RE said "Surrogate". Pg/loss ment.

(11 posts)(6 voices)
  1. I just had a D&C for my second missed miscarriage. After my 4th IVF cycle failed (ended in missed m/c), I told my RE, who is not on the immune testing boat, that I wanted to so some immune testing. I did. It was found that I have compound heterozygous MTHFR and tested positive for anticardiolipin antibodies. I was put on Lovenox and Folgard for my FET to help with the issues but the pregnancy still ended. I met with RE for a post op and he says a surrogate may be the way to go because I have had 2 missed m/c and one was on Lovenox and Folgard. He says he has no explanation for why this is happening (and I know he couldn’t) but that the extra folic acid and blood thinner should have done the trick. I just question if he is right. Is it my body? Is it the embryos? Was this 2nd m/c just bad luck? Is there any other testing I can do? Anyone in, or has been in, the same boat?

    I’ve got 4 embryos frozen left of 6. Two of those were used for my FET and, looking at the betas, both implanted and then one did not make it and eventually, in the end, both did not. We talked about doing PGD testing with a fresh cycle and I learned that with that only 50% of the chromosomes are tested and that it is a risk to the embryo and those embryos that were tested has a lower implantation rate. So, I don’t think PGD is what I want to do given that and my age and the fact that I don’t know if a fresh cycle is for me again. Surrogacy is just not something I think we can afford. I almost want to do another FET to see if the last loss was luck of the drawl but then since I have so few totsicles I don’t know that I want to take that risks.

    Time is running out for me and I just don’t know where to go from here. Any help is appreciated.

  2. Take this for what it's worth...but maybe a second, or third, opinion would be a good step to take. My first RE was 'local' to me and while he was a very nice human being...he wasn't even 1/2 the RE my second one was, who was a pretty well recognized RE at a larger, city clinic (I live in VT in a pretty rural area.) My 2nd RE, when she first read through my charts, told me that two, max three cycles were all you should do with an RE - if they can't change your protocol or come up with a better answer, then it's time to get another look at it.

    FWIW - I had PGD done with my 2nd cycle with my new RE. I had always had 'textbook perfect' the lab they looked perfect, doubled and divided as needed in great shape...imagine our surprise when we found out that our best looking embies were all genetically flawed. We had always transferred the best looking ones and frozen the 'b team'...the b team turned out to be the stronger embryos - we never would have known without PGD.

    Sorry I can't speak to MTHFR or immune issues - just wanted to let you know that the value of another opinion could be priceless.

  3. Did they do karyotyping with the D&Cs? Also, did you have a hysteroscopy done? Its the gold standard for looking inside the uterus.

  4. babyblues-I am really sorry for your losses. I have had 4 losses (5 if you count twins). Accordingly, I have launched a full-fledged investigation including structural issues, immune issues, blood-clotting issues. check out my m/c testing thread on the ny bd. Lots of helpful information.

  5. Baby... I'm so sorry for your losses. I agree with the other ladies... a 2nd, 3rd, 4th, etc... opinions are alway a good idea. I've had 5 m/cs with 3 tested chromosomally abnormal. My OB started to test me for RPL after my 2nd m/c... all of which came back normal. I went to see an RE, and he tested me for the last set of tests... immune issues, also normal. We also checked for structural issues with repeated sonos, pelvic MRI, HSG's, SHG, and hysteroscopy. Structurally, I have issues... adenomyosis, 12 new fibroids, prior surgery with a reconstructed uterus, and stage iv endometriosis with lots of adhesion. All of my Drs... RE, OB, Peri and an endo specialists, felt that even with all of my issues, they felt that my uterus can carry a pregnancy. They're not 100% sure about carrying the pregnancy to term b/c it's never been tested... mainly due to the unknowns of what the multiple fibroids will do during pg.

    After my 3rd m/c, my RE put me on Lovenox as precaution, but I still m/c #4 with OE and #5 with DE. I had doubts at that point with my uterus, so we started on the GS process. I went back to my other Drs. and had a last look at my uterus, and they all said the same thing again... that my uterus can do it. We cycled again with donor embies with younger donors having a great history with IVF... 4 kids from IVF and very high pg and live birth rates... plus the embies were PGD'd normal, vitrified and excellent quality. Again, I was on Lovenox as a precaution, transferred a single blast, and I'm currently 21 weeks pg. My OB and Peri are keeping a close watch on my pg b/c my now at least 12 fibroids are growing with the pg, but the adenomyosis and endos/adhesions aren't even an issue.

