Early Pregnancy Loss - 1

Thursday, March 15, 2007

Kenneth F. Trofatter, Jr., MD, PhD

One of my sonographers came out of an exam room the other day with a vaginal transducer (ultrasound probe) held out in front of her, still sheathed in a lubricated condom, and lightly streaked with old blood. The expression she had on her face is one that I have seen hundreds (probably thousands) of times over the years and so I simply preempted her report to me with the simple question, “How far along was she supposed to be today?” Not surprised at all by my ‘insight’, she responded just as straightforwardly, “Well, she is supposed to be 12 weeks, but the baby is only 8 weeks size and does not have a heartbeat.” “Does she know?” I asked (thinking wishfully, but also anticipating the response). “No,” I was told, “All they wanted to know is if it is a boy or a girl, and I told them the doctor would have to talk with you about that.” My sonographers do their jobs and know their roles all to well. The MD after my name means that I am the one responsible for the Morbid Discussion that has to take place to inform a couple that they have a pregnancy that didn’t make it through the first trimester.

I went into the room, introduced myself, and picked up another transducer to ‘lay my hands’ on the patient before giving them the bad news. They were a young couple, neither one more than 19 years old, and had “just gotten married the week before,” probably because of the unplanned pregnancy. But, they were also very excited about the prospects of being parents, and almost immediately asked me the same question they asked my sonographer, “Is it a boy or girl?” I told them that “I can’t tell because the baby is too small” and at that point, as so often happens, they opened the door with the question that almost always inevitably follows, “Does that mean there is something wrong?” Then, in a routine I have had too many opportunities to rehearse through the years, with the transducer focused on the tiny embryo so that they could see the baby on the viewing screen, I told them, “You are supposed to be 12 weeks by your last period and the baby appears to have stopped growing at about 8 weeks. Here (using the pointer) is where we should easily be able to see the baby’s heart beating, even if the baby was only 8 weeks, and there is no heart beat. I’m so sorry.”

At that point, also as so often happens under these circumstances, she sat straight up in the bed, the tears streaming out of her eyes and, hoping she had misunderstood my words, she asked, “Does that mean there is something wrong with my baby?” “Yes,” I responded, handing her the box of tissues we always keep in close proximity to the exam table, “The baby is not alive, you have lost this baby, and we are 100% certain of that diagnosis. I am very sorry.” Since most patients are in a ‘state of shock’ after hearing this news, and are not receptive to any kind of ‘input’, I also said at that point, “Let me give the two of you a few minutes alone together and then we can talk about all this…”

I left the exam room, still within earshot of the heart-wrenching sounds of anguish that I have never gotten used to after all these years; the conversation we had when I returned will be continued in our next post…

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150 Comments:

At Tue Apr 03, 02:36:00 PM 2007, Anonymous said…

I've had several miscarriage (lost the baby before 12 weeks), the baby would start growing and then stop. We have 2 healthy girls now, but after so many tests, never found out the reason for the 4 losses. I'd love to know why?
At Wed Apr 04, 03:20:00 AM 2007, Anonymous said…

I too have had two miscarriages within the space of a year. The last one being in December last year. They say that they cannot do any tests until I have gone through another miscarriage. What is it about the third miscarriage that is so important that they couldn't do for the second one? Also what do you suggest could be the resons why I lost them when I am young, fit, healthy, don't smoke and have no genetic abonormalities within my family? I'd love to know. Thanks.
At Thu Apr 05, 04:22:00 PM 2007, Anonymous said…

I also lost my so expected baby before 12 weeks, he or she didn't grew up after the 7 week. But my question is why the bleeding start right after the first vaginal ultrasound, and 2 weeks after they had to do a second vaginal ultrasound to confirm the bad news and again at doctor's office I had to stop walking since bleeding increased.
At Fri Apr 06, 03:38:00 PM 2007, Anonymous said…

I had an incomplete miscarriage almost identical to the one you described. 8 weeks old fetus, 12 weeks along. Same reaction too. Had a D&C 4 days ago and still have period cramp like pain - is this normal? When should the pain go away?
At Sun Apr 15, 06:49:00 AM 2007, Anonymous said…

please give a detailed information on diagnosis of spinal bifuda, meningomylocele & hydrocephalus during pregnancy. And also wheteher it can be diagonised between 10 to 14 weeks, by ultrasound where a rod in inserted through vagina
At Thu Apr 26, 05:49:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

All of you, thanks for reading and for your comments. I am sorry for the losses you have had. The first three pregnancies I fathered were also lost and I remember to this day the anguish we felt, even though I knew the most likely reasons the babies were lost...they were still our babies that I would never see or hold. To answer some of your questions, please read the other posts I have written on this subject over the past month and please, keep up your HOPE. Chances are that ALL of you will eventually succeed in having your babies.

With regard to the questions related to "spina bifida, myelomeningocele, and hydrocephalus", it is possible to make the diagnosis of a neural tube defect (NTD) early by vaginal ultrasound, but unless the problem is suspected, or there is a family history of the same, it is not something that is typically looked for early in pregnancy. These re often only suspected after having had an elevated maternal serum alpha-fetoprotein screen at 15-18 weeks or at the time of a later ultrasound. If you have had a baby with a neural tube defect, it is recommended that you begin high dose folic acid (4 mg per day) prior to another pregnancy. This can reduce your risk for another baby with an NTD substantially. Also, you should discuss the findings of the previous pregnancy with a genetic counselor to evaluate your risk for other problems that might have a higher risk for recurrence due to chromosomal or genetic conditions. If you are a diabetic, that should be tightly controlled before embarking on another pregnancy. Good luck!
At Wed May 09, 09:48:00 AM 2007, Anonymous said…

Hello i had a miscarraige at 12 weeks. didnt kno i was losing it until i went for my first scan.. had no bleeding until they gave me tablets to bring it on.. had a D+C a week lter and it really helped the bleeding and pain.the doctors never told me why i miscarried i would love to know the reason why as im 21 young fit and healthy and i dont smoke. thank you
At Thu May 10, 09:59:00 AM 2007, Anonymous said…

hi my daughter is 17 and on her first pregancy she went for her first scan at 12 weeks and they found no heartbeat they told her to come back a week later still no heartbeat but the baby had moved its arm to sucking its thumb hows that happened also she had no pains or bleeding could a scan be wrong
At Fri May 11, 11:34:00 AM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To the two "anonymous" posts above...We will probably never know why you (the 21 year old) lost your baby. But if this was your first pregnancy, it may well have been nothing you did or didn't do. Please see my post after this one and check out a later post in this series on "immunologic causes" of early pregnancy loss. Odds are in your favor, and a big 'workup' probably is not indicated at this time. Start a prenatal vitamin and try again in a few months.

With regard to the woman whose 17 year old daughter lost a pregnancy... it is VERY unlikely the ultrasound exam was wrong. It can take awhile for her body to realize the baby is not alive because the placental tissues will continue to make 'pregnancy hormones' for some time...that's why she did not immediately start bleeding and cramping.
At Mon May 14, 12:48:00 AM 2007, Anonymous said…

The story above is almost identical to what I have just been through. I had a dating ultra-sound that showed our baby at 8 weeks a strong heart beat and they said everything surrounding the baby looked really good. We returned for our 12.5 week ultra-sound, excitied to see how our baby had developed since we last seen him/her, watching our baby on the screen in front of us I knew I couldn't see the heart beat but I thought I must be looking in the wrong place (after all I'm not trained to know where to look) The baby was clearly there and I had no spotting or bleeding to make me think anything had gone wrong. The lady left the room and returned with another staff who look and the screen. They asked us how far along I am supposed to be today, I replied "12.5 weeks" they told us the baby has seemed to have stopped growing after 8 weeks and no heart beat could be found. They left the room to allow myself and my husband try to process the news. Two days later I had a D&C (2ND MAY), still slightly bleeding now (14th). I wish I knew what it was that caused this as I am a healthy 29 yr old, non-smoker who took vitamins and stayed away from all the foods the Dr told me to. Is there any research being done to try to find out why this happens? My Dr told me it happens to 1 in 3 women.
At Mon May 14, 12:21:00 PM 2007, Anonymous said…

I went in for an ultrasound and found out the baby had stopped growing. After my D &C thy analzyed muy pregnancy tissue and found out the baby had an extra chromosome 8. My doctor said that was rather rare and that most babies dont survive the pregnancy. I do have encephalomalacia, but haven't had any seizures in several years. Do you think we should be concerned of having problems with chromosome 8 again or is it likely that we will be able to have a healthy baby? We are going to see a genetic counselor...
At Wed May 16, 02:40:00 AM 2007, Anonymous said…

I recently had a D&C after being told my baby had not survived the first trimster, does using an electric blanket during pregnancy increase the chance of a miscarriage? I usually have it on high. This is the only thing I could think of that may have contributed to this.
At Wed May 16, 06:11:00 AM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

Responses to the last two "anonymous" comments:
Your dooctor is correct. Far more pregnancies end in miscarriage than most folks realize. As I have said before, it is very likely that there is nothing you did or didn't do that caused you to lose this pregnancy. Either the baby had a chromosomal problem or your body had just not yet figured out how to carry a pregnancy. The former is more likely if you have carried a baby before and the latter if this was your first.

With regard to the miscarriage of a baby with a trisomy for chromosome 8, this is fairly unlikely to occur. Trisomy 8 occurs in about 1% of all chromosomally abnormal first trimester miscarriages. Having had a trisomy confirmed, you are probably at slightly greater risk than your 'age alone' for another baby with a trisomy of some sort, some would say as high as 1 in 100. By the way, it would be VERY unlikely to actually carry a trisomy 8 baby past first trimester and more than 80-90% of all trisomy babies, including Down syndrome, are miscarried early in pregnancy
At Wed May 16, 10:12:00 AM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

It is not likely the electric blanket contributed to your miscarriage unless you substantially raised your core body temeperature above normal.
At Tue May 22, 03:24:00 AM 2007, Anonymous said…

I think I may have had a miscarriage at about 2-3 weeks but I'm not sure...the reason I think this is that my period was 4 days late and I am NEVER late even by 1 day...you can set your calender by my cycle....for the whole 4 days I had cramps that I kept thinking were menstrual cramps which woke me up a couple of times but no bleeding....then after 4 days the bleeding started and the cramps stopped....for 2 days it was heavy with quite a bit of clotting then nothing on day 3 and light bleeding on the 4th day...nothing since.........just wondering if I should see my doctor......I feel fine
At Tue May 22, 09:54:00 AM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

At this point, you probably don't need to see your doctor. But, if you have anymore abnormal bleeding (even with the next cycle), develop pain, or fever, you probably should. Bet you did have a very early miscarriage.
At Tue May 29, 07:49:00 AM 2007, Anonymous said…

just home from sonohysterogram operation for recurrant miscariages 13 in all in 3 years nothing wrong with wombhave had blood test both husband an my self all fine though i was on asprin 75mg a day to thin blood because one of the tests was a bit over.it has been 7 weeks from my last pregancy which to my and doctors horror was an ectopic had to have tube removed doctors saying that had nothing to do with other miscarriages but im not sure as i have read u can have ectopic but they are at the end of tube and just look like miscarrage is this true.alos we have a 14 year old my husband and i i was very sick threw out my pregancy body was fighting against it.just would love answers can i try again this month r should i i feel fine
At Tue May 29, 07:47:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

Whoa, slow down girl! 13 miscarriages in 3 years is a lot to put on your body. I think you need to see someone who specializes in recurrent early pregnancy loss and I would recommend a specialist in Reproductive Endocrinology and Infertility. By the way, because you have had one ectopic pregnancy, you are at much greater risk for having another and NO, they are not just like having a miscarriage. Ectopic pregnancies are still one of the leading causes of death during pregnancy. Like I said, slow down, take a big breath and find an expert before you try to get pregnant again! Thanks for reading!
At Wed May 30, 03:17:00 AM 2007, Anonymous said…

i have 2 healthy children. had a misscarriage last june 2006. went for scan , i was 10wks but scan showed baby had stopped developing at around 6-8wks. i was feeling all the lovely pregnancy signs at that time and even until around a week after a d+c until things slowly went back 2 normal. i was working in a very tiring and physically heavy job and wonder was this a factor? i am a healthy 28yr old. and still have days when i cant forget what happened and would love some answers, thanks
At Wed May 30, 09:58:00 AM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

