Unfortunately most doctors consider 1-2 losses fairly normal. It’s only considered repeat pregnancy loss and “rare” after 3. Doesn’t make them any less devestating but getting testing and treatment before 3 losses can be difficult because 1-2 losses is still considered just really bad luck.
I’ve had five losses before my current pregnancy. I’m in the home stretch of my first successful pregnancy. I spent 2.5 years pouring over any kind of research, forum, message board, etc trying to find answers. The sad truth is 50% of even recurrent losses never get an explanation. There’s just not enough research out there to provide women and families reasons and solutions.
If your RE is willing to treat this as recurrent pregnancy loss, I’d first make sure s/he is very knowledgeable in RPL. I went through three REs before I found one that actually took the problem seriously. The rest still blew me off as a case of bad luck. One went as far as to start out the appointment saying “well the good news is at least you can get pregnant!” This was 2 weeks after a D&C for #3. I cried through most of the appointment and never went back.
Stuff you want them to check – hormone levels, dna fragmentation on dh (normal sperm analysis doesn’t mean much because count, motility, etc isn’t an issue if you’re getting pregnant. You need to know the percentage of damaged dna that could cause chromosome issues), egg reserves (the lower the reserves the more likely to have chromosomes issues), clotting issues, immune issues, environmental issues (heavy metal, etc). If any of these are a problem, IVF doesn’t always fix them. I wasn’t jumping into IVF with the cost and mental/physical toll if we didn’t know why I kept losing pregnancies because it’s a really expensive gamble.
Also, IVF is not a guarantee. You have other, much less expensive options you can try before IVF. We did three rounds of Femara, monitoring, trigger shot, booster shot, prednisone (I’ll get to that below), and progesterone. The 3rd (and final round we planned to try) worked. Some RE’s will also try IUI to add in the benefit of washing the sperm to help weed out some of the bad. Darling Husband dna fragmentation came back really good so medicated/timed intercourses cycles had the same odds as IUI for us so no reason to try an IUI.
This is already so long but this is a little more what I did. I don’t know if all of this helped, if any of it helped…maybe none of it helped and we were just a case of the worst luck, but I always wanted to see what others did in case there was something I could try. First, almost all of our testing came back great. On paper we should have been popping out all kinds of kids, even with me being 37, dh was 40. Testing looked like we had the fertility of people in their 20s. My NK cells came back elevated. Not terrible, but enough to show a possible immune issue. I took prednisone for the first trimester to try and keep my immune system suppressed. The Femara was used to help boost my egg quality (and produce 2-3 follicles to increase our chances). The trigger shot was to release all follicles at the same time, the hcg booster shot was to trick my body into thinking I was pregnant at about 5dpo to ramp up my hormones naturally. My RE added progretrone just as a precaution and huge doses of methylfolate in case of an MTHFR issue.
I didn’t just stop with what the RE added. One thing no one ever really talks about when it should be #1 is egg quality. There’s not really a test for it so I guess it gets overlooked. It’s assumed if you have a lot of eggs, they’re good, low reserves, they’re bad. That’s so not the case. There are so many factors that affect egg quality. Bad eggs can create issues with implantation, chromosomes, progesterone levels, hcg levels, etc. I really have to wonder how many of that 50% never get an answer have egg quality issues. The only time we did testing on the fetal tissue cake back as a trisomy 16, definitely a quality issue and not genetic. Egg quality can be turned around in most women though. I changed my entire life for over 6 months trying to improve my egg quality. The book It Starts With the Egg can help so much. They go into supplements that can improve egg quality, environments changes, dietary changes. I took all the supplements, I changed my diet to a lowish carb AIP paleo diet, we got rid of all chemical based products in our house (cleaning, laundry, soap, hair, makeup). I stopped using plastic bottles, containers. I did Accupuncture, lost weight, tried to manage my stress, lowered my inflammation. Does it seem extreme and overkill – maybe, but my miscarriages brought out so much anxiety in me that all the changes I made made me feel like I was at least doing my part. There was nothing to be lost by making these changes
This is just my small novel on pregnancy loss. I hope you find some answers to yours…or at least find a solution.