The Next Steps in our RPL Journey

We saw our RE on Friday.

Some would say we have a bit of going-forward plan.

Some would say the plan has some pretty big gaps in it.

Regardless, all I know from 2 years into Recurrent Pregnancy Loss, is that the best laid plans mean nothing. But, I’ll try to explain everything we discussed with our RE. I should point out, I love our RE – he is amazing and always takes the time to answer my questions in a way that I can understand them. Every time we see him, we have some pretty awesome conversations about all of this and I do feel like he is looking out for our best interests, even if his medical advice doesn’t necessarily feel useful due to our unexplained diagnosis.

Going in we didn’t expect a miracle cure (although we always hope for one), and surprise, surprise, we didn’t get one.

Here’s the summary of the discussion:

Our RE does not believe embryo adoption is a practical route for us. First, here it is almost unheard of for people to donate or allow other people to adopt there embryos – if we want to do this within our province/country, we would have to find someone who has some left over from IVF and do some sort of private adoption agreement. Different counties have different laws, so we may be able to pursue this outside of Canada and then presumably pay big dollars for it. Second, he’s pretty confident it won’t solve our problem because our karyotyping is normal, so we should be able to produce a healthy child ourselves. So, why spend tens of thousands of dollars on something that will likely have no effect on the outcome?

If we are adamant about trying something different from a genetic perspective he suggests either turning to donor eggs and/or sperm because they are more available (although costly). He is still does not think this will solve our problem, but it’s the route he would recommend due to the lack of donor embryos. He also stressed that if we are able to create a fertilized embryo using some sort of donor product, this will not change our chances of having another miscarriage.

We also discussed doing In Virtro Fertilization (IVF) with Comprehensive Chromosomal Screening (CCS) to see if we find anything. We have discussed this before, and know that it is unlikely to provide us with an answer. And, again, this will not change the likelihood of another miscarriage. So, we could spend $30,000-$50,000+ and have the embryo’s all look perfect and end up with the embryo’s not sticking right away or just have another miscarriage. Or we could find that all our embryos are screwed up, but still be no further ahead because this can happen to anyone going through IVF. So, unless we are made of money (and we are not) and feel like going through IVF in hopes of finding something through CCS, then why would we do this?

We also spent some time talking about the fact that we are still not pregnant again.

  • Our RE was just as surprised as us that we are not pregnant yet. He simply does not count the biochemical pregnancy, so for the sake of argument, today I will not either. So, this means we are now in cycle 5 of trying – 50% of all couples will be pregnant within 6 months of trying. So, he is not worried about us at this point. He believes we are falling back into the normal timeframes for people to conceive, rather than being at the head of the bell curve as per our last 4 pregnancies. I absolutely hate it, but it is nice to hear that it’s not a medical worry at this point.
  • To be proactive, I will be tested this month to confirm ovulation. And, to be proactive my husband will have a semen analysis done. Our RE fully expects both to come back normal, since we have been pregnant 4 times within the last 2 years and 4 pregnancies indicates reliable ovulation and reliable sperm. But, he wants to be sure something hasn’t changed and we agree. So, I’ll get some blood work done on CD 21 – next week. My husband will go in October (when the next available appointment is).
  • Broken ankles do not impact sperm quantity or quality. There goes that theory.
  • If we pass the 6 month mark of trying without success, he recommends introducing either clomid or letrozole. For people our age (31), 6 months is not a concern, and would not warrant a visit to an RE in our medical system (the requirement is 12 unsuccessful consecutive cycles for couples under 35, and 6 unsuccessful consecutive cycles for couples over 35), but since we are seeing one he would not want to see us wait until the normal 12 month mark given all our RPL history. More than likely he would put us on letrozole and he suggested I research them both but focus on letrozole in the next few months (if anyone has any thoughts on clomid or letrozole, please let me know). The idea being that they should increase our chances of getting pregnant (5% risk of twins, and 1% chance of triples because I already ovulate normally). My husband and I both expressed that we are not really interested in taking these drugs because we know I ovulate, so what’s the point? But as I always like having a plan, I am happy to know what he will suggest if we still are not pregnant by November.

