# 1 miscarriage 1 'chemical' pregnancy - should I seek further investigations?



## Miss V (Sep 25, 2015)

Hi there,

I have just completed my first FET which was on a natural cycle with a grade 5AB thawed blast. We were told 100% of the cells had thawed and it was expanding after the thaw. By official test day I had a BFN, however my af was 4 days late which has never happened before and on 9dp5dt I had a very faint BFP on 2 separate tests. This was gone by 10dp5dt. I'm not sure whether this counts as a chemical pregnancy?

My fresh cycle in November we got 4 embryos which all made it to good quality blast. We had the top quality grade 5AA transferred and this resulted in a BFP with a healthy heartbeat seen at 7 weeks. Sadly at my 12 week scan it was found that I had had a missed miscarriage at 8-10 weeks.

We have 2 more good quality frozen blastocysts left and 1 more try on the NHS. I am wondering if I need to look into further testing before transferring our last to blasts as I don't want to 'waste' them. Up to now the diagnosis has been unexplained with a low egg reserve. The last time I saw a consultant he mentioned possible adenomyosis but he wasn't sure and if it was there it was not affecting the shape or lining of my uterus.

Does anyone have any advice fro next steps? Is it too early to get testing for miscarriages or should I pursue this? I am worried that there is something else wrong given that our embryos seem to be good quality.

Thanks!


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## jdm4tth3ws (May 20, 2012)

miss v,
sorry first of all to read of your struggles. its hard. 

i would go and get myself checked out. however, NHS wont help you until you've had 3 consequitive losses. you would need to go privately. Also, i would invest in a private endocrinologist first so he can check out the basics as well. after a few miscarriages, i finally got my gp to refer me to  private endocrinologist and he found i had severe anaemia, very low vit d, borderline diabetes, and PCOS. my thyroid levels were higher than the optimum as well. 
8 months on, im still on the medication prescribed, lifestyle changes prescribed and at our last appt was told i am now physically fit enough to try again, as long as i stick to the meds program and lifestyle changes program. 
i had also been to dr quenby for uterine biopsy and she said i was an enigma as my biopsy was perfectly normal and there should be no reason to keep miscarrying. 
i wouldnt advise going to your gp for bloods as thyroid levels are considered normal up to 5.50 whereas in fertility, the optimum level is nearer to 1 but between 1-2. 

again sorry for losses, and good luck moving forward. 
Jade xx


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## Ms G (Aug 4, 2014)

Miss V,

Sorry that you find yourself here. It really is tough.   I'm not an expert in this but didn't want to read and run. Since you had a natural FET, there would be no other reason for HCG in your system, so it does sound like a chemical to me.

Is your consultant open to discussion about other factors like immunes etc? Could you arrange a follow up appointment to consider next steps?  If your consultant is not someone that could support you in the this, you can certainly get advice separately and continue with you NHS treatment in your current clinic. Many consultants will support you cycling with your existing clinic and treat you concurrently. 

Regarding quality, it is so hard to tell. It is not possible to identify chromosomal abnormalities in an embryo just from visual appearances. However, this is the most common cause of miscarriage. Unless, there is reason to believe that you or your partner may have something hereditary then it is most likely a random occurrence. Not helpful I know! 

I think you do need to explore this a bit further if only to put your mind at rest and understand your options. You may decide to carry on as you are but at least you will feel that you have made an informed choice and not wonder 'what if'.

Best of luck. xx


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## Argybargy (Mar 18, 2015)

Hi Miss V
I'm really sorry to hear about your situation. I had one blighted ovum and one miscarriage. For my mc, although there was a HB at 7 weeks it was slow so we always knew there was a problem, so I can't imagine getting the thumbs up at 7 weeks and then finding out at 12 weeks it's a mc.  

Our clinic did recommend lots of tests, all the usual hormone tests, progesterone, vit D, immune testing, karyotype, NK cells etc as a follow up. It would have been very expensive nearly 2k, it was a really tough decision because it really could just be down to bad luck and also we have run out of NHS tries. We ended up doing them at an overseas clinic for a fraction of the cost, all normal, still none the wiser. But I am glad I did them so now these are all ruled out and definitely glad I did them at an overseas clinic.

Good luck!


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## Miss V (Sep 25, 2015)

Hi ladies,

Thanks so much for your replies and sorry to hear of the heartache you have been through too. This fertility journey is so tough!

I spoke to a nurse at my clinic today. I will not be having a follow-up with the consultant before my next cycle - I was quite shocked by this! They say I can have my next frozen transfer on my next cycle which will be in July. They won't be doing any further investigations except keeping a close eye on my lining on my next cycle as it was only 7.2mm (their cut-off is 7mm) at ovulation this time but should have thickened between then and the transfer (they didn't check it again). I have contacted a private clinic that does all sorts of recurrent miscarriage tests and should hear back from them tomorrow to book an appointment. 

Jade, my thyroid function is slightly low (so TSH levels are slightly high) and I had to fight with the gp to get them tested and my medication increased when I was pregnant. I need to have them retested but I know what you mean about the GP's not being aware of the right levels. I have stayed on the higher dose medication since my miscarriage so not sure what they are now. I think we will get some basic testing, e.g. thrombophilia, hormones but not sure about immunes for now. Will see what the consultant at the miscarriage clinic says.

Argybargy, thanks for the info about going overseas. We probably don't have time for that, but it's good to know. It must be weirdly frustrating to find them all normal, but at least your mind can be at rest that there is nothing else going on for your next cycle.

Ms G: I know that the embryos are a bit of a lottery, but you are right, I need to find out if there is anything else wrong (or not!) so that I can enter my next cycle with confidence.

Thanks so much for the support! Good luck to you all.


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