2nd m/c in 4 months... Need help

Atomic and others who have gone through this... I could use any help and advice...

So I’m going through my 2nd m/c in 4 months – both happened at 5 weeks, so very early (maybe technically they're chemicals?). I started swaying girl in March and we have ttc a total of 4 cycles from July until now – two BFNs, two BFPs that ended in m/c. Both times I knew for over a week before I m/c that it was going to happen b/c my hormone levels (both HCG and progesterone) were terribly low. I’m terrified about what’s happening. I have two boys and we conceived both on the first try with no m/c. Nothing major has changed in my health status since then (except being 3 years older – I just turned 34). And at time of this last BFP, I'd been swaying on LE for 8 months, exercising and have lost 50 lbs. So now I’m beating myself up terribly that I’ve caused all this with swaying. I just don’t understand what else is going on.

I have lots of questions but here are a few…

1.) I know most m/c are caused by chromosome issues but is it unlikely that I would have two in a row caused by that, and if so, should I be worried there is something seriously wrong with my egg quality? Or are there other likely reasons – perhaps the changes in my body from swaying – that might be causing this? My cycles in general have not changed that much over the course of the last 9 months.
2.) Is it possible I’ve depleted my body’s nutrients too much and that’s why this is happening?
3.) I’ve seen atomic talk on here about COQ10. If I am having some egg quality issues, should I try this? I know atomic has already told me to add zinc and iron 3x/week which I haven’t been doing consistently but will now. Is there anything else I should be taking that doesn’t sway blue?
4.) I was basically off of LE for 10 days after BFP & I haven’t exercised in two weeks. I wasn’t eating too terribly but also not following diet & had started prenatals. We probably wont start ttc again until late January at the earliest – so if I’m on LE again for the next 5 weeks (with a few unavoidably cheat days during the holidays and visiting out of town family), is that enough to “undo” the possible damage to my sway?

In October, I had some basic fertility tests done (FSH, AMH, estradiol, progesterone, follicle u/s), and everything was normal in those. My uterine lining is good. My thyroid is fine. DH had a SA and that was all normal. No big red flags. My doctor put me on Clomid 50 mg anyways for a short LP and I was on cycle #2 of that when we pregnant this time. I seemed to be responding well to that as I had two large, mature follicles at the time of O (seen on u/s) this last cycle and I had a higher progesterone level on my day 21 test. I’m hoping – but I haven’t talked to him yet – that he’ll put me on it again next month. Shouldn’t Clomid be giving me a “better” quality ovulation? I guess that doesn’t necessarily mean a better egg though?

Sorry this is long – I just feel lost now…. I’m so worried this is going to keep happening, like my body has decided it can’t support a pregnancy anymore. I want a healthy baby and still want a chance at girl, so any thoughts on how I should move forward are appreciated.

ABC I'm so sorry.

1)I doubt this is much consolation but to answer your question there are other things that may cause chemicals. Thyroid, blood clotting disorders, PCO/blood sugar stuff, autoimmune disorders, etc. Plus there are lots of chromosomal things that can go wrong, and even though it seems farfetched we absolutely have had people who have a loss due to one abnormality that turn around and have a different one with the next pregancy - some do go on long enough to get tested. We also have people doing IVF rounds that will have tons of eggs and many or most of them are chromosomally abnormal - either the egg or the sperm or something in the way they combined and so people get 30 eggs and only have 3-5 to transfer. The miracle is not when something goes wrong, but actually that it goes right as often as it does.

Still, I would advise having more testing done if they'll do it. Clotting disorders and I have a new test I'm going to start recommending, the "antinuclear antibody" test which will help rule out autoimmune diseases.

2) and 3)Anything is possible and I do want you to add in the nutrients we talked about. But losing that weight - honestly that's great for your chances of having a healthy pregnancy (provided you are still in a healthy BMI). If anything you've only improved your ability in the long term to have a healthy pregnancy so I just want you to keep that in perspective. Also maybe we talked about this already, can't remember but since your thyroid is good let's also do iodine 150 IU daily from now all through pregnancy.