Immunology was one of the big topics of the appointment. As we suspected he doesn’t really buy into the whole idea. And surprise, surprise, he never received a letter from my immunologist. But, we discussed what my immunologist said (read that here). So, our RE doesn’t see a big deal with reducing my gluten intake, but he really doesn’t think it’s the answer. He agrees that there are some doctors outside of Canada who have made their profession of treating RPL and immunology together. But, he stresses that the research does not support the link, and it is his opinion that the risks associated with many of the medications they use during the first trimester outweigh the benefits of taking them. For example, we spent a lot of time discussing the idea of a low dose steroid in the first trimester. Research indicates that it doesn’t make a difference to a creating a viable pregnancy, but there is strong research indicating low birth weights and other complications for the baby if it makes it to term. Needless to say, we are at a loss right now on whether or not to pursue the expertise of someone like Dr. Braverman or not. Our big thing has been having a healthy child, not just having a child, so my initial reaction is that I would rather not introduce medications into our next pregnancy that could have long term negative effects on the child

As for trying something slightly different with our next pregnancy, our RE would rather put us on daily heparin shots then a low dose steroid, as there is more research indicating that it can help in creating successful pregnancies for RPL patients and it has no harmful effects on the baby because it does not cross the placenta. So, this may be something we do next time we are pregnant. But even then, he doesn’t see heparin as providing enough benefit to do it. Either way, if we push for the steroid or the heparin, he will work with us and treat us.

So, for now, we keep trying the old fashion way, which has proven rather successful for us. Our RE made it clear that there is no need to panic (which of course my husband loved, because he’s been saying that to me for a few months now).  We will continue on our current plan* with the possibility of adding heparin into the next pregnancy.

And while we wait to see our RE again in November, at the same time we will be thinking very hard about a few things:

  1. Do we want to pay out of pocket to visit an RPL specialist? Possibly Dr. Braverman.
  2. Do we want to consider going out of country to try embryo adoption?
  3. Do we want to venture into using clomid or letrozole to help encourage a pregnancy, knowing that we should get pregnant on our own if we are patient? And of course, we cannot neglect to acknowledge that getting pregnant doesn’t mean we will actually maintain a pregnancy.

It is unlike us to rush into any major decisions, and we are only 31 so age is on our side, so we will take the time necessary to think through our options and make an educated decision. If we are lucky we will get pregnant before we have to make any decisions and the baby will stick (so far we have never been lucky in our attempts to have children, but a girl can hope, right?).

If anyone has any thoughts or experience with any of the above 3 options, we would love to hear them!

* Note that this post is all about what our going forward plan is.  We already have had extensive testing completed over the last year or so – We have undergone what feels like hundreds of tests, including the standard RPL testing. And, we have pushed for tests outside of the typical tests as we believe we needed them. Just to name a few of the tests we done – Hysterosalpingogram (HSG), Sonohysterogram, karyotpying on my husband and I, karyotyping on 2 fetus’, blood tests for multiple immune issues, etc.. And, every single test has come back perfectly normal. Like, perfectly normal.  Also, know that our already existing going-forward plan includes daily baby aspirin, prenatal vitamins, daily vitamin D and low dose synthroid (I have had a perfectly controlled hypothyroidsim with no fluctuations on low dose synthroid since 2009 – before we started trying to conceive). Once we are confirmed pregnant we start on progesterone supplements as well.  Note that we lost our fourth baby while taking all of the aforementioned medications except baby aspirin.  This was not introduced earlier because I have a history of stomach ulcers and my husband and I chose not to risk it.  After our fourth loss, we have decided to risk a stomach ulcer and I am now taking daily baby aspirin.  We have since had a biochemical pregnancy where we took everything including the aspirin and that pregnancy also did not work.

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47 Comments on “The Next Steps in our RPL Journey

  1. If you weren’t so far away, I’d be convinced that we have the same RE. because of there viewpoints on everything 🙂 Although mine seems to think my CD 20-22 day ovulation might have something to do with it.. so I tried clomid to move ovulation, my body was outraged by it and then I tried injectables, but that resulted in a SUPER thick uterus lining. So I have no idea. I am also going to ask about Heparin though. I’ll be thinking of you and hoping that next time it just works out..

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    • My guess is our RE’s are reading the exact same research to produce there recommendations.
      I have a perfectly normal 28-29 day cycle with ovulation occurring right around CD 14. (I don’t always use ovulation sticks because I don’t see the point given our normal cycles, but I’m pretty sure I ovulate on time each month and every time I use ovulation sticks I ovulate as expected).
      Anyways, my husband and I are both struggling with the idea of using a medication to improve my already perfectly functioning ovulation pattern – even the doctor cannot give us a really good reason why should other then it wont hurt and will probably help us get pregnant quicker, but wont help with a pregnancy sticking. We laughed with our doctor when we all agreed that we will end up being the 1% who get triplets (because, hey we are already the 1% who has RPL), and neither of us is crazy about all the risks associated with that.
      Anyways, thanks so much for your thoughts! I am curious what your RE says about Heparin and I am wishing you the absolute best as you continue on this RPL road.