The most common reason for a miscarriage in someone who has previously had healthy pregnancies is that the baby had a chromosomal abnormality. This occurs much more frequently than folks realize and most chromosomally abnormal babies do not survive the first trimester. This is not something you have any control over and it is unlikely that your work caused you to lose the baby this early. Thanks for reading and good luck in the future.
At Sat Jun 02, 10:14:00 AM 2007, Anonymous said…

I had a miscarriage recently, I came home from work ligtly spotting blood so it scared me so I called my doctor and told him I was on my way to the ER he advised me to stay there and get checked out, so I did. They did a number of test pelvic exam, blood test urine test with a cather and an unltrasound the used in my vagina the ultrasound showed I was 5 weeks and 3 days when according to my last period I should have been 12 weeks they could not hear a heartbeat I thought maybe I wasn't as far along as I thought because I had a healthy daughter going on 7 years ago and I had no pain and by the time I left the bleeding had stoped. I was told to make an appointment with my doctor and not to go to work until he say I can. A couple of days later he had to do a emergency D/C because I was in so much pain I couldn't bear it. I still long for questions it has only been 3 weeks ago since my D/C I am having signs of pregancy again I feel nausea, sleepy, and sometime I feel like something is moving in my stomach. I know I not crazy and I know I miscarried. Could I be pregant? Is it a higer chance of me getting pregant and having another miscarriage if I get pregant before I have had two periods? I have yet to have a period. I am thinking that the cause of my miscarriage is because of my home being destroyed in the tornado March 1,2007 I felt angry, sad, lonely, and depressed at the same time my daughter and I was in the house when it was destroyed neither of us was physically hurt. I am still having a stressful time trying to piece our lives back together. I am 28 years old and I have no health problems and I did take Ultra Natalcare Tablets ETH the doctor prescribed for me and I am taking them now because my husband and I are trying again. Is this a bad idea, should we wait longer?
At Tue Jun 12, 10:22:00 AM 2007, beverley74 said…

my sister whos 29 and healthy had a miscarraige after baby stopped growing at 8 weeks she found out at her 12 week scan,,had d+c.still shoed pregnant after 7 weeks,,then a greyish red thing came out left over from d+c.now a month after that shes pregnant again 5weeks but has had spotting all week and now has period like bleeding last 2 days and also a thing(she descibed as a pink/red grain of long rice with a crotchet like hook on end) came out on her pad..is she having a miscarraige again ?
At Tue Jun 12, 12:24:00 PM 2007, beverley74 said…

update: an hour after i posted my last message my sis rang and after a pain in her belly she passed a jelly blob wich i pressume that she did have a miscarraige again..i wish i could tell her why?? as me and my other sisster has had 3kids each with no problems at all,,why her?? and im stuck for words to say to her after last miscarraige we both was so upset
At Wed Jun 13, 07:37:00 AM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

Beverley, I am not sure what is going on with your sister. She should not have had a positive pregnancy test 7 weeks after the D&C if the pregnancy was in her uterus and was removed completely by the D&C. Several possibilities come to mind:1) They might not have removed everything from her uterus at the time of D&C; 2) She might have had both a nonviable intrauterine pregnancy AND an ectopic (tubal) pregnancy; 3) She could have gotten pregnant again; 4) She has a more serious problem called choriocarcinoma (a cancer associated with abnormal placental tissues). Regardless, she needs to go back to the doctor who did her D&C, have them review the pathology report from that procedure, get a quantitative hCG (pregnancy test) to find out how much pregnancy hormone is in her blood, and then figure out what to do once they have gotten all that information. Thanks for writing! Wish your sister luck!
At Thu Jun 14, 02:38:00 PM 2007, beverley74 said…

hello thanks for replying kenneth,,my sister did miscarriage later that day..the excact same weeks that her last miscarriage was..is their an explanation why it happened at same time and why the pregnancy didnt go longer
At Fri Jun 15, 01:12:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

Hello again Beverley. I am sorry for your sister and the family. Tell her to try to wait at least 3 months before trying again. She should stay on her prenatal vitamins and talk with her doctors about other evaluation they might deem important. If she miscarries again, she should think about getting a 'second opinion' from a physician who has a special interest in recurrent early miscarriages. Some doctors will do a more complete workup even now if she requests it. Wish her luck for me.
At Sat Jun 16, 02:20:00 AM 2007, Christina said…

I recently went to the doctor to find that my baby stopped growing at 10 weeks and 2 days. I was supposed to be 12 weeks and 6 days on the day of the scan. I am a bit of a difficult case. I had a tumor near my pituitary gland rhat was removed when I was 15. The pituitary gland does not function. I am 30 years old now. I under went ART and we conceived after three tries. The doctor said that it could be a chromosome issue. But he also mentions that it could have been an implantation problem. I had a D&C yesterday and we sent to tissue off to be examined. This was very shocking because I was having sono scans about every two weeks before moving to the new ob doctor. The doctor said that on the next round, if I took a baby aspirin every day that this should help. What will the baby aspirin do? The other question that I have is what does implantation mean. I thought that it had already implanted at the beginning? We could see on the sono scans blood flowing into the umbilical cord and the heart rate was 179 bpm prior to this visit. I don’t go back to the doctor until two weeks from now and he stated that tissue sample could take up to four weeks. These are questions that I would like answered sooner or get an idea of what other questions I can ask the doctor. Thanks
At Tue Jun 19, 04:28:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

Christina, I am presuming this was your first pregnancy? If you are seeing a specialist in Infertility, they probably made sure that your hormonal status is in good shape because of your previous tumor, correct? Even with ART (what kind did you have?), you can have a chromsomally abnormal baby and as we have discussed on numerous occasions, most of those will not survive first trimester. Another possibility is that your immune system did respond adequately enough to allow PLACENTATION (not implantation) to progress normally through the end of first trimester. I will be publishing a post within the next few days related to abnormalities of placentation that are associated with preeclampsia later in pregnancy. I think these two issues (losing babies and developing preeclampsia) are related under these circumstances, but the women who develop preeclampsia figured things out at least partly right! Of cousre there are other possibilities like insufficient progesterone production, thyroid disease, uterine abnormalities, autoimmune diseases, thrombophilias, etc, but have that chat with your infertility doctor when you go back to see her/him!
At Sat Jun 23, 08:37:00 PM 2007, Anonymous said…

hi, I just miscariaged at about 7 wks and the baby stoped growing after 2-3 wks, I didn't have to have a D&C and I feel fine but I was woundering when can I expect my next period? Do we have to use birth control for 3 months? My husband has low sperm motlity anyways.
Annoymous J
At Tue Jun 26, 02:35:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous June 23: You will probably become fertile again within the next 4-6 weeks. Remember, you will ovulate (and therefore be fertile) before having another period. So, you could possibly get pregnant again without ever having a period, even if some degree of 'male factor' problem is present. It is probably a good idea to wait a couple of cycles before conceiving just to give any left over inflammatory reaction from the lost pregnancy a chance to die down. Good luck and thanks for reading!
At Tue Jun 26, 06:29:00 PM 2007, Anonymous said…

If one were to have recurrent miscarriages, do they typically occur around the same time in a pregnancy? I lost my first pregnancy at 12 weeks (baby @ 8 weeks), in March. I am now approximately 5 1/2 weeks pregnant and, as to be expected, am anxious. I'm not feeling any symptoms yet (I had very sore breasts last time), except for some light cramping in my lower abdomen (off and on, no spotting). Should this be cause for concern?
At Wed Jun 27, 04:22:00 PM 2007, Anonymous said…

Am I right that the risk of miscarriage (statistically)decreases at 12 weeks? Is this 12 weeks from the last period, or 12 weeks from conception (14 weeks from last period)?
At Wed Jun 27, 04:39:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous June 26: When you lose pregnancies depends on the reason you are losing them I know you are anxious right now, but there probably isn't much you can do except try to relax a little! You have no control over what is happening in there right now. With regard to your absence of symptoms, I do not have a good answer. Although we would prefer to see them (soon), I have also found no two pregnancies are the same. Maybe this is a good sign since the other pregnancy ended after 8 weeks despite your symptoms! If you are worried, your doctor should be able to tell you if the baby is alive by ultrasound within the next week. Good luck!
At Thu Jun 28, 06:18:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous June 27: When we refer to '12 weeks', we mean 12 weeks from the first day of your last period (presuming regular 28 day cycles). And, yes the risk of miscarriage drops dramatically from once a baby reaches 12 weeks. Thanks for reading. Hope this means things are going well!
At Tue Jul 10, 06:02:00 AM 2007, Amy said…

I came upon this blog in searching for answers for 4 miscarriages. I gave birth to 2 healthy boys in 2001 and 2003. We tried for baby #3 starting in July of 2005 and went on to have 4 early miscarriages between Jan 2006 and August 2006. I went thru the gammut of tests and nothing was found to be wrong with me, my husband or my uterus. We took a break from trying for 9 months and I got pregnant on the first try in February 2007. I am currently 22 weeks pregnant with another boy. The last miscarriage ended with a D&C and the testing that was done on the cells came back "Normal Female Karyotype". Could it be that these 4 miscarriages were girl fetuses and my body cannot carry a girl?
At Wed Jul 11, 11:47:00 AM 2007, Anonymous said…

hi, i'm 17 and this is my second pregnancy. the first one was a blighted ovum. does that put this pregnancy at a higher risk for a miscarriage? and at 6 weeks, 4 days we saw a heartbeat. today i am 8 weeks, 4 days and i don't feel nauseous like i have been feeling daily. should i be worried? my next doctor's appt. isn't until 10 weeks, 4 days. thank you.
At Fri Jul 13, 06:37:00 AM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Amy July 10: It is possible that for some genetic reason you are having trouble carrying a female baby, but that is also not very likely. Most "sex-linked" genetic problems occur in males. The female X-chromosome and the male Y-chromosome do not share much in common. If there is a bad 'recessive' gene on one of your X-chromosomes, and you pass that along to a son, they may have problems, but a daughter would not, presuming they inherited a normal X-chromosome from their Dad. There are circumstances where a parent carries a "Fragile X" chromosome and they are not themselves affected, but the children (male and female) could be. I think it is more likely that your problems arose as the result of so many pregnancies in that short period of time (one or more of which could have been chromosomally abnormal) and your body never completely recovered to allow a good implantation. Probably the best thing you did was take the break before trying to get pregnant again. Hope things go well and maybe some day you'll get your girl. If you don't, I will give you one of mine (just kidding!).
At Fri Jul 13, 06:41:00 AM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous July 11: Because you lost the first baby early, you are at slightly higher risk for losing the second. If you really are feeling like things aren't going well at this point, tell your doctor about that. They can tell, unequivocally, by ultrasound at this point if the baby is still alive. Good luck and thanks for reading.
At Tue Jul 17, 01:46:00 PM 2007, Anonymous said…

Dr. Trofatter, this is Christina, June 16. I wanted to follow up with you and let you know about the results after my miscarraige. This was my first pregnancy and I did under go ART (with FSH and LH drugs, some shots and vaginal suppository, I think it was the progesterom sp?) and we also did insemination. After all is said and done the final results were that there was a slight chromosome indication but was ruled and implantation problem. So our next step is to go back to the fertility doctor and see where we go from here. Thanks
At Wed Jul 18, 04:43:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

Hello again Christina. Thanks for the feedback and best of luck the next time around. Let me know how things turn out, okay!?!
At Thu Jul 19, 01:00:00 PM 2007, Anonymous said…

I wonder if you might be able to advise me - I had a 6 week scan, all was good, heart beat and everything fine. From then I felt sick, exhausted and felt pregnant but for the last couple of days the sickness has gone completely, I have had no bleeding, a bit of pain high up but nothing else but just wondering what it might mean. I realise you can't help but can symptons totally disappear and everything still be ok or is it likely that things aren't so good. Is the only way to find out another scan? I should now be 7 weeks. thanks so much.
At Thu Jul 19, 08:50:00 PM 2007, emily said…

I have had 2 miscarriages in the last 6 months. One in Feb, one in April. My doctors told me that as soon as I have a normal period that I should go ahead & try. Well this time I waited for 3 cycles & I am currently just barely pregnant (postive test this a.m.)period due tomorrow... but have already started some spotting & went for a quant today & it was 280, so it could be hopefull. I had a miscarriage in '99 a son in 2000 & twin boys in 2002...have been scared ever since, but now have been trying & couldn't get pg for an entire year & now have had 2 & possibly on my 3rd miscarriage now. Any suggestions? Or thoughts for the future? My dr. said they will do the work up on me if I lose this one checking for blood clots??...but I would love to save this one if at all possible. I am on 100 mgs of prometrium 3 times a day. Glad I found you & thanks for your help
At Fri Jul 20, 04:01:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

Emily, take a big breath and relax for the time being. Keep taking the prometrium. Ask your doctor if it's okay to take a baby aspirin (81 mg) daily as well as some extra folic acid (1-4 mg). If you lose this pregnancy, read my last 3 posts in this series and see if they don't answer some of your questions. Good luck with things and keep your chin up. Odds are since you were successful before, you will be again! Thanks for reading.
At Fri Jul 20, 04:08:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous July 19 01:00. It's hard to say because different folks experience the hormonal changes in pregnancy in different ways (even with their own different pregnancies!). Tell your doctors about your concerns. Neither they nor you have any control over what is going on on there right now, but they may want to do another sonogram on you if you're "not feeling pregnant" anymore and certainly if you develop any signs or symptoms of miscarriage. Good luck. Hope things turn out okay!
At Fri Jul 20, 07:36:00 PM 2007, Anonymous said…

hi. right now i am about 10 weeks pregnant. at 6 weeks i saw a heartbeat and i've been feeling very pregnant ( nausea, fatigue ) for the past few weeks. i have had 1 miscarriage in the past. i'm worried because the last time i had a miscarriage i still felt sick and had no bleeding or cramping up until my d&c. is there anything i should be looking for to see if anything is wrong this time around?
At Thu Aug 02, 03:01:00 PM 2007, Anonymous said…

Dr. Trofatter,

First I want to thank you for blogging and answering people's concerns.