We can also add in the lowest dose Vit. D 2x a week and the lowest B12 you can find 1x a week.

Coq(ubiquinol) is fine if you want to take it. I was having people use it for a while but didn't see any improvements and that's why I'd kind of backed off of it (since it's expensive it really seemed to be adding stress for some people) If you want to try it that's fine.

Oh and switch from folic acid, indeed totally cut it out of your diet (unless you get the all clear for clotting disorders) in favor of folate and up that to 2000 mcg a day if you weren't already.

4)Yes that's fine, 5 weeks is plenty.

Clomid can give you a better quality ovulation but that is no guarantee that the egg will be right and/or that the sperm will be, and/or that something can't go wrong along the way. So many cell divisions have to go just perfect in those early days and sometimes something doesn't go quite right.

Again, I'm so sorry for your loss. I really, really hope we can get this figured out and have you enjoying a healthy pregnancy very soon. :heart:

Atomic - thank you for the quick response :) I really appreciate it.

Ok so I left out a few details that go right into some of the things you pointed out...

1) Antinuclear antibody... unfortunately I already know all about this. :) I have tested positive for it in the past.. I was diagnosed about 7 years ago w/ an underlying connective tissue AI, however, which one is not clear b/c I don't meet enough criteria (according to my symptoms and further antibody testing) for any of them. What I have is a positive ANA and one primary symptom. However, I had all that before I conceived both of my two boys and it didn't cause any issues w/ them and from what we can tell (I've seen a rheumatologist within the past year), the condition hasn't progressed further since then - at least, I have no new symptoms. Also, at that appt I had with the rheumatologist this past spring, she ran tests for the blood clotting antibodies and I was negative on all those. Nevertheless, I will ask my OBGYN if he thinks my condition COULD be affecting me now even if it didn't in the past. The rheumatologist told me she didn't think I should have problems w/ another pregnancy. I know my OBGYN has suggested that just b/c I have these underlying issues, baby aspirin MIGHT help - but I know your concerns with it and so I'll ask him again if he really thinks I should try it (and the rationale for trying it).

2.) Ok - good to know about the weight loss. My BMI was about 27 when I started (so I was overweight) and now it's down to about 20. I need to stop losing weight - I know that - b/c I've had a LOT come off just in the past couple of months and I'm now having a hard time controlling the weight loss. When I started all this - you thought (and I agreed) that I probably had some IR issues - losing weight didn't come easily for me. I'm wondering if alllllll the stuff I've done to lower blood sugar/improve insulin sensitivity really did work and those IR issues are gone/have improved a lot, but now I have to figure out how to stabilize my weight loss so I don't lose more.

That brings up another question - How do I keep myself from losing more weight while keeping up the exercise and staying in the LE limits? I was already semi doing the PCOS version of LE (meaning, I'm trying to do it but it's hard to completely stick to), so I have already been on the higher limits of fat intake (50-60). However, I'm often under 50 g of protein. What can I do to stay w/in the limits but stop losing weight?

3.) Ok, I will get strict w/ doing the zinc and iron, plus add in low dose of vitamin D and B12, and iodine. On the iodine though - I am on synthroid, so will that affect that? My tsh was at the high end of normal a year and a half ago (Tsh of 3-something), and doc just wanted it lower b/c of pregnancy. Last time it was checked it was 1-something, so a good number and doc hasn't told me to stop the Synthroid but maybe I'll ask him about that too and see if he wants to check it again. Should I ask him to check my vit D levels too? I've wondered if that could be low (and my iron since for the first several months of sway I ate no meat and still eat very little...). I think I will also try COQ10 - should I do 100 or 200? I was already doing folate - not folic acid - and usually take 1600 a day. The pills I have are 800 each so I should do 3 for a total of 2400 each day?

Thank you atomic for all your continued support. This is so hard but I'm trying to be hopeful still that it will all work out in the end.

Agh I'm sorry yes NO iodine in that case. I'm sorry when i read your prev. post I read "thyroid checked" and didn't realize you were on medication for it. Hugest apologies.