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      • I don’t blame you.. with regular cycles, I would do the same thing. I can’t see using drugs if you are ovulating every month on CD 14. Why mess with it? I’m just waiting for the WTF appointment once they get the chromosomal results back, but I’m certainly going to ask. I’ll let you know.

        That’s the problem though.. we are the 1%, so the research on RPL isn’t out there. And of the 1% there are a whole variety of problems.. so it’s impossible to pinpoint exactly what is going on. That’s the frustrating part.. (well, one of the frustrating parts)

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      • I so hope you get some information from your chromosomal analysis – we never did, everything was healthy.
        You are right, the research on RPL sucks since it only affects 1%, and it isn’t a life and death situation like many other issues are (i.e. cancer, ebola, etc.). And, while I love the research on reproductive immunology, it is very much considered experimental at this point in time, and I’m just not sure I want myself and my child to be part of that – the negative consequences might just be too much for us to risk. I just wish someone had a crystal ball to tell us what to do next!

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  2. My last doctor suggested daily injections of heparin as well but said the research doesn’t show that there is a greater success rate over all. I was supposed to do this with #5 but his nurse couldn’t read his notes correctly and I miscarried before it could be clarified.

    I’m glad you have sort of a plan! I follow your blog so closely since your journey is so similar to mine.

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    • We’ve been told the exact same thing about heparin, but in respect to the fetus’ development it is a safer option to try then steroids. All the information can be so overwhelming! And so contradictory too! I always say that this would be fascinating, if I weren’t the one living in the middle of it.
      I too follow your blog closely because we are just so similar, so I look forward to what your new RE will tell you.

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  3. Seems like there are so many things on your plate during your visit. Try to take it one day at a time and always do what is right for you and your husband. It’s great that your doctor is willing to talk so much over during your visits. I just changed RE’s this week so after 6 miscarriages we are hoping to find that “miracle” also. I will be praying for ya’ll.

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    • There is definitely a lot going on in our last check in with our RE – you are right! We always go in with a giant list of questions, so we can use our time well.
      I love your advice of taking it one day at a time. I just wish I were better at that.
      I so hope your new RE is awesome and can provide you with your miracle! 🙂

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      • Still waiting for my HCG to go to zero after my miscarriage. I am still in the 200’s! We shall see. I will pray for you & taking it one day at a time is harder said than done!

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  4. There’s so much more out there than, um, Clomid, bye. That’s not a plan at all! There are SO many test about compatibility. And you haven’t even had a plain old sperm analysis? This isn’t something I have experience with, but I know there are a TON of tests out there, (even just the standard CCRM protocol requires a few) and I can’t believe you are taking none of them???

    I think you need to be your own advocate and push for more testing. I know there’s more out there.

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    • I should have been more clear in my post, that this was just about moving forward and what’s next. Not, about what we have done in the past or what we are already doing. We have undergone what feels like hundreds of tests, including the standard RPL testing. And, we have pushed for tests outside of the typical tests as we believe we needed them. Just to name a few of the tests we done – Hysterosalpingogram (HSG), Sonohysterogram, karyotpying on my husband and I, karyotyping on 2 fetus’, blood tests for multiple immune issues, etc.). And, every single freaking test has come back perfectly normal. Like, perfectly normal. The only reason we have never done a semen analysis is that they show quantity and mobility, not quality. And with having had 4/5 miscarriages, we know that they can swim and we know that his count is high enough to conceive multiple times. The only reason we are doing it now is to make sure nothing has changed in the last few months for some unknown reason.
      Also, our current protocol includes daily baby aspirin, prenatal vitamins, daily vitamin D and synthroid. Once we are confirmed pregnant we start on progesterone supplements as well.
      So, while I totally love your reaction (I really do, I think it’s so awesome that you care so much), I should have been more clear about what we are already doing (I think I’ll go back an add that, because its so important to show the whole picture). And I completely agree, we have to be our own advocate and push for the best possible care, because no-one else will do it for us.
      Th

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  5. It’s all so frustrating that with all they can do now, none of these doctors (even the immune specialists) can give any concrete answers as to why RPL happens. I was told, my eggs were likely the issue because my AMH was so low, but I was also told it was amazing I got pregnant so easily because my AMH was so low. So what the? We know my hubby has super sperm because his analysis was perfect and we had 90% fertilization rate when we tried IVF so maybe that’s why, but we tried the medical intervention and the hormones and the testing and it did nothing to improve our chances. We spent all that money and it didn’t work, only to get pregnant on our own again and have that be the one that stuck so far with no more answers as to why then before we had our first RE appointment. So I can’t help thinking with you being 6 years younger than me, and not having the low AMH and egg issue I apparently have and having gotten pregnant 4(5) times on your own, that all those options with the exception of the heparin are a bit premature. I know your frustrated and want to be pregnant again now, but I really believe it will happen again soon, and I really hope this is the one that sticks. It’s good that your RE isn’t letting too much time go by before seeing you again though I hope you’ll only have to see him because you’re pregnant and need the prescription for heparin 🙂 Hang in there hon. Hugs.