This is my first pregnancy, I am 29 yrs. old. This week I went for my first ultrasound. I was expecting to be into my 10th week based on the date of my last menstrual period, which was 5/18/07. I have a 30 day cycle. My husband and I were planning this pregnancy, and I am 100% certain that the baby was conceived on 6/1/07...I know because lets just say we only got one try in....and didn't get the chance to get intimate again for a while....

On father's day, June 17th, I took two home pregnancy tests, and both showed positve. I went to the doctor the next day and got a positive confirmation.

All has been well, no cramping or spotting, and I have been definitely feeling pregnancy symptoms..nausea, fatigue, etc.

Well, on our ultrasound July 31, no heartbeat could be found, there was no movement, and the baby only showed a gestational age of 8 weeks 0 days.

The doctor would not say that anything was wrong, nor would he say that everything was ok. He kept questioning if I was sure of the date of my last period. I'M SURE. The doctor simply said "if it would make you feel better, I'll do another ultrasound in a couple of weeks."

The HMO couldn't get me another appointment for three weeks, and I'm simply worried sick. I simply can't wait that long...I'm thinking of fibbing to the HMO and telling them I'm cramping or spotting just so they'll get me in for another ultrasound next week.

Please, I just need to know, should I be worried? Is there hope for my baby? I'd rather hear it straight because my HMO won't give me any answers. Not knowing is the hardest part. Thank you greatly.
At Thu Aug 02, 04:16:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous August 2: If the baby is 8 weeks size, and they don't see a heart beat, and they are experienced in interpretation of early OB ultrasounds, then they have not been honest with you. This pregnancy did not make it and there is no sense beating around the bush. I'm sorry, but honesty is always the best policy under these circumstances. The only hope would be if they are NOT experienced in the interpretation of an early ultrasound and if that is true, then they shouldn't be doing them. I am so sorry. Best of wishes to you and your husband.
At Fri Aug 03, 08:07:00 AM 2007, Anonymous said…

Dr. Trofatter I am 22 years old, healthy, nonsmoker/drinker and I lost 2 babies around 14-16 weeks due to an incompetent cervix. This time around I was suppose to be 11 weeks and the ultrasound showed only a gestational sac and it looked to be 6 weeks and 5 days. My dr. said the baby just stopped growing. Why would my baby stop growing and the others did not? Also they will be doing a d/c will that cause more harm to my cervix?
Please help
At Fri Aug 03, 05:12:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous August 3: Losing babies at 14-16 weeks due to an incomptenet cervix is a little unusual, especially the first loss. I would be curious to hear about the circumstances surrounding those losses. Were the babies normal? Have you ever been evaluated for the possibility of a uterine abnormality such as a bicornuate or septate uterus, or perhaps a submucosal fibroid? Have you had any infertility problems? As for the most recent loss, I bet that baby had a chromosomal abnormality. They occur much more frequently than folks realize and often are lost as a "blighted ovum" or an early embryonic loss in first trimester. If you really have such severe cervical incompetence that you are losing babies early in midtrimester, I doubt a D&C will worsen the situation. You should give very serious thought to having an abdominal cerclage after your uterus has been throughly evaluated. I wish you well and hope things eventually work out. Thanks for reading! Dr T
At Fri Aug 03, 08:10:00 PM 2007, Anonymous said…

Dr Troffater-thank you for replying to our queries!I had an ultrasound scan yesterday which showed a heart beat which was apparently 'fine & normal' according to the Dr. He has indicated that the foetus is approx 1 week small for its age. I should be 7wks & 4 days, and the Dr has said it looks more like 6 weeks & 3 days. I am pretty sure of my dates of menstruation as I have neen noting these down. I usually have a regular 28day cycle. I am due to go back for another scan in 1 week, but I am understandably very anxious as he said the chances of miscarrying are pretty high. I have miscarried once already in January this year. What are the chances of 'catch up growth' and my baby surviving or should I prepare for the worst. Many Thanks
At Sat Aug 04, 04:28:00 PM 2007, Anonymous said…

Dr. This is anonymous from Aug. 3rd with the incompetent cervix. The two babies were healthy with no abnormalities. What are these three possibilites:bicornuate or septate uterus, or perhaps a submucosal fibroid? I never had any infertility problems and I just don't know what to do I really want a child and my fiance does too. Will there ever be hope for us? Thanks so much for answering my comment it is greatly appreciated!
At Sun Aug 05, 06:04:00 AM 2007, Anonymous said…

Dear Dr. Trofatter,

I was Anonymous August 2nd...I just want to let you know that you were right. After reading your reply, I couldn't wait any longer. I called the HMO and lied and said I was cramping, and I managed to get an appointment the next day with another doctor. He confirmed that the baby had passed away somewhere in my 8th week of pregnancy, as there was no growth, movement, or cardiac activity whatsoever. I have a "missed miscarriage". I chose to medically induce the miscarriage at home with suppositories that will cause labor...

My husband and I are devastated, but we're just glad that we know now. We keep telling ourselves that it just wasn't meant to be.

I appreciate you answering my question honestly. You helped me to have the courage to not wait any longer to find out. Thank you for your help.
At Sun Aug 05, 10:07:00 AM 2007, Jessalyn said…

I am on my third pregnancy. I had a daughter healthy daughter in October 2002. I lost triplet daughters at 12 weeks in March 2007 with no chromosomal defects (babies measured approximately 8 weeks). My LMP was May 28, 2007. I ovulated on June 21, 2007 with the assistance of the Clear Blue Fertility Monitor. I had my first ultrasound on July 18, 2007 with a FHR of 120 BPM. I called my doctor on July 23, 2007 with c/o cramping, back pain and difficulty emptying my bladder. I went in that day and gave a urine sample to check for a bladder infection. I also had a trans vag ultrasound. Baby measured 6 weeks 5 days (exactly what I should have been that day); however, no heart beat detected. I elected to have a D&C done the next day (7-24-2007) with the exception that I have an ultrasound done prior to getting prepped. My husband and I arrived at the hospital, filled out paperwork and got admitted. We went in to have the transvag ultrasound done prior to surgery prep and found a heartbeat of 144 BPM. My OB came in with a sick look on his face (I will NEVER forget the look) and the first thing he said is "This makes me nauseous." He ordered an additional ultrasound to be done in two weeks from July 24, 2007. Obviously, we went home without the D&C! Since then, my anxiety and stress levels have been "through the roof." I could not wait for my August 7, 2007 ultrasound. I called on Friday, August 3 and asked if I could come in to get my ultrasound done earlier. I was able to get in at 11:20 am that day. Baby measured accurate at 8 weeks 1 day, but no heartbeat.....AGAIN! I had a second ultrasound done right after with an OB present to confirm no fetal heart tone. I, again opted for the D&C the next day (Saturday, August 4, 2007) with the exception again of having an additional ultrasound done prior to surgery prep. Again, we did paperwork, got admitted and went in for the ultrasound prior to surgery prep. No heart beat. A doctor came in for confirmation...no heartbeat. My husband and I elected to NOT do the D&C yesterday because of what happened to us nearly two weeks ago...when they DID find a heartbeat after not. Since the baby measures right on....is it POSSIBLE at 8 +/- weeks that there still may be a live fetus and the heartbeat simply is not being detected or is it possible that my baby's heartbeat stopped and started again??? Or has the inevitable happened again? I am not having bleeding, cramping, etc.
I still have occasional breast soreness and fatigue. I requested an additional ultrasound for next week to check the baby's status (additional growth and/or possible heartbeat). What may be happening? My self and my husband are healthy, 25 years old and have no family or self history of any chromosomal abnormalities. I do not smoke, but my husband does.
At Sun Aug 05, 10:08:00 AM 2007, Jessalyn said…

I am on my third pregnancy. I had a daughter healthy daughter in October 2002. I lost triplet daughters at 12 weeks in March 2007 with no chromosomal defects (babies measured approximately 8 weeks). My LMP was May 28, 2007. I ovulated on June 21, 2007 with the assistance of the Clear Blue Fertility Monitor. I had my first ultrasound on July 18, 2007 with a FHR of 120 BPM. I called my doctor on July 23, 2007 with c/o cramping, back pain and difficulty emptying my bladder. I went in that day and gave a urine sample to check for a bladder infection. I also had a trans vag ultrasound. Baby measured 6 weeks 5 days (exactly what I should have been that day); however, no heart beat detected. I elected to have a D&C done the next day (7-24-2007) with the exception that I have an ultrasound done prior to getting prepped. My husband and I arrived at the hospital, filled out paperwork and got admitted. We went in to have the transvag ultrasound done prior to surgery prep and found a heartbeat of 144 BPM. My OB came in with a sick look on his face (I will NEVER forget the look) and the first thing he said is "This makes me nauseous." He ordered an additional ultrasound to be done in two weeks from July 24, 2007. Obviously, we went home without the D&C! Since then, my anxiety and stress levels have been "through the roof." I could not wait for my August 7, 2007 ultrasound. I called on Friday, August 3 and asked if I could come in to get my ultrasound done earlier. I was able to get in at 11:20 am that day. Baby measured accurate at 8 weeks 1 day, but no heartbeat.....AGAIN! I had a second ultrasound done right after with an OB present to confirm no fetal heart tone. I, again opted for the D&C the next day (Saturday, August 4, 2007) with the exception again of having an additional ultrasound done prior to surgery prep. Again, we did paperwork, got admitted and went in for the ultrasound prior to surgery prep. No heart beat. A doctor came in for confirmation...no heartbeat. My husband and I elected to NOT do the D&C yesterday because of what happened to us nearly two weeks ago...when they DID find a heartbeat after not. Since the baby measures right on....is it POSSIBLE at 8 +/- weeks that there still may be a live fetus and the heartbeat simply is not being detected or is it possible that my baby's heartbeat stopped and started again??? Or has the inevitable happened again? I am not having bleeding, cramping, etc.
I still have occasional breast soreness and fatigue. I requested an additional ultrasound for next week to check the baby's status (additional growth and/or possible heartbeat). What may be happening? My self and my husband are healthy, 25 years old and have no family or self history of any chromosomal abnormalities. I do not smoke, but my husband does.
At Mon Aug 06, 09:30:00 AM 2007, Anonymous said…

Dr. T this is anonymous from Aug.3 with the IC. I have never had any fertility issues but ultrasound found that I have a cyst on my left ovary. The Dr. did not tell me this when she told me that my baby had stopped growing I saw it on the ultrasound report. Why do you think she would withhold info. from me? I am going to request a copy of my medical records after the DNC can they deny me access to my records? Thanks
At Mon Aug 06, 08:12:00 PM 2007, Anonymous said…

