOH or smoke. We have a healthy 2 and a 1/2 year old little girl who we had no trouble conceiving. Since she turned 1, we have been trying to have another baby. I had 4 chemical pregnacies and was sent to a fertility clinic. All of my lab work (thyroid, thrombophylias, lupus, genetic testing, etc) and tests (u/s, HSG, sonohistogram, etc) have been normal. I was started on cycles of Clomid, ASA, and vaginal Prometrium. 2 weeks ago I got a positive home preg test. My HCG levels have climbed very slowly. (7-72-167-457-807) All of these were taken 4 days apart. I am supposed to be 5wks and 7 days today. My HCG level yesterday was 807 and my u/s showed a questionable yolk sac. I know that my --'s are not normal, but I have had no bleeding. I feel like I am prolonging the inevitable with the ASA and Prometrium. If this does result in a m/c, which sadly I think it will, what could be causing this? My husband has a varicocele and has never had a semen analysis. Is this worth checking? I have read about the immunologic response to pregnancy. Could my body be rejecting any future pregnancy after my little girl? Thank you for any insight or help you might have!

Dr. Braverman

2024 Posts
Re: Recurrent Pregnancy Loss Posted on: Nov 16, 2010 at 12:13am
I always have ideas. First the SA does need to be performed along with a DNA and what we call an OSA(oxidative stress assay) as abnormalities here could cause repeat chemical pregnancies and early losses. clearly you need a full immune w/u as well, for the losses could be do due immune rejections , we commonly see this even after a first successful pregnancy as this could have been the trigger event. These are all very treatable but rarely worked up at many fertilty centers. Feel free to fill out a patient questionairre , and call to schedule a consult I would be happy to help you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

fondren82

0 Posts
Reply Re: Recurrent Pregnancy Loss Posted on: Nov 16, 2010 at 1:07am
Thank you so much for your response. I clearly asked my Fertility clinic about SA and about immune testing, but I was told neither of these were likely my problem. This has been so frustrating! If you don't mind me asking, what is involved in an immune w/u? I will be happy to fill out the questionairre, but I live really far away. Thanks so much for your help.

Dr. Braverman

2024 Posts
Re: Recurrent Pregnancy Loss Posted on: Nov 16, 2010 at 1:26am
The immune workup is just blood work for you and a sample he has to donate. The blood work we will get drawn at your home wherever you live(we follow patients from all over the world) and the sample for him will be sent to you , he donotes and ships it back to our lab.
We manage immune treatments regardless of where you live and we can do this in conjuction with your own fertility specialists. First we need to find the problem so we can offer you some solutions.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

fondren82

0 Posts
Reply Re: Recurrent Pregnancy Loss Posted on: Nov 16, 2010 at 1:39am
I can't thank you enough Dr. Braverman. I have gotten more questions answered in 1 night, than I have in a year. I return to the fertility clinic on Friday, and if I get the news that I am expecting, I will definitely fill out the consult form and send it your way. Thanks so much!

cherylt

0 Posts
Re: Recurrent Pregnancy Loss Posted on: Nov 16, 2010 at 2:43pm
Hi Doctor

I had a miscarriege on the 10/11/2010 and the Doctor i was going to never really explained what went wrong, i was 11 weeks pregnant and lost the baby, the doctor was saying something about my levels being completely off and the baby wasnt growing, i need to know if myself and my fiance try again what are the chances that i will go through this again. They did the DNC on me on the 10/11/2010.

Thank you

Dr. Braverman

2024 Posts
Re: Recurrent Pregnancy Loss Posted on: Nov 16, 2010 at 3:29pm
Hi Cheryl,

The most important information you will need is the genetic studies on your loss. If they are abnormal then both of you need to get "karyotyping" genetic studies to see if either one of you is the cause. If that is normal then there is minimal risk of this happening again.

If the genetics are normal then you need a full investigation as it is unusual to loose a pregnancy so late. Let me know what the genetics show then I can guide you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

fondren82

0 Posts
Reply Re: Recurrent Pregnancy Loss Posted on: Dec 9, 2010 at 2:59am
Hey Dr. Braverman,
I did in fact have a miscarriage over 1 week ago without a D&C. I recently went for my f/u appt. They told me the next step is to continue Clomid, ASA, and Prometrium, but they now want to add Lovenox. I would understand adding Lovenox if I had a known clotting disorder. I can't see giving myself daily injections for no known reason. I feel like they are taking shots in the dark. I was wondering if you have ever put pts on Lovenox when they don't have a known clotting disorder? Thank you

Dr. Braverman

2024 Posts
Re: Recurrent Pregnancy Loss Posted on: Dec 9, 2010 at 10:37pm
It should not be done until a complete workup has been done, sometimes during the immune workup we find elevated levels of complement or inflammatory cytokines that can lead to clotting and this would require lovenox. But you still need to rule out the need for other treatments before embarking on another pregnancy.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.