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    • I was so looking forward to your thoughts because I know you’ve tried a few of the things we were discussing today. And, I know your attempts at IVF with CCS didn’t result in a take home baby or a reason for your losses.
      Part of me agrees that given our age and our healthy results on all testing, that using donor eggs/sperm or seeking out of country treatment with embryo adoption or RI specialized treatment, it is a bit premature. Part of me dreads the idea of trying again, having another miscarriage and being a year older and continuing to live n the pregnancy / RPL bubble (which I so totally hate) The rational part of me, and the fiscally responsible side says we should give it some time.
      And on that note, who knew I’d ever actually think, we’ve only had 4/5 miscarriages, maybe we need to just give it a bit more time/tries and then re-evaluate if we want to do a significant change in protocol (i.e. donor sperm/eggs, donor embryo or seeing and RI).

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      • I don’t blame you for dreading more time however long in the pregnancy/RPL bubble. That really is the worst place to be. God I hated it too, and I really hope you don’t have to go through it anymore!

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  6. I know everyone is different and there are a lot of things that can cause RPL. I know for me personally, the only change we made for our last cycle (which was finally successful) was starting lovenox/heparin on CD1. Starting earlier and at a higher dose made all the difference in the world. I truly believe it is the only reason I was finally able to carry a pregnancy to term.

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  7. I can’t imagine what you’re going through. First, I think it’s important to throw out there as a reminder to everyone…doctors are not God. They do not know everything. Second, no matter how much testing is available and done, it may never give an answer. As heartbreaking as that is, I believe there is always HOPE. Technology is always changing. New medical practices are always being researched and evaluated for best possible outcomes. You are in such a tough position. I suppose if it were me, I would be looking for the place that is doing the MOST research and clinical trials on RPL and see if participating is an option. For those that need more information on RPL, I feel this is a great article that pretty much covers what research is out there and what is currently being done. http://www.ivf.com/recurrent.html. Please know you are in my prayers.

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    • Good point – doctors are definitely not god’s! While we really like our RE, he doesn’t know everything.
      I just checked out that link, and it might be the best description of RPL and possible causes and treatments I have ever read. I know all this information, and have been tested for every thing it mentions, but I love how summarizes all the information. Thanks for the link.
      I like your perspective on going to the clinics doing the most research and clinical trials related to RPL and immunology (i.e. Dr. Braverman). We really are concerned about the outcomes of the cocktail of drugs that I would take on the possible child. And, of course there is a pretty big price tag attached to seeking treatment outside of Canada. That’s not to say we wont do it, we are fortunate because we can likely make it work financially if we choose to, but we really need to be sure about it before we will jump in. And, if our doctor is willing to put us on the treatments without traveling to those clinics, it would make a lot more sense and it sounds like if we push it, he would be willing to. Oh, the hard decisions in front of us….

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      • I can’t imagine, but I think you are absolutely on the right track! I know it will be difficult seeking treatment away from home, but I have a feeling no matter the outcome…and it looks like from the statistics of people that are experts in treating RPL, you will have a positive outcome and no regrets! Dr. Braverman is probably one of the smartest Reproductive Immunologists out there and has a great team. Here is one in Chicago that does a lot of research as well: http://chicago.medicine.uic.edu/departments___programs/departments/obgyn/divisions/reproductive_endocrinology___infertility/mary_stephenson__m_d/
        Wishing you only the very best!

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      • Thanks again for another awesome link. I have actually read this site before. And, I suspect my RE is aware of her research, as he too has discussed that the research indicates the best approach to RPL is preconception care and close monitoring. The link you shared stated a success rate of 94% once cardiac activity is seen at 6 weeks (of course we are the other 6%). Basically, the mother needs a little more TLC from her doctors to improve her chances of a successful pregnancy.
        Anyways, thanks again!