((Dr Troffater-thank you for replying to our queries!I had an ultrasound scan yesterday which showed a heart beat which was apparently 'fine & normal' according to the Dr. He has indicated that the foetus is approx 1 week small for its age. I should be 7wks & 4 days, and the Dr has said it looks more like 6 weeks & 3 days. I am pretty sure of my dates of menstruation as I have neen noting these down. I usually have a regular 28day cycle. I am due to go back for another scan in 1 week, but I am understandably very anxious as he said the chances of miscarrying are pretty high. I have miscarried once already in January this year. What are the chances of 'catch up growth' and my baby surviving or should I prepare for the worst. Many Thanks))
Subsequent to this-I had my HCG levels checked yesterday and the nurse put them at the level equivalent to 6 weeks. She was using the ranges of 850-20800 for a pregnancy of 5-6 weeks. My level was 15830. I was meant to be 8 weeks pregnant yesterday, on my calculation. Based on all this I am of course very worried, your thoughts would be greatly appreciated. Thank you.
At Sun Aug 12, 03:57:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous August 3: If the baby has a heart beat, then you were problably just 6 3/7 weeks on the day they did the ultrasound. You may have regular menstrual cycles, but you also may have simply ovulated later in the cycle than day 13/14. Hopefully, the next ultrasound will hsow appropriate interval growth of the baby and a healthy heart beat. Hope things turn out well. RELAX a little! Dr T
At Sun Aug 12, 04:07:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous August 4: there is ALWAYS hope, especially if you have had no trouble getting pregnant. I would strongly suggest that you ask your doctor to perform a procedure (before you get pregnant again) to evaluate the shape and contour of your uterine cavity: options include a hysterosalpingogram, a sonohysterogram and/or a hysteroscopy. Your doctor can explain those different procedures to you. Other recommendations would depend on what is found by these procedures. If nothing is found, I strongly suggest that you ask your doctor to send you to a specialist in Maternal-Fetal Medicine who has a special interest in cervical incompetence to discuss different cerclage procedures. Good luck! I would be curious to know what is found and what is done! Dr T
At Sun Aug 12, 04:13:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous August 5: Thanks for letting me know. I really appreciate the feedback. I am sorry for your loss, but I just don't like beating around the bush in these situations. Many doctors think they are doing you a favor, but when there is a certain diagnosis, it's better to let the patient know in a way that is caring and understanding so that they can begin to regroup. Best of luck on the next go-around and let me know how things turn out! Dr T
At Sun Aug 12, 04:23:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous August 5: OMG what you have been through! Your baby OBVIOUSLY was alive at 6 5/7 weeks and for some reason the heart beat was not adequately visualized (it did not stop and then restart). If the baby is now 8 weeks size and no heart beat was seen (by two separate doctors), I am afraid you have finally lost this pregnancy. In your case, however, it probably IS worth looking again one more time. I hope I am wrong, but it is unlikely at this point. You may continue to "feel pregnant" for awhile before your body figures out the baby has been lost because the placental tissues may continue to make the hormones of pregnancy for a little longer. If this was your first pregnancy together, odds are in your favor that the outcome will be better the next time. Best wishes to both of you and I am sorry for your loss and the stress you have gone through. Thank you for reading. Dr T
At Sun Aug 12, 04:30:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

P.S. to Jessalyn August 5: Sorry, I missed that you had previously had a child and lost triplets. Are you an "infertility patient?" If so, what was done to help you conceive? With regard to your husband's smoking, all I can say that there is more and more information on the effects of "second-hand smoke." Maybe he should use these losses as an incentive to QUIT!!!! Best regards. Dr T
At Sun Aug 12, 04:36:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous August 6: No they cannot deny you the records. However, the "cyst" on you ovary was most likely a 'corpus luteum cyst' or simply CL cyst. Cl cysts are the site from which the egg 'hatched' that became this baby. That site makes the hormones that support the pregnancy during the early stages of pregnancy until the placenta takes over. Almost ALL women have a CL cyst early in pregnancy and they are nothing to worry about. That's probably why your doctor didn't think to mention it to you. They usually go away before 14-16 weeks and yours should too shortly if that's all it is. Best wishes and thanks for reading. Dr T
At Sun Aug 12, 04:40:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

Reprise to Anonymous Aug 6: I don't know. With a normal heart beat and a normal quantitative hCG for the size of the baby, that sounds pretty darn reassuring to me! Like I said before, you just need to relax and let nature take its course. There's nothing you have any control over at this point. Start BREATHING!!! Dr T
At Mon Aug 13, 06:50:00 AM 2007, millie said…

hi about a week ago i took a pregnancy test as for the past couple of months i have been tired, felt nauseous, really hungry straight after eating and for a short period i had sore breats and dizziness when standing (sometimes)the test was positive on the clearblue digital pregnancy test, BUT whilst i had had all those symptoms i have been bleeding constantly for approx 3 months and i have also had abdominal pains and lower back ache for approx the same time. the day after i got the positive pregnancy test i was worried because i thought if i was pregnant, surely i should have stopped bleeding?? about the time the sickness and other symptoms started (couple of months ago)i did a pregnancy test and it was negative so i waited two weeks and went to see the doctor (1 1/2 months ago). The doc said that the bleeding was down to my mini pill and that the nausea,bloating and abdominal and back pain was down to IBS, so i left the docs and stopped taking my pill. All the symptoms continued and the sickness and dizziness, hunger etc seemed to get stronger but then going back to the day after the positive pregnancy test i was told to go to hospital to see gynacologyst, when they did a urine test and a blood test it came back negative, the doctor id seen originally said id had a miscarriage, she said as i had used such a sensitive pregnancy test it must have picked up the last of the pregnancy hormone and i should now stop bleeding, which i did 3 days after. The problem is i still feel nausious, hunger, tired and dizzy at times and i still have the back and abdominal pain and i swear im not going mad (at least i hope not) but im sure i can feel something moving sometimes in my stomach and im worried because what if i havent had a miscarriage and the baby is alive but distressed? i have a little girl who is 11 months old.I just dont understand, ive got an appointment with the doctor again in an hour but im worried hes gonna think im crazy, i havent had any scans, D&C's nothing. please help x
At Mon Aug 13, 08:32:00 PM 2007, Anonymous said…

Hi Dr. Trofatter,
I came across your site when looking for answers to a previous miscarriage. At that time you answered a question that I thought should have been simple, to that just let me to chatroom after chatroom when searching for an answer on the internet. (On a positive note, I am 13 weeks pregnant now, and all appears well). I don't have a question now. I just wanted to thank you, and this site, for providing an educated place for individuals to ask questions about a sensitive, and strongly opinionated, issues. Although, in my opinion, chatrooms can provide a venue for support, I worry that too many anecdotes create worry when none is due, or a lack of worry when action should be taken.
-The thankful Cannuck.
At Tue Aug 14, 06:04:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Millie Aug 13: You have raised more questions in my mind than I have answers for based on what you have told me! One thing is sure, it sounds like you are NOT pregnant. The symptoms you are having could be due to one or more problems. Do you have irritable bowel syndrome and how has that been evaluated? Have you been screened for diabetes and thyroid disease? If you are having pelvic complaints, this could be the IBS or endometriosis, or fibroids, or a tumor of an ovary or bowel. Talk to your doctor about all your complaints and let me know what they find! Thanks for reading. Dr T
At Tue Aug 14, 06:05:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous Aug 13: Thank you for your kind feedback. Glad we could offer some support. I hope everything goes well with your pregnancy!!!! Dr T
At Wed Aug 22, 04:00:00 PM 2007, Anonymous said…

Just wondering I just lost my first child I had three ultra sound and they confirmed my baby stoped growing around 71/2 weeks
but didnt find out till I was ten weeks I never had bleeding cramping and still had all the signs of being pregnant after three ulta sound three weeks and changing Dr. I finally I gave up and had a d&c now Im in the why stage so my question is my Dr. gave me no prenatail at all and I had been seeing him for 7 weeks he did no test and put me on a prenatal pill called Prenatal Elite I didnt start taking them until I was about 7 1/2 weeks and when I started taking them I got sick and had rapid heart beat they made me sick could this be the reason the baby died
At Fri Aug 24, 06:29:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous Aug 22: As I told the patient in this post (see the next one on March 16, 2007), it is very unlikely (just as it is with you) that anything she did, ate, drank, or smoked caused her to lose her first pregnancy - that includes prenatal vitamins. Miscarriage rates for true first pregnancies are very high and probably related to the fact that your immune system had not yet learned how to help you carry a baby. I know that doesn't make things any easier at this point, but women's bodies usually figure this out sooner than later. You have a very good chance at success the next time around. Why don't you give your body a break for 3-4 months, start a prenatal vitamin with extra folic acid BEFORE you try to get pregnant, and go for it again. Odds are in your favor. Good luck and thanks for reading. Dr T
At Wed Aug 29, 12:10:00 PM 2007, Anonymous said…

I had a very healthy pregnancy resulting in a little girl 5 years ago. Two years ago, I became pregnant, and lost the baby at 12 weeks. Last year I became pregnant again, that resulting in an eptopic pregnancy and a tubal removal. My husband and I have diligently been trying to concieve ever since; so far, no luck. I am athletic, healthy, and I don't smoke. Now what do I do?
At Thu Aug 30, 03:06:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous Aug 29: You really should see a specialist in Reproductive Endcrinology and Infertility (REI). If you had one ectopic pregnancy, there may be 'tubal' reasons that led to the ectopic and are now causing your secondary 'infertility.' If you really have been unsuccessful for a year, and are serious about another preganancy, it's time to see someone who can help you. You may be at such an increased risk for another ectopic pregnancy if you do manage to conceive that even in vitro fertilization may be the best option. Thanks for reading and good luck!
At Wed Sep 26, 11:52:00 PM 2007, Anonymous said…

I got pregnant in November last year and miscarried in January i decided to let nature take its course as i have a major needle phobia. I bled for just over a month with lots of fainting and so forth but never went back to my needle happy doctor once the miscarriage commenced. Since somewhere about march i haven’t been using protection but have not fallen pregnant again. What are the chances of me falling pregnant again or was that my only chance. I am 25 and don’t smoke, drink or do any type of drugs (neither does my partner) it seems kinda ironic taking birth control for years and then not being able to fall pregnant anyway.
At Fri Sep 28, 11:31:00 AM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous Sept 26: Did it take you long to get pregnant the first time? Do you have regular menstrual cycles? My gretaer concern is that if you had prolonged bleeding with your recent miscarriage, you could have developed an infection of the uterine cavity or fallopian tubes that might impair conception and/or implantation. You are still young, but if you haven't conceived again within 6 months, you should ask you doctor to evaluate you further. Best wishes and thanks for reading!
At Tue Oct 02, 12:03:00 AM 2007, Anonymous said…

Hi its sep 26 again, no it didn’t take all that long to fall pregnant the first time perhaps 2 months or so although we were seeing each other more often at the time, now I live in a different city and only visit during the weekends.
After the miscarriage I didn’t have any pain and my cycle is now more regular than it has ever been so hopefully it’s just a question of time and I didn’t get any type of infection, would there have been any signs if there was an infection?
Still young... gosh I’m in the middle of my ¼ life crisis and feeling older every day! Nice of you to call me young though.
At Thu Oct 04, 05:50:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous Oct 2: Well, if you are not seeing each other except on weekends, I could seee where it might take awhile to get pregnant again. Remember, after you ovulate (around day 13-14 counting from the first day of the last menstrual period in women with a regular 28-day cycle), the egg is only good to be fertilized for about 24 hours. Maybe you need to be scheduling your visits around your midcycle 'surge.' You can buy ovulation detection kits or simply count the days in your cycle. If you haven't conceived in 6 months having intercourse in mid-cycle (again, around days 12-15), then go see someone to help you with your 'infertility.' Bet you won't need help at that point! Take care and good luck! Dr T
At Wed Nov 07, 04:29:00 AM 2007, Anonymous said…

