# Advice recurrent miscarriage clinic - what to expect?



## RebeccaJane (Dec 16, 2015)

Hi, I am being referred to a miscarriage clinic _) after 2 mc and want any tips or advice what to expect? I believe they are going to do blood tests- but i have also booked up Dr Gorgy to do other tests but they are v expensive, any advice appreciated. 
I have had two miscarriages at about 4 and a half weeks in the last 6 months ( this is with a new boyfriend to the one I was with before - as the previous boyfriend did not want children). I have been to the royal free early pregnancy unit both times I started to bleed - and so they have referred me to the recurrent miscarriage clinic ( to see Dr Economides) but as it's NHS I'm still waiting for the appt. but the lovely nurse there booked up all the blood tests in advance I need to do in prep for the appt, so I need to go in on the 1st day or my period to do the blood tests.

Apparently I  conceive easily but I'm having trouble keeping the baby at around 4-5 weeks. So I saw Dr Gorgy as I couldn't wait for the clinic - he has advised me to do other blood tests for chromosome testing ( translocation ) and other gene testes - sperm tests for fragmentation and mobility - and other- but it will cost 2,400 but I guess it's worth it to know the problem. Then after that I'm guessing we can try IvF as the good thing about it is you get tested in the embryo for any chromosome defects so you feel safer as well. I turned 43 yesterday so I need to get on with it.

It's heartbreaking for me - as last time I saw you- a bit later I conceived with me Ex with no issues but he forced me to have a termination - so now I'm with a new amazing man who wants a child as much as me so I'm so keen to make it work this time. The good news is I conceive easily - also my progesterone is normal according to the last tests. 



Thanks, 
RebeccaJane


----------



## daisyg (Jan 7, 2004)

Hi Rebecca Jane,

I am so sorry to hear that you have had 2 losses.  I know how heartbreaking it is as I also had a termination with a previous partner before going it alone at the age of 43 nearly 44.


I had 3 own egg and 3 donor egg miscarriages at about 6 weeks.  There are several potential issues to investigate with miscarriage, some you can do something about and some you sadly can't.  The most common reason for miscarriage is chromosomal abnormality usually due to age and at 43 we are sadly pretty old fertility wise and that makes miscarriage more likely.


However,  there are other issues which may be causing loss in tandem with age and the main ones to be tested for are:-

Karyotype for you and your partner to make sure you don't have any genetic issues causing losses.

Sperm issues with your DH including DNA fragmentation etc.  Lifestyle issues affecting sperm (and for you!).

Uterine - No fibroids, polyps or abnormalities

Thyroid - making sure your TSH is between 1 and 2 and testing antithyroid antibodies

Blood clotting issues - MTHFR, FVL, APS etc

Infection - you and DH - Ureaplasma, Mycoplasma, Chlamydia, Group B Strep, BV

Autoimmune - Antinuclear antidbodies, Rheumatoid factor any other autoimmune issues.

Immune - NK Cells etc.

Dr. Gorgy is very expensive but he should cover all these issues.  Your GP can do some for free, but you need a specialist doctor to interpret and treat you as necessary.

Are you having PGD/PGS to select chromosomally normal embryos?

The good news is that you do get pregnant and that is always a positive sign.  However, you do also have to be realistic about your age and the low chances with IVF vs natural pregnancy.  It is not impossible, but we do need to be pragmatic I'm afraid.

I was finally successful using double donation, but I did it on my own so never had a chance to try with a partner!

Best of luck to you.
D xxx


----------



## Rabbit100 (Oct 26, 2010)

Hi Rebecca Jane,

I'm so sorry for your losses, it's good that you are being referred after 2 losses though most people don't get referals until after their 3rd (& for me it was my 4th).

My experience at St Mary's in London was I got sent a very detailed questionnaire through asking chapter and verse on all my gynae, fertility & losses history. So any gynae ops I'd had, pregnancy details, incl dates & how/when it ended. I think I was asked about family fertility related history too & what investigations I'd had to date.  At the appointment we chatted through the questionnaire, what further testing options that they good do for me (which in my case wasn't much because my local hospital was very good on that score), took some blood & told me what the potential outcomes maybe.

My recommendation if they don't send you a questionnaire through in advance is to try and go prepared with the sort of info I outlined above, with you written down, it's amazing what you forget when under stress or time pressure of a short doctors appointment.

I also had the immune testing separately (though not through Dr Gorgy) & lots of NHS hospitals (including St mArys ) are very dismissive of that. I was told by St Mary's that it was just my age/bad luck, which didn't make sense to me when there was a clear pattern / similarity in all my losses & they started in my early 30's. For me it was the immune issues that were my problem & the subsequent treatment for that has given me my son (& fingers crossed his sibling that I'm currently pregnant with).  So while the tests with Dr Gorgy may seem expensive in your shoes I would be doing the same.

Good luck
Rx


----------