More when I'm on my laptop! just wanted to catch that one fast!

Quote:

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Originally Posted by atomic sagebrush

Agh I'm sorry yes NO iodine in that case. I'm sorry when i read your prev. post I read "thyroid checked" and didn't realize you were on medication for it. Hugest apologies.

More when I'm on my laptop! just wanted to catch that one fast!

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Ok no worries I will not do iodine. I have not limited salt while swaying so I'm probably getting enough anyways

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I'm so sorry you're going through this. I think sometimes it's just a streak of terrible luck. I had three early losses while swaying and despite tons of testing for both DH and I through my RE, nothing was wrong. I, too, worried swaying for several months had played a role in it but I ended up conceiving a healthy baby after a year of swaying. I didn't do anything different either that month, just lucked out. So many things have to go right for a healthy baby to be conceived and then for the pregnancy to go well that it's amazing it ever happens. Unfortunately miscarriages are common and are often due to something going wrong from the outset.
I think if you need to hold steady in your weight, you can reduce exercise a bit and up calories. I had to do this a few months into swaying because my BMI got scary low.
Good luck and I hope you're able to conceive a sticky baby soon.

Thanks, ks. :) I remember reading about your losses - and it is really encouraging to me that you were able to go on to have a healthy baby after all that! I'm hoping that it's just a streak of bad luck - I think it's just harder after this 2nd one to not worry that it's something more than bad luck. It does seem that something went wrong from the very beginning with both of mine given that each time my progesterone at 4 weeks was very low. This time around I had a progesterone test one week after ovulation and it was 17, and one week later it had dropped to 8 :( So I guess something did go wrong right at conception and my body recognized it quickly. I'm thankful that neither dragged on after we knew things weren't going right. Honestly the waiting in limbo - being pregnant but knowing things aren't going right & that a m/c is coming - is maybe harder than when it actually happens.

This baby making is tough :(

1) I think it's worth a closer look for sure. These autoimmune disorders often have their flare/dormant cycles and it may be that when you conceived before you were in a dormant phase and now you're in a flare.

I am really, really, REALLY hesitant now more than ever to toss aspirin at you. The reason is because aspirin is not only a pretty common allergen but also it makes your thyroid get wonky and I just don't think it's going to help. They have actual medications that can slightly suppress your immune system without the blood thinning effects and since you know you don't have "clotty" blood I think the aspirin can cause actual harm for no benefit anyway.

2) agreed. That's what happens as we lose weight is that our insulin response (for most people anyway) does really really improve a lot.

To keep weight on, you have to eat more LOL. The rules have to change over time. More calories, and more carbs (and yes, I always want anyone with any suspected IR to be at 50-60 g protein anyway). I still want you on primarily healthy carbs like fruit and veg but given the autoimmune stuff I wonder if you'd be better off gluten free or at least cutting back on gluten/wheat stuff. And since the weight is still coming off, don't be too averse to adding in some sugar to keep weight on.

3)200 on the coq10, yes let's up folate to 2400 just to be on the safe side (you'll just pee out any excess) Getting the tests done for Vit. D and iron is up to you, I'd probably not bother and just take them but your call to make.

Thanks, atomic, this is really helpful. I'll talk to my doctor about the AI stuff and see if there are other tests he wants to run. I know years back when I found out about my AI, they had run some tests that check inflammation levels in the body so maybe that's the kind of thing he'd want to check now. I think I may see if he'll recheck my thyroid too just to make sure that's still ok. I will follow the vitamin recommendations you've laid out and reassess my diet to try to get more protein and calories in, and see if there are some gluten free substitutions I can make to lower the wheat/gluten in my diet.

Thanks so much - will let you know if doctor gives me any other recommendations or testing... Hopefully we can figure this all out soon and I can still have a healthy baby!!!

Atomic - just sent you a quick PM... Just talked w/ my doc about my next cycle and I am confused and nervous!!! Had a couple quick questions for you if you don't mind!

ok thank you!