I have had 2 miscarriages this year (one in Feb) - went for scan at 12 weeks. Stopped growing at 8 weeks old. Then pregnant again in July but and at 12 week scan found that embryo did not attach. Doctor won't test until after 3 miscarriages. All very upsetting. Can't help thinking I won't ever be able to have a baby. Getting on in years too, now 40 and time is rapidly running out. Can't help think it is down to age. All very frustrating as would like answers and wonder whether we should really continue. Advised by doctor to have a break and try again in October which we did - I had pinching pains, cramps during mid cycle which I never normally get. My period was a couple of days later than normal so did pregnancy test. It was negative but there was a very faint line which almost looked positive. I think I may have had an early miscarriage. We would like to try again but don't know if I should wait a month or 2. Desparate to try again soon but want to give it the best chance possible. Any advice?
At Sun Nov 11, 07:16:00 AM 2007, Anonymous said…

i have 3 healthy children but a few months ago i had a early miscarriage but didnt even know i was pregnant. i had a period but a few days later started to bleed heavier and was losing blood clots. i went to the hospital and did a test which came out positive. the doctor said that i has an early miscarriage, the reason the test came out possitive is i still had a small trace of hcg in my blood. the following month my period was a few days later than expected but it came. has anyone else experience this and is it common?
At Tue Nov 13, 05:18:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous Nov 7: At age 40, you really are running out of time. You need to have a lot of evaluation, and perhaps help, done quickly and most generalists in OB/GYN do not have the expertise or the incentive to do that properly. I usually recommend, even to my own patients in these circumstances, that you ask your doctor to refer you to a specialist in Reproductive Endocrinology and Infertility (REI) ASAP. Good luck and thank you for reading! Dr T
At Tue Nov 13, 05:22:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous Nov 11: Even if you have always had very regular menstrual cycles, it is not unusual to take a couple of months for your cycle to get back in synch after a miscarriage. Of course that also makes it less predictable about when you will ovulate and possibly get pregnant again, so be careful if you don't want to! Dr T
At Fri Nov 23, 10:13:00 PM 2007, Anonymous said…

I am 36 years old and just had a miscarriage. They found no heartbeat at around 9 weeks. I have a tubal reversal in march of this years ( my tubes were done in 1996 after my son was born ) and got pregnant the beginning of september. We were so excited but now we are scared of trying again. Is there a connection with me getting pregnant so fast and the miscarriage?
At Thu Nov 29, 05:04:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous Nov 23: Can't rule out the possibility that conception right after your surgey caused the miscarriage, but I think it is encouraging that yoiu were able to conceive so quickly. At 36, you are starting to get in that 'increased risk' rang for a baby with a chromosomal abnormality and that is still the most common cause of sporadic miscarriages in women who have previously had normal pregnancies. So, don't panic. If you want another baby (I imagine you do if you went through the trouble and expense of the tubal reversal), then wait a couple of months and try again. Take your prenatal vitamins and some extra folic acid while you're waiting! Good luck! Dr T
At Tue Dec 04, 06:10:00 AM 2007, Anonymous said…

hi doctor kennath i am worried i concived 12 weeks ago. i have been for my scan at 10 weeks and found there are two feotus but the one i seemingly smaller than the outher the doctor said the placenter was not attached properly or was comming away. i fell down 6 stairs 1 week ago and have had severe pain through my abdomain and lower back the doc said everything seemed normal. is it? is it possible to miscarry this late into the pregnancy please help.
At Fri Dec 14, 12:33:00 PM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous Dec 4: It is certainly possible to miscarry this late into the pregnancy. It is also possible to lose only one of the twins either because of a chromosomal abnormality, physical abnormalities, or a poor placenta and still carry on with one healthy baby. We frequently refer to that as a 'vanishing twin' problem. Your body pain is probably related to the trauma from your fall, but is you are worried about that, you should tell your doctor. Be careful, Girl! Hope things turn out well and thank for reading! Dr T
At Sun Jan 06, 07:21:00 PM 2008, Julia Mangan said…

I had a miscarriage in the Fall of '06 at 27 years old. Like a lot of the posters, I had an ultrasound at 12 weeks that showed a baby that was only 8 weeks old. (We had already had one ultrasound at 8 weeks where we saw and heard the heartbeat and they explained my spotting by saying and showing me I had placenta previa. This factors in to my question later...)
I wanted to let the miscarriage occur naturally but after one night of 5 hours of contractions that were up to a minute long and sometimes only 15-30 seconds apart, and another night of 3 hours of contractions, I wanted to be examined and for someone to tell me I was at least getting closer to miscarrying. I went to my OB/GYN practice and met with a Dr. who examining me, told me my uterus was hard, closed and thick and that I couldn't handle a natural or medical-induced miscarriage and basically I was being irresponsible and needed to get a D&C right away. I went with the Dr's recommendation although it was the last thing in the world I wanted and scheduled the D&C for the next day.
A different Dr. from the practice did the procedure, said she got everything and it was successful and sent me home. We had asked for our baby so we could bury it.

We thought our nightmare was over and we could start the healing process but 3 days after the procedure I started cramping and then felt something pass. I looked and couldn't tell at first, but my husband saw eyes and then hands and feet. He was looking at our baby. It was a Sunday so we couldn't talk to the Dr. but called the answering service which was completely unhelpful.

The Dr. couldn't explain at all what happened. They did look at our baby and confirmed it was the fetus. They did ultrasound, after ultrasound, after ultrasound over the weeks and still kept telling me I had a lot of tissue left to pass. I kept passing blood clots and bleeding but still wasn't passing this tissue that remained. They even tried Cytotec with no success.

Finally, we faced the horrible fact I would have to have a second D&C. I was told by the surgery scheduler that in her 15 yrs. of scheduling, she had never scheduled anyone for a repeat D&C. Even at the hospital, they kept getting confused that I was having another D&C for the same pregnancy.

They analyzed the tissue from my second D&C and said it was placental tissue. The Dr. who did this surgery had to do 3 ultrasounds to make sure he got everything out and said the tissue was "stuck" and they had to keep knocking it to get it out.

To wrap up this extremely long post, I will finally get to my question. Is it possible I had placenta accreta? Would this explain the need for another D&C? Have you heard of this happening before? I have had no luck in finding this happening to anyone else but there has to be other people this has happened to. My Dr's could give me no answers. Maybe there isn't one.
At Thu Jan 17, 08:32:00 AM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To Julia Jan 6: You poor thing. I have known other women who have gone through the same thing. Yes, you could have had a placenta accreta, but more likely the complications arose as the result of the D&C not being completely done the first time. Sometimes doctors performing a D&C, especially if it is a different doctor than the one you saw originally, err on the side of being 'too careful' rather than taking a chance of perforating the uterus, or feel like they are in the uterus but are only in the cervix (if the cervix happens to be unusually long. I believe if they looked at the path specimen from the first D&C, they would have realized that not all the pregnancy tissues had been removed. Sorry for what you have been through aand best wishes for the future. Dr T
At Sat Jan 19, 11:53:00 AM 2008, Julia Mangan said…

Thank you for your response!
At Tue Jan 22, 05:09:00 AM 2008, Anonymous said…

Hello, I have a slightly different situation. I'm 39(nearly 40!)and try to have a baby since october 2007. However after years of cmoletely regular periods I have not had one since november 23 2007. At first I was excited, but I've done several tests and all have been negative. What can be going on? I've now missed 2 periods (I have a 25 day cycle)- am I too late in life to get pregnant, suffering from a miscarriage or is something else asmiss? The only 'symptoms' I've got are slightly tender breasts.... Many thansk for your input. Lynne
At Tue Jan 22, 06:24:00 PM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To Julia Jan 19: You're welcome
Dr T
At Tue Jan 22, 06:29:00 PM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To Lynne Jan 22: It sounds like you have not ovulated for at least a couple of cycles. There are many reasons that this can happen, mainly hormonal, so you should discuss the recent events with your doctor. It is not at all unusual as women approach the menopausal years that they beginto ovulate irregularly and then not at all. But, if you become anovulatory before your ovaries have stopped making estrogen, the inner lining of the uterus (the endometrium) can become overstimulated putting you at risk for endometrial hyperplasia and cancer. Good luck to you. Dr T
At Fri Jan 25, 07:52:00 AM 2008, Anonymous said…

My husband and I have been trying to conceive since August 2006. We finally went to a fertility doctor in November and did a round of insemination with clomid. I got pregnant right away but when my 7 week ultrasound came up we discovered that I had a blighted ovum. I just had a D&C on Jan. 18. My question is, when should I get my next period? Does this usually happen again? When would I be able to resume inseminations? Thank you!
At Fri Jan 25, 11:19:00 AM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous Jan 25: Sorry for your loss. Most women will resume menstrual cycles within 6-8 weeks after the D&C, presuming you were cycling normally to begin with. I usually recommend waiting for one cycle after that to get pregnant again to allow any inflammation and tissue damage a chance to die down and improve your chance at a successful implantation the next time. Every doctor is a little different, so you will need to discuss this with yours. I do NOT feel you need to wait 6-8 months. I wish you better luck the next time and thanks for reading! Dr T
At Tue Jan 29, 09:28:00 PM 2008, Desiree said…

Hello my name is Desiree. My husband and I just found out we were pregnant. We were on vaction when I started my period, but it was very light and I have always been reg and heavey flow. I bled for about three weeks light tho. Then last week I went to the ER cause I was cramping and bleeding heavier. The next day the bleeding stopped all together. The doctors have taken blood test to see how my HCG levels were doing. They havent really changed at all. I go in on Friday for another test. I really just want to know whats going on. If anyone has any advice please share:)
At Wed Jan 30, 02:29:00 PM 2008, Anonymous said…

Hi. I am anonymous from Jan 25. I had the d&c on Jan 18 and I am still bleeding. Sometimes I have blood but most of the time its just a lot of the really dark brown stuff. Is this normal 2 weeks after your d&c? Also, I just got a call from the doctor and the person who examined the remains of the d&c is a little concerned about a molar pregnancy. I will have my hcg levels checked in two weeks but should I go in sooner? Is it true that if it is a molar pregnancy then I have to wait a year before trying to conceive again? Thank you for your help!
At Wed Jan 30, 06:05:00 PM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To Desiree Jan 29: I am sorry, but if the hCG levels have not changed, that is NOT a good sign. hCG levels should double every 2-3 days at this point in a normal pregnancy. That means you have probably lost this pregnancy and there is still a small chance you could have an ectopic (tubal) pregnancy. Please follow-up with your doctors and let us know what happens. Best wishes. Dr T
At Sat Feb 02, 05:02:00 PM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous Jan 30: This most likely is NOT a molar pregnancy, however, the tissue can have "hydropic degeneration" that may mimic a molar pregnancy. I wrote a post on this December 15, 2007. If your hCG has returned to negative. There is no reason why you cannot try to get pregnant again in a couple of months. Best of luck to you! dr T
At Sat Feb 02, 08:15:00 PM 2008, Anonymous said…

Hi Dr. T...This is Christina from June 16, miscarriage. I wanted to update and ask a couple of questions. We have gone through two more rounds of fertility treatment with no luck. The fertility dr. wants us to move to IVF...very expensive....I started taking baby asprin, what will this do if I should become pregnant and does it really work? The other is flying after IVF. I plan to do IVF this summer but will have to fly towards the end of summer. Will this be a problem?? Is there a higher chance of miscarring when you fly? If so then I will wait on IVF. The other question is, I take a prescribed prenatal vit. Should I add extra folic acid supp.? Thanks for you insight and your knowledge!
At Sat Feb 02, 08:26:00 PM 2008, Anonymous said…

Hi Dr T...This is Christina from post June 16... I wanted to update/ask questions. Since the last post I have gone through two more rounds of infertility with no luck. The dr. wants us to move to IVF. I plan to do this is summer but am worried because I will need to fly towards the end of summer. Is there a higher chance of miscarraige after IVF/pregnancy when flying??? If so I will wait. Another questions is I am now taking baby asprin...because of the last miscarriage. I have read that taking baby asprin alone, it is not helpful. Is this true? And finally, I take a prescribed prnatal vit. Should I take an extra dose of folic acid??? If so how much. The prenatal has 1mg. Thanks for your kind words and knowledge that you give to us!!!
At Thu Feb 14, 02:41:00 PM 2008, Anonymous said…

Hi, this is anonymous from Jan 30 again. I had my HCG levels checked yesterday and the doctor said they are at 29. He gave no indication that he even remotely thought this was a molar pregnancy. He said that we need to test again in another month. Should we hold off on trying to get pregnant this month while we are waiting for the next hcg test? Does he think anything is wrong by these levels? I am very worried, thank you.
At Fri Feb 15, 09:50:00 AM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To Christine Feb 2: No one has convincingly shown that air travel increases the risk of early miscarriage. There are conflicting reports even among flight attendants who are in the air constantly, but there is more odf a suggestion that there might be a slightly higher risk among these women. Of course, that is not controlling for all variables, including the stress of the job. It might not hurt to take some time off, if you feel like you have it , and defer the IVF until after your tavels this summer. There's nothing worse than having a miscarriage when you are on vacation or out of the country. With regard to the ASA, the data also is not clear. I am convinced it, alone, has helped some of the patients I have cared for. It is relatively 'safe' and if your doctor says it's okay from their standpoint,you can use it. If you are taking that dose of folic acid on a regular basis, you should be covered. Good luck and, again, thanks for writing. Dr T
At Fri Feb 15, 09:51:00 AM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous Feb 14: At that level, there should not be much to worry about. I would recommend not getting pregnant again until the hCG is undetectable under these circumstances. Good luck! Dr T
At Mon Mar 03, 07:52:00 PM 2008, Anonymous said…