    I don't know how old you are, but the #1 cause of a m/c is aneuploids. AMA is a huge factor in aneuploids and m/c rate. It's a gamble at any age with a m/c, but the odds aren't in your favor if you're AMA. I think even testing 1/2 of the most common chromosomal abnormalities will help you to rule out the aneuploids. If you want to test all, then do CGH at CCRM or SIRM. More importantly at this time, get a 2nd, 3rd, etc... opinions. Get the tests that haven't been done to cover your basis before doing the FET. Good luck!

  6. Thanks ladies. Lots more to think about.

    We just got the karyotyping results back and found it was abnormal. RE did say that because it is, he feels better about doing another FET. If it were normal he would not feel the same. I have not had a hysteroscopy but did have several saline sonograms done that I understand are the same things. Not sure about that.

    I did forget to mention that I was also on low-dose aspirin and then some antibiotics for a few days. But, I was not on prednisone or any other steroid. I have heard others with immune issues use it. Maybe I can ask about adding that to my cocktail.

    kalerante_2~I’m glad to hear there is worth to the testing. It’s some food for thought. My RE mentioned a new test that can be done on my frosties that we are looking into.

    salex~That’s a wealth of information and I am trying to swallow it all. Thank you for directing me to the link.

    cristiyen~I am 40. My totsicles are from two cycles when I was 38 and then 39. Thanks for sharing the info about aneuploids. CGH may be the way to go. I highly doubt CCRM would take me. My FSH spiked to 14 at one time and I know they turn away difficult cases. Maybe SIRM.

    I’m just ready to get off this roller coaster and wish I knew the right path to take, as we all do. Thanks for all your help!

  7. I have not had a hysteroscopy but did have several saline sonograms done that I understand are the same things. Not sure about that.!

    No, they are not exactly the same. A HSG or a salien sono are indirect views of the uterus, using saline or dye, so it is possible to miss things using those methods. A hysteroscopy is a direct view of the uterus, and the gold standard for looking into the uterine cavity.

  8. Sorry your results came back abnormal, but you do have a reason for your m/c. I've found it helpful for me to have some closure with an abnormal result. The m/c still sucked nonetheless...

    A saline sono and hysteroscopy are 2 different uterine tests. Although both use saline to fill your uterine cavity, saline sono uses an ultrasound to see what's going on inside your uterine cavity (to a limited extent, I think) and your uterine wall. The hysteroscopy uses a small camera that's inserted through your cervix to see what's going on inside your uterine cavity. It allows the Dr. to see clearly what's inside your uterine cavity like polyps, fibroids, any anomallies, etc...

    A hysteroscopy is what my RE used to see if there are any fibroids and scar tissues from my D & C inside my uterine cavity... The saline sono is what my surgeon used to map out my uterus for fibroids in the uterine cavity and wall post surgery. To a certain extent, they can tell from a saline sono if there are any fibroids intruding in my uterine cavity, but a hysteroscopy is the best test for that.

    For your purpose, a hysteroscopy is probably the best test since you want to make sure your uterine cavity is smooth, pretty and pink... no obstructions for the embies to land and implant.

  9. Thanks for the explainations about the difference! Uggh. I've heard hysteroscopies aren't a walk in the park.

  10. Check with your doctor. From my research, a saline sonogram is just as useful as a hysteroscopy for diagnostic purposes. If something is found during a saline sonogram, then an operative hysteroscopy would be required in a separate procedure scheduled later.

    There was no way I was going to be put under again if I didn't have to! I've heard some clinics do the hysteroscopy "not under" but that didn't sound good either.

  11. I think everyone will have a different experience with a diagnostic hysteroscopy... It depends on your cervix and skill of the Dr. doing the procedure. My hysteroscopy was done with 2 Advils, so I was awake and got to see my cervix, smooth, pretty and pink uterus, and tube openings. It felt like a pap with visuals and narrative from my RE... It was actually kind of cool. My HSGs' and SHG's were much more uncomfortable.

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