I had my 3rd miscarriage 2 weeks ago. I saw a heartbeat at 8 weeks, but then at 10 weeks there was no heartbeat and growth was at 8 weeks. I am still questioning whether I should have had another sono before getting a d&c. Could the technician been wrong? Is the measurement that acurate on a sono?
At Tue Mar 04, 08:07:00 PM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous Mar 3: The measurements are very accurate. If the baby stopped growing at 8 weeks and no heart beat was seen, the diagnosis was confirmed. We always offer a subsequent scan for those women who request it and that is fine because under most circumstances, the mother is in no great danger at that point. Thank your doctors for being so starightforward with you. I have seen this situation go on for weeks and weeks because providers are sometimes unwilling (hopefully, not unable) to be honest with patients. I am sorry for your loss and wish you luck in the future. Dr T
At Thu Mar 06, 11:06:00 AM 2008, Anonymous said…

I had a D&C on Jan 18 and got my next period on Feb 23. It has lasted 12 days. I went into the doctor today and they did an ultrasound. I have a clot in my uterus and a cyst on my ovary. I am leaving for Italy in 4 days so the doctor did not want to do another d&c right away. He put me on birth control instead and I have to go back for another ultrasound once my next period arrives. Will the birth control help to get rid of the clot? Will I need to have another d&c if the birth control doesnt work? Thank you.
At Fri Mar 07, 05:12:00 PM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous Mar 6: You probably will not need another D&C. The small cyst on your ovary is probably a 'follicular cyst' from the egg you made with you most recent menstrual cycle. The birth control pills should suppress formation of these kind of cysts by suppressing ovulation and may help the one you have go away. Don't worry about things for now, and enjoy your trip! Dr T
At Wed Mar 12, 05:06:00 PM 2008, Anonymous said…

I went in for my 8 week check and the baby was measuring right on but they said the babies heart had stopped sometime in the 24 hours prior. After a week of still no heartbeat and my body carrying on like nothing was wrong I had a D&C. A week later I went in and the OB asked if I had any bleeding before the procedure..I hadn't. She said the pathology report came back that there was little to no tissue. (I had just had a ultrasound a few days before and the baby was seen) She did another ultrasound after our discussion and found that a great deal of the baby was still there. How does this happen?? I have heard of small amounts being missed but not MOST of the baby. I have only had very, very mild daily spotting since and it's like my body is just continueing on as normal pregnancy. She has scheduled me for another D&C in a coule of days. MY concerns...how will this effect my uterus having just had one last week?? Also we tried for 4 1/2 years to get pg with this one, will two D&Cs so close together cause problems when trying to conceive again?? Thank you.... (this is my fourth miscarriage over a 16 year period--the one before this was 8 1/2 years ago)
At Sun Mar 16, 06:09:00 PM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To anonymous Mar 12: Staed simply, your doctor must not have gotten far enough into your uterus at the time of the first D&C. Sometimes doctors are overly cautious, and sometimes women have uterine or cervical abnormalities that make the procedure more difficult. My suggestion, if you have no children and have had multiple early pregnancy losses, is that when this pregnancy is over, you find a specialist in Reproductive Endocrinology and Infertility to help you out. Under your curent circumstances, I am sure your doctor will help you find one. Sorry for your troubles, but keep your chin up! thanks for reading. Dr T
At Thu Mar 20, 12:18:00 PM 2008, Anonymous said…

Update from Mar 12th

Well I am now in my OB’s record books as a first and something she has never seen before…

She did go in the first time and thoroughly get half my uterus done correctly. HALF?!?!? Here comes the bizarre part.. I had a membrane that had grown across my uterus basically cutting my uterus in half and not just a little thin membrane…a thick one that had to be cut out to remove it. This membrane had grown at an angle ---if your uterus was a clock it would have run from the one to the seven---thus allowing my one ovary which was one side of the membrane to receive swimmers and the fallopian tube when it swept and picked up the egg dropped it into the other side. (The other ovary was completely blocked off and she said because of how this was she was shocked and amazed that I even got pregnant at all.) The baby had attached itself to the center of the membrane thus not giving it a good blood supply and no chance at making it for any real length of time. When she did the U/S this week to see what was going on my uterus almost looked like a ½ to ¾ moon with the baby being right in the middle of the arch on the inside of the moon shape. She said she has seen very thin membranes in people before but not a thick one like this that has grown all the way across and cutting the uterus in half. She has no idea how or why this happened. I had an HSG done in fall of '05 and both tubes filled and spilled quickly so this had to have happened since. Any thoughts on this or experience you may have seen with something similar??
We have been to a RE and have had 3 IUIs...they want us to move on to IVF but we have no ins. coverage and it's not cheap where I live. I will keep my chin up..It happened for us once; we can get our miracle again...

Thanks....
At Thu Mar 20, 06:58:00 PM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To anonymous mar 20: So you have either a uterine septum (Mullerian abnormality) that had not been previously recognized by your doctors or scarring from a previous D&C and/or uterine infection. In either case, rather than IUI or IVF, the best thing to do would be to have the septum/scar tissue removed (usually this can be done by operative hysteroscopy) and then perhaps let nature take its course. Insurance should pay for thta procedure. There are other options to consider in addition to removing the abnormal tissue, but that in and of itself is associated with recurrent pregnancy loss for reasons that are not entirely understood. Best of luck to you. Dr T
At Fri Mar 21, 03:39:00 PM 2008, Anonymous said…

The results from my D&C came back as normal female karyotype. My doctor told me that this meant I miscarried a healthy female fetus so it was something in my body that caused the miscarriage. I recently read that a result of normal female karyotype could also be misdiagnosed and actually be my tissue that was mixed in with the fetus when analyzed. I had a full D&C so they had all the fetus to examine. Also, if this was a female and I've had 2 miscarriages prior, but thankfully I have 3 healthy boys, does this mean I might not be able to carry a girl?
At Tue Mar 25, 09:22:00 AM 2008, Anonymous said…

The results of my d&c came back normal female karyotype. My doctor said it meant the female baby was normal. It was something in my body that couldn't carry it. I recently read that this result could be wrong if the lab was reading my cells i/o the baby's. I had no bleeding before the miscarriage so they were able to look at the entire fetus. What does this result mean? I have 3 healthy boys and have had 3 miscarriages. Could this mean I just can't carry females?
At Wed Mar 26, 03:36:00 PM 2008, Anonymous said…

Hi, this is anonymous from March 6 regarding the clot in my uterus. Well, Italy was fabulous but I did have bleeding off and on. I would have a gush of blood and some clot would come out. After we got back, I passed a clot the size of an apple and did not bleed afterwards. This was a week ago and I started to bleed again. I just finished the colored pills of my birth control and should be getting my period in another week. Could this just be leftovers still trying to expel itself? It seems to be a lot of blood. Should I be worried that there is something wrong? Thank you.
At Wed Mar 26, 05:39:00 PM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To anonymous Mar 21/25: Even though the baby was chromosomally mormal, that does not rule out the possibility had a genetic problem. We all carry some bad genes and if the mother and the father happen to each have a single copy of the same bad gene, they have a chance of making a baby that has both bad copies and might have problems. I am not saying that's what happened, but it is a possibility. It is also unlikely that "you can't make girls." That might just have been a chance event. Best of luck to you in the future and thanks again for reading. Dr T
At Wed Mar 26, 05:41:00 PM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To anaonymous mar 26: It may just take a little longer for your birth control pills to 'take hold', however, if the bleeding continues to be heavy, you should contact your doctor. You might need a stronger pill or you could have an infection. I doubt that this is still related to pregnancy.
Dr T
At Sun Apr 13, 12:41:00 PM 2008, Anonymous said…

hello,i've been trying to have a baby for the past 9 months, i have PCOS and the thing is that after i got married, my p's got regular (was a virgin). now i havnt had my p since feb 17(30 day cycle), i took home preg test and was negative 5 times, and i feel and look preg. and usually after i orgasm i feel something weird insside me, can i be preg? thanx
At Tue Apr 15, 06:21:00 PM 2008, Kracinda said…

Hello:) I had a missed abortion approx. 1 year ago. I am now 5 weeks and 5 days along with another baby. My breasts just got sore about 1 week ago, maybe a week and a half. I started with the "all day" sickness yesterday(nausea and vomiting). Today I still have constant sickness, but my breasts don't feel as sore. My first appt. isn't until next Thurs. Of couse, I am sooo very nervous from last time. Will I be ok? Do pregnancy symptoms come and go sometimes(hoping breasts might hurt tomorrow again)? Last time my breasts stopped hurting about 2 weeks before I had my ultrasound that confirmed no fetal heartbeart, so I feel like I'm going crazy with worry and I know thats not healthy. Please help. THanks
At Tue Apr 15, 07:01:00 PM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To anonymous Apr 13: I doubt you are pregnant at this time. If you have PCOS, it is very likely that you have either not ovulated or are beginning to become oligoovulatory (ovulate irregularly). It is sometimes very hard to get pregnant under those circumstances and that also increases your risk for early miscarriage when you do manage to conceive. I suggest you find a doctor (usually a specialist in reproductive endocrinology and infertility) who can help you with the PCOS before things get too far out of control. Good luck. Dr T
At Sun Apr 20, 06:12:00 PM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To Kracinda: Symptoms can come and go and they can be different in different pregnancies. Regardless, there is nothing you can do at this point and so try to keep your chin up until next week and hopefully everything will be fine by ultrasound! Best wishes. Dr T
At Sat Apr 26, 03:51:00 PM 2008, Anonymous said…

hey dr. t.
i posted awhile back with questions about robertsonian translocations.... and well here i am again. my history is that i am 30 y.o. caus. f/m, normal weight, good health, non smoker and non drinker. i have had 3 prior pregnancies with outcomes of first miscarriage and d&c with testing that revealed same bal.translocation as me, then early miscarriage on own, then chromosomally perfect child no intervention but closely motitored due to my issues and presence of a single umbilical artery. i was diagnosed during my 3rd preg and so i have a bal. rob. trans. and MTHFR. I take 4mg of folic acid daily.
well we want to grow our family so i opted for the costly ivf with pgd. we transferred 2 embryos that were either balanced or normal and i began rather heavy bleeding prior to my first beta that laasted 2 days . i really didn't think they took. but threes days later after the bleeding subsided i had a beta of 10. my bleeding was very runny, watery with no consistency and bright red. i had light implantation bleeding with all three of my previuos pregnancies so i did not think this was okay but in hindsight it was also not like my regular period which is a little heavier and ends with a darker discharge day. i had a second beta 2 days later and well it went to 33. (so no bleeding for almost 5 full days) and then the next day i had more bleeding, still bright red but not nearly as heavy and only lasted about 4-6 hours. so i went for a 3rd beta, the day after this bleeding and well the numbers went up again to 156. i have a 4th beta in 2 more days... i have researched everything i can from fibroids to decidual bleeding... and was wondering what you think?
i have refrained from intercouse since starting ivf so i have not irritated my cervical lining. but i am on 1 baby aspirin a day and twice daily vaginal inserts of 100mg progestrone. i guess i am hopefull thinking that the progesterone has made my lining so healthy and that the bleeding was just from implantaion and a super healthy lining. i do not know my progesterone levels but my RE has been checking them and they just say that everything is still going well but to be cautiously optimistic due to the bleeding. i have no explanation for the bleeding and i will not have an ultrasound until beta is in the thousand range. as for the late implantaion, since i was doing pgd, my transfer was a day 5.. and i heard that day 5 and FET tend to be late implanters. i am wondering if the late implantaion is the cause for the low betas.... but they are rising at more than double and then... could the second bleeding be from possible late implantation of the second embryo. and well i have had no bleeding again fo r now 2 days. i am hopeful as all heck and just wanted to know what you thought. thanks a ton as you have always been so wonderful -mimi ps.. today i would only be 4 weeks pregnant based on when i ovulated so this may help with the initally low readings, and i don't know if lateimplantaion would change the gestational age.
At Wed Apr 30, 05:52:00 PM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To Mimi Apr 26: Girl, I am very good at what I do, but I have no claims to clairvoyance! Wish I did have a crystal ball. Keep hanging on to the hope that the hCGs keep rising and that the bleeding is the result of implantation of all the embryos into a 'lush' endometrium. Hang in there. It sounds like you are in good hands. I know you will keep us informed, so I don't need to ask! Best wishes to you my friend! Dr T
At Fri May 02, 07:06:00 PM 2008, Bethany said…

I am about to undergo my second IUI cycle. The first IUI I was on 50mg clomid days 3-7. My OPK was positive on day 19 and the IUI was done on day 20. I ended up miscarrying early with a blighted ovum. I was wondering if with this next cycle should I have a trigger shot since I am ovulating later? Is it possible to get pregnant with another IUI when I ovulate around day 19? I am just worried that the egg will no longer be viable at that point. Thank you!
At Tue May 06, 03:51:00 PM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

Hi Bethany: I am an MFM and not an REI doctor, but in my experience, your odds are improved the closer you are to a normal (day 14) midcycle. Good luck! Dr T
At Sun May 11, 07:15:00 AM 2008, Anonymous said…

I have had 6 miscarriges and 5 living children. I just miscarried in January with a dignose of a blighted ovum. I am pregnant now and scared of another possible blighted ovum. Saw my dr last week, and he did a hcg quant and those numbers are not rising as it should be. My first reading was 10,156 and two days later it was 10,900. Dr. says that I should stay hopeful, and that we should just wait until my u/s appt. I should be about 8 weeks along according to my last menstrual. My question is can a woman have more than one blighted ovum happen? I have been diagnosed with having a balanced reciprocal translocation with my chromosomes. But again, I do have 5 healthy normal children with no complications during my pregnancies. I am now 33 and faced with all these new complications. Not quite sure how to feel and what to expect. I do experience some pregnancy symptoms and some days I don't feel all of them. I think that I may have another blighted ovum, but dr. will confirm with vaginal u/s. Can a pregnant women still continue to have certain preg symptoms and still be pregnant? Even when its a blighted ovum?
At Tue May 13, 06:17:00 PM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To anonymous May 11: I would expect that most if not all of the pregnancies you lost were the result of babies that had UNBALANCED karyotypes (chromosomes) secondary to your balanced translocation. If your hCG is 10,000, this is not a blighted ovum, but it could be another unbalanced and nonviable baby. I have written several posts on balanced Robertsonian translocations and pregnancy outcome if you care to look through my archives or query the search engine for more information. Best of luck and thank you for reading. Let us know how things turn out. Dr T
At Thu May 22, 06:01:00 PM 2008, Anonymous said…

Nina,
I had IVF and at 5 weeks Dr could see 2 sacs via intravagianl US.I had other IV US at 8 weeks and 3 days of pregnancy, when we could see both embryos but just one heartbeat (187bpm, CRL 1.90cm).I was really upset because my doctor didn't even mesure the other baby.However, he ask-me to come back in one week to see if there is some heartbeat from baby B.My question is, there is hope that my little star can be alive? This waiting week is killing me, I cannot stop thinking about it.I did not have any bleeding or pain. I know this can be a vanishing twin syndrome, but i still think that I should have some symptoms. Am I wrong?

thank you for your attention.
At Fri May 23, 08:31:00 AM 2008, Anonymous said…

I'm 42 and miscarried 2 months ago and got pregnant again the 1st period after my D&C. I am now just starting my 5th week and had some spotting 2 days ago. I went to the ER and had an ultrasound and bloodwork done. The bloodwork came back and my levels were 325. The ultrasound showed no gestational sac. ER dr. told me that my levels should be around 30,000. So I was told that I miscarried. When I followed up the next day with my OB-GYN, I was told that my levels at my first blood test the week before were 150 and in the ER they were 325 which is RIGHT WHERE they should be. I was also told that it is not unusual to not see anything at 4 weeks and that MY doctor believes that I still have a healthy pregnancy. She wants me to come in next week for another blood test to check my HCG levels again.

Should my HCG levels continue to rise on a daily basis if I am still pregnant? Or are the levels so minimal that I wouldn't see an increase 2 days after my last blood work. The uncertainty is making me nuts. Can a get another blood test earlier than 7 days from now (will it show a difference either lower if I did miscarry or higher if I'm still pregnant)? Or is it too close to the last test to make a difference?

Thanks
At Sun Jun 08, 07:44:00 AM 2008, Anonymous said…

A few weeks ago we had to terminate a pregnancy at 21 weeks. During the ultrasound they found the baby had severe meningomylocele, hyrdocelephaus, and chiari malformation II. It was so bad the opening in her back was from her ribs to below her hip bones and her entire cerebellum was in her neck and not visable in the ultrasound. We saw two specialist who both said she would not survive if we carried her to term so we did and D & E last week. I have started taking 4 mg of folic acid and my prenatal and want to know how soon we can try to get pregnant. I should get the results of the chromosome test done on the babys tissue next week and that should tell us if it was random spina bifida or a chromosome defect. Some people have told me to wait one peroid and others say 6 months. We just want to be sure the baby and myself will be safe and at the lowest risk possible.
Thanks
Jen
At Sat Jun 14, 09:35:00 AM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To Nina May 22: I am sorry that I have not answered you sooner, but I just received this post in my mailbox the other day. So, you may well already have the answers to all your questions. However, in most experienced hands, by 8 weeks one should be able to tell with virtually 100% certainty wheter or not a baby is alive. And, no, you may not have any symptoms related to a vanishing twin - in fact you may not even have any bleeding related to the loss of a baby that early as long as the other baby is healthy because of the hormone production by the placenta and the healthy baby that supports the pregnancy. Good luck and let us know what you have found out! Dr T
At Sat Jun 14, 09:40:00 AM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To anonymous May 23. As noted in my response to the reader just before you, I did not receive your comment in my mailbox until the other day, so I apologize for not responding sooner. The simple answer is that in early pregnancy, the hCG hormone really does increase significantly every day. Indeed, they double about every 48 hours. Sorry for the delay in my response, but let me know how things turned out. It has been almost 3 weeks so you should have your answers by now. Best wishes. Dr T
At Sat Jun 14, 09:46:00 AM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To Jen June 8: I usually recommend waiting at least 3-6 months under these circumstances for several reasons: 1) To give your body and mind a chance to recover from the current pregnancy and the tragedy associated with that. 2) To get the final results of the testing so that your doctors can counsel you apropriately and order additional testing if necessary before you conceive again. 3) To give your uterus a chance to heal from the D&E 4) To get a good amount of the folic acid on board prior to another pregnancy. We know there are greater risks for some pregnancy complications when the spacing is brief, so if you are young, it is probably worth waiting a little while to improve your prospects all around for a betteer outcome. Good luck and thank you for writing! Dr T
At Wed Jul 02, 06:36:00 AM 2008, Anonymous said…

I went to my 12 week scan to be told quite rudely that there was no 12 week baby there, instead all that could be seen was an ammniotic sac measuring about 6 weeks, all that the doctor could see was a'yolk' inside but no baby so i was told to come back nine days later to be re scanned to see if anythin grew. meanwhile i have been bleeding pink/red blood whilst passing urine and have lost a few small clots but no pain.
i have been examined and they assured me that the neck of the cervix is still closed and upon further scans they were able to see the sac still present in my uterus. However, my bladder wasnt full enough to see if there was a baby inside the sac.
Can someone help me please i just don't know what's going on and i am so scared. Could this just be an early pregnancy? Could my baby be okay?
At Thu Jul 03, 07:24:00 PM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To Anonymous July 2: I wish I had my crystal ball. You are correct. It could be either of those possibilities - a good pregnancy that is only 5-6 weeks along or a 'missed abortion' wherein you lost the baby at 5-6 weeks and you body is just now figuring out that the pregnancy did not make it and is preparing to miscarry. I know this is upsetting and frustrating, but your doctors did the risght thing asking you to come back in 7-10 days. If you have not gone on to miscarry by that point, they will most certainly be able to tell you whether the baby has survived and has a chance or really was lost earlier. Hang in there. All you can do is wait and hope at this point. Dr T
At Mon Sep 15, 02:04:00 PM 2008, Anonymous said…

Hi Dr. T,
It is really great how you take time to answer concerns. I wanted to ask questions concerning my missed miscarriage starting at just over 11 1/2 weeks. The day before it started, I had a seemingly normal prenatal exam, they said everything was great but two things stood out to me which nagged at me... 1. They didn't find a heartbeat yet they said that is normal. 2. They said the sac was about at 10 weeks pregnancy size and assumed I got my last menstral period date mixed up.
The next day I woke up with bleeding and I ended up having to get a D&C at 12 1/2 weeks (there was no fetal pole also and the sac was collapsing).. the lab from D&C didn't show embryonic tissue--said "not recognized" (it showed "deducial &placenta tissue, orderly trophoblastic cells with 20% of the chorionic villi showing hydropic degeneration and focal necrosis of dedidual tissue". What I wondered is did conception occur or not? Did we really get pregnant or was the baby never really conceived/formed?
Also, after the D&C, I had 8 weeks of period-like bleeding. Then no periods... they put me on metformin then I had a period 8 months after the D&C. I was 38 at the time of the m/c and D&C. I struggled iwth infertility after that though before my cycles were like clockwork. Six months ago my labwork showed normal; now my LH, FSH and DHEA-Sulfate levels all show "postmenopausal levels."
Can you offer any explanation into all of this? Would a D&C cause early menopause or do you think the miscarriage was due to genetic problems since perhaps I was at the end of my fertility age?
Thanks for your time.
At Tue Sep 23, 06:39:00 PM 2008, Kenneth F. Trofatter, Jr., MD, PhD said…

To anonymous Sept 15: Yes, you conceived and the baby was lost very early (ofetn called a 'blighted ovum') but the placetal tissue continued to grow and make pregnancy hormones making your body think everything was still okay for awhile. Under these circumstances, and at your age, that baby probably was chromosomally abnormal. The D&C would not have caused early menopause. I am sorry for your loss. Best wishes and thank you for writing. Dr T
At Sun Nov 02, 01:47:00 PM 2008, Anonymous said…

Hello Dr,

here is my history.
chemical pregnancy april 08 ( i noticed because my period was lighter than usual. beta never went higher than 12)
immediately following this chemical, i again became pregnant likely 10 days later while i was ovulating. this pregnancy ended at 5 weeks. in mid june.
i took a break until september 08, my doctor empirically started me on low dose oral progesterone. i was able to see a g- sac in correct position at just over 5 weeks. just like my prior pregnancy, i lightly spotted for about days, and then bleeding started and i miscarried just before i was 7 weeks. i have had an MRI/ hysterosono to eval my anatomy- normal. blood work done to rule out abnl clotting factors. my anticardiolipin IGM level was only one point higher than the norm. what should i do at this point. will i ever be able to carry to full term? my age of menarche was 16. i was on birth control for 4 yrs up until a year ago. i have noticed since stopping birth control, although my periods are still every 27-30 days, i spot for 4 days prior to my period flow.
At Wed Nov 19, 11:57:00 PM 2008, Gincy said…

Iam 24 yrs old nad I've had two miscarriages.The first one was on Nov 07.This was a pregnancy which I was not aware off ..since my periods delayed for around 10 days i had my test done..the day i got my report i started bleeding and i did not need D & C.July 08 me and my husband were delighted to find that i was pregnant ,this time we really took good care and i was on Duphastone and folic acid. but it so happened that we had to consult another doctor because of shifting to another area. the previous doc had also prescribed Aspirin and prenatal tablets, which the 2nd doc asked me to start only after 3rd month.we went for our usual check - up on 11.4 weeks.The Doc failed to recognize any heart beat and we were told that our baby grew till only 8 weeks.Then I did D & C on Sep 16th.i would love to know of what had happened and what should be done next??
At Sun Nov 23, 06:56:00 PM 2008, Amy said…

Dr. T -

I'd REALLy love to get your input on my current situation....here goes
Two months ago I had a "faint" postive pregnancy test...5 days later a usual period started and the test was then negative. Two days later, went in to have blood work to "confirm" and sure enough, I had a hcg level of less than five and progesterone of 1. Within the very next cycle, we got pregnant. I had hcg and progesterone checked at exactly 4 weeks and the levels were 36 and 17respectively. Two days later they only checked the hcg, which was 65. Five days later, the hcg was 437. They said we didn't need to check values anymore. We went to our 8 week ultrasound which showed a 6 week fetus..sure enough that evening started bleeding, went on to have a miscarriage...now my question, do you think b/c I have had two EARLY losses, that I would benefit from empiric treatment with progesterone?? I really feel in my heart that this would help. I have no health issues expect for that I didn't start my period until I was 19. I was on the pill for several years, but for the last two years have been off and have cylces that are very regular and range form 28 to 31 days (minus the chemical pregnancy cylce that was a 35 day cycle). I just want to be proactive and do all I can to ensure that we don't have to go through this again. Any advice is of great help.
At Sun Nov 23, 07:10:00 PM 2008, Amy said…

Dr. T -

I am really hoping I can gain some of your input regarding my current situation...here goes.

In September of this year I had a very faint positive on a few pregnancy tests on the 30th day of my cycle, but within 5 days a typical period came and I did a repeat pregnancy test which was then negative. The following day I had my hcg drawn and sure enough, the value was under five and my progesterone was 1. Within the very next cycle, we were pregnant again. At 4 weeks, I had my hcg drawn the value was 36 and my progesterone was 17. Two days later the value was 65 hcg...five days later, my hcg was 437. My doc. said everything looked great and that she would see me at 8 weeks. At our 8 week ultrasound is where we were told the fetus was that of a 6 week fetus and there was no heart beat. That evening the bleeding started and I went on to have a subsequent miscarriage.....with that, here are my questions...does that constitute as TWO miscarraiges? secondly, do you think I would benefit from empiric treatment of progesterone and aspirin? I am currently taking extra vitamin b6 and folate along with my prenatal. I am otherwise healthy. Only significant medical hx is that I was 18 when i got my period, only due to a progesterone challenge. I have since gone on to have very regular periods (28-31 days). Any advice you can lend would be of GREAT appreciation!
At Sat Mar 07, 12:23:00 PM 2009, Anonymous said…

My husband and I have endured two miscarriages in a span of four months. We got Married in July of 2008 and started trying to conceive in September of 2008. We got pregnant on our first try (I found out I was pregnant on October 15th). I went for an early ultrasound because I started spotting. The ultrasound showed a gestational sac, but no baby. I had my hcg levels checked...and they were dropping. I had a natural miscarriage on October 31st. We were told to wait until I get my period and then we could try again. We waited, aunt flo came, and then tried again. Low and behold, we were pregnant again. My first ultrasound showed a baby with a heartbeat. I started spotting, so I had another ultrasound which showed a slow heartbeat. A third ultrasound showed no heartbeat. I opted to take misoprostol to pass the tissue. It didn't pass all of it, so I took it again..and still had a little tissue left. My doctor took the rest of it out in the office. My question is this: I'm 23, and my husband is 24. I don't smoke, drink, or do any drugs. My thyroid was checked and it was normal (They thought I may have had an overactive thyroid). I am scheduling a sonohystogram once I get my period to check for uterine abnormalities. My doctor mentioned a uterine septum...i'm guessing that wouldn't show on a normal ultrasound?? If they notice a uterine septum during my sonohystogram, will it be taken out right then and there or how does that work? And recovery time? And if I don't have a uterine septum, what should our next step be to figuring out why I may be miscarrying?

Any suggestions would be very helpful as we really would love to start our family.
Thank you,
Jen
At Sat Jun 13, 11:42:00 AM 2009, Anonymous said…

I have had three miscarriages in the past year. my first i held for 6 weeks, seond 7-8 weeks,thrid 10 weeks. I don't know why it's hard for me to hlod a baby. I'm only 18 years old. can u tell me what u think?
At Thu Jun 18, 05:24:00 PM 2009, Kenneth F. Trofatter, Jr., MD, PhD said…

To anonymous June 13: I would suggest that you have your uterine cavity evaluated by a sonohysterogram and consider having chromosomal studies done on yourself as a start. There is lots more that can be done to evaluate and to treat you under these circumstances (see the last two posts in this series), but the odds are that you will be successful in the future even without the help of a doctor!
Dr T
At Sun Jul 19, 10:24:00 PM 2009, Anonymous said…

My daughter had a miscarriage last year and was told by the er doctor at the hospital that she had a septum in her uterus that went part way down/that was shaped as a V. She was supposed to be about 13 weeks when she had bleeding and cramping. The baby was the size of about 9 wks and they could find no heart beat. She is pregnant again and is right at 8 weeks now. She had some bleeding at 5 wks that went on for a few days (no cramping). We went to the hospital again. They did an ultrasound and said the heartbeat was good and the sack was intact. The bleeding has stopped (so far). She has an apt. this Wednesday for an ultrasound. I was wondering if they would be able to tell if the baby was in the septum again? Is there any possibility that the septum was misdiagnosed last time?
At Sat Jul 25, 08:50:00 PM 2009, Anonymous said…

Dr. Trofatter,

Thank you so much for taking the time to answer questions posted here even 2 years after writing this article. Your answers have helped me relax my mind because I seem to be going through a miscarriage right now.

I had one 8 months back (12 weeks but the baby was only 5 weeks) and no cause could be found. I am supposed to be 5 weeks now and I feel the same way about this pregnancy too because I stopped having any symptoms 4 days back. I don't have my first prenatal appt. until I'm 9 weeks.

What's eating me is that the doctors don't know why this is happening, and I don't know what I can do to prevent this next time. Do you have any advice? Thanks.

Jody
At Fri Aug 07, 03:17:00 PM 2009, Anonymous said…

I've experienced my 2nd miscarriage in 4 months - my husband and I had undergone interuterine insemination after over a year of unsuccessful pregnancy attempts. These were my first two pregnancies. I had a d/c both times to test the products of conception, and both times, the result was tetraploidy, 92, XXXX. After the first loss, I was tested for many of the miscarriage factors, and was found to have elevated anticardiolipins, so was on 2x daily heparin shots and baby aspirin for the second pregnancy. I'm 35, almost 36, and have been diagnosed with PCOS in the past year. I've been on 1500 mg metformin as well as my prenatals, folic acid supplement (and Vitamin D when I was on the Heparin). It looks like tetraploidy is a pretty unusual outcome; what could cause this, and what would be the next recommended steps for us? Is a normal pregnancy *ever* possible?

Thanks for your response.
At Mon Aug 17, 01:51:00 PM 2009, Alli said…

I am 28 years old and I had a miscarriage in April/09 and was approximately 8 weeks - this was my 1st pregnancy. I started cramping and bleeding with this miscarriage and went to the ER, where they sent me home and told me to come back in the morning for an u/s as I was not bleeding heavily. I had a tv u/s and they told me nothing was in my uterus and that I had passed everything on my own. My doctor told me to wait at least one cycle and I could start trying again. Although worried I would have the same thing happen again, we decided to try again as this seemed to heal the pain of what happened. I was so excited to receive a ppt on June 14th/09 (LMP May 15th/09). I got into see an OB pretty much right away due to the previous miscarriage and was set up for an early u/s at 9 weeks. There was no fetal pole detected and I was showing more like 6-7 weeks, I was diagnosed with a blighted ovum and had a d & c procedure a week later (also had another u/s in between to confirm).

I was wondering if you think the two issues could be related (like getting pg too soon). I have read your other posts which talk about 1st pregnancies where your body seems to reject it because it is half the mother. The blighted ovum was so disappointing since I felt great, had no cramping / spotting and thought for sure everything was ok.
I am now 2 weeks post d&c and will be waiting 2 periods before I start ttc - do you have any advice for me? Things I should ask my OB for next time (baby aspirin, etc)? Can't imagine having to go through this again - it is so emotionally draining.
At Mon Aug 24, 11:20:00 AM 2009, Anonymous said…

Hello. I would first like to apologize to all of you who have miscarried. I know too well how incredibly devastating they are. I have miscarried twice now in a year's time.

I had my first son when I was 19, a second son when I was 25, and a third son at 30. I do have a few problems (Rh-, heart shaped uterus, incompetent cervix, and preterm contractions), however, I still managed to successfully carry all three of my first pregnancies and have three very healthy boys!

When I turned 36 (and a half ;)), my husband and I decided we better get on it to have our last child because of my age. We knew there was a higher risk of miscarriage, but with such a successful past, miscarriage never even crossed our minds. We became pregnant on our first cycle of trying and were so very happy. I went in for a scan at 7 weeks and was completely shocked to be told there was no heartbeat. I was utterly devastated. I gave up on the idea of having a last child, but after a few months, I couldn't shake it and we tried again. It took us 8 long months and I finally became pregnant again. I was not as ecstatic this time around and was actually very guarded. Once again, I went in for a 7 week ultrasound and there was no heartbeat! I was more angry than anything this time! Something was just not right and I needed to know why this was happening.

After those two miscarriages, I met a friend online who told me she had a blood clotting disorder and was currently pregnant again (after two losses, as well) and was taking daily injections of a blood thinner.

I told my doctor I wanted the "blood clotting" testing done, but he "felt" that I did not have that issue considering I have already given birth three times successfully in the past. I told him I wanted the testing done anyway.

I had to give 13 viles of blood and waited about a week. My doctor called me and told me that the tests were negative and I asked him if "all" of them were negative. He had only gotten 7 back. So, he called me the next day and told me that I did in fact have a clotting problem.

I have what's called protein C deficiency. Protein C deficiency is a genetic trait that predisposes one to the formation of venous clots. It was explained to me that tiny clots were forming in my babies' umbilical cords and cutting off their life supply. My doctor felt I must have just been lucky with my boys.

We are now once again pregnant. I am currently 9 weeks 3 days and we saw a beautiful heart beating at 7 weeks. I have to take 81 mg of aspirin a day and daily injections of Lovenox (a blood thinner) to help clear any clots I may form. So far, so good. I am once again very guarded and probably won't really believe I'm going to have a baby until it is in my arms.

I just wanted to make sure that this testing was brought to everyone's attention. I did not have to see a fertility specialist to find this out, so you should be able to ask your regular OB to order this testing for you.

I wish all of you the best of luck and for happy, healthy babies! ;)

JustMe
At Fri Aug 28, 06:24:00 PM 2009, Kenneth F. Trofatter, Jr., MD, PhD said…

To anonymous July 19: We do not understand why women with a uterine septum are at greater risk for early miscarriages, but they clearly are. They are also at greater risk for later miscarriages and preterm labor due to 'cervical incompetence.' Early in pregnancy, an experienced doctor should be able to determine if your daughter has a uterine septum by performing a transvaginal ultrasound. Best wishes.
Dr T
At Fri Aug 28, 06:29:00 PM 2009, Kenneth F. Trofatter, Jr., MD, PhD said…

To Jody July 25: There are so many possible causes for early miscarriage but the most common cause is still a baby that is chromosomally abnormal. This can occur spontaneously if you make an egg or your partner makes a sperm with too few or too many chromosomes and those abnormal gametes join to make your baby (and you have no control over that) or it can be the result of one or the other of you have a 'chromosomal rearrangement.' If you continue to read the articles in this series, you will stumble on lots of other causes that occur with greater or lesser frequency. Good luck to you.
Dr T
At Fri Aug 28, 06:36:00 PM 2009, Kenneth F. Trofatter, Jr., MD, PhD said…

To anonymous Aug 7: Tetraploidy (4 complete sets of chromosomes in a single cell) can actually be found in about 1 out of every 30 early miscarriages, so it is NOT that uncommon! It is believed to result when an unequal division of chromosomes in mitosis causes the cell to not abort the division into two separate cells, resulting in a cell with 92 rather than two cells each with 46 chromosomes. I do not think there is a familial tendency for this to occur although the formation of tetraploid cells is a common intermediate found in the development of certain cancers. And yes, there is a very high likelihood you can have a successful pregnancy even with the other factors working against you! Best wishes and thanks for writing.
Dr T
At Fri Aug 28, 06:41:00 PM 2009, Kenneth F. Trofatter, Jr., MD, PhD said…

To Alli Aug 17: I know it is emotionally draining and I am sorry for your losses. I would only suggest starting a prenatal vitamin, 4 mg of folic acid and a single baby aspirin (81 mg) daily before you try again. If you miscarry the next time, have them send some of the tissue from the pregnancy to the laboratory for chromosomal studies. If the tissue is chromosomally normal, a workup for hormonal abnormalities and certain 'thrombophilias' may be in order. You might also consider a sonohysterogram at that point before trying again as well. Best of luck.
Dr T
At Fri Aug 28, 06:42:00 PM 2009, Kenneth F. Trofatter, Jr., MD, PhD said…

To Just me Aug 24: Thank you for sharing your story!
Dr T

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