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  8. This is a lot of information and a lot to think about! In some ways, it’s nice to know what he thinks. In other ways, it makes some things more complicated/harder. I have taken Letrozole, but I don’t have much to say about it. I think it gave me headaches. I’ve never been pregnant to my knowledge. Wishing you all the best in making decisions that are right for you! ❤

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  9. I tried a battery of things to get pregnant. To start, was number 3 on your list, but combined with IUI. After three trial of IUIs, it did not happen for me. I need to add, I could not get pregnant for 2 years prior to IUI. Since you were able and relatively young, natural way is still doable at this point.

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    • Thanks so much for sharing. My husband and I both are leaning towards sticking with natural for the time being, because we just don’t see the link to how clomid of letrozole will change anything. I’m happy we have a few months to keep trying and to think about what we want to do next. I guess, I’m feeling really happy that we are only 31 right now, because I know if we were older we wouldn’t have the blessing of time.

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  10. FWIW, I would choose Letrozole over Clomid–no contest. Also, me & my OB, Dr. Angel, chose to use baby aspirin + Heparin for this pregnancy even though I have no known clotting disorders, because neither will hurt the baby and both have been shown to help RPL–my perspective is better safe than sorry. I hate the Heparin shots but I think *what if* it’s the magic ingredient? So that’s my deal. These decisions about treatment are tough & I felt an insane amount of pressure/responsibility to prevent another loss. I hope you find peace with whatever you decide and that you get your BFP soon! XOXO

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    • From what I’ve read over the last few days, I too am leaning towards Letrozole if anything.
      And, my husband and I have discussed that we would like to try heparin as well with our next pregnancy. The data on it makes sense, or at least it does in our minds.
      Thanks for sharing and I keep rooting for you and that little one! It sounds like you have the right treatment plan and things are going smoothly! 🙂

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  11. If apsirin gives you ulcers, there are other options. I have an anaphylactic allergy to all NSAIDS so aspirin is not an option for me, and our genetic counselor recommended fish oil because it works as a natural blood thinner. Obviously, go with your gut and your doctor’s recommendations-I was just so excited that we had another option and wanted to make sure you know too. Unexplained RPL is a special type of hell, and I will keep you both in my thoughts and prayers.

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      • I always spell aspirin wrong – I have to go back and fix it every single time!
        Anyways, thanks so much for the idea of fish oil! I had not heard about it before, so that’s good to know in case I end up with issues from the baby aspirin. That said, I’ve actually been taking it daily now for a few months now without any problems. I always take it with lots of food (i.e. supper) and it seems to be working out for me. 🙂

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  12. I think its awesome that you and your re have a plan in place. I wish mine would get on it and start trying some stuff already. I have heard that clomid does produce a better quality egg if you already ovulate on your own (that’s what my doc said) so it might be worth trying. I honestly don’t think the re knows what to do with me lol. I hope something happens before you get to the real expensive sruff

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    • I too have heard that it can produce a better quality egg, but from what I can find, the research isn’t great or really conclusive. And, with the risks of cysts and everything else, I’m just not sure its worth it considering from all the testing done so far I should be producing good eggs.
      It’s so frustrating being at a loss – like you said, sometimes I think the doctors just don’t know what to do with us which makes the expensive doctors seem like they might be a good option.

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  13. I keep hearing about Heperin in RPL patients regardless of blood clotting disorders. My doctors brought it up to me but feels it’s not necessary. I’m
    Thinking maybe I’ll try it?! As for Clomid I guess you could say that it increases your chances since there’s multiple eggs which means more chances for fertilization and maybe a healthier egg in there, but it’s not proven. Letrozole did not work for me AT ALL. It made no impact on my follicles, less growth than normal actually, I never ovulated, had a false LH surge, my lining was super thin and I spotted for a whole week. So far Clomid likes me and Letrozole does not. People with bad reactions to Clomid like it, those with PCOS seem to benefit from it as well. That’s all I have. Hope it’s even remotely helpful. I feel you.

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    • Thanks so much for your thoughts! I find the difference for people on letrozole vs. clomid fascinating. And, at the same time so scary in our situation because why mess with something that is already proven to work (i.e. natural). If we choose to take either medication, we are currently leaning towards Letrozole, but it sounds like we may end up trying both of them to find the one that’s right for my body?

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  14. So many things to think about…. I am not an RPL patient but I did consult with Dr. Braverman. After a ten minute phone call, he recommended doing a surgery to remove possible endometriosis and also doing the immunology testing. I was overwhelmed at the time and opted for just going ahead with another round of IVF instead of following his recommendations. But it seems like (from what I have read online from people who have RPL as well as a friend of a friend who successfully got pregnant twice using his protocol) that Dr. Braverman’s protocol really works for them. It is really pricey but I think if you get pregnant on your own but has difficulty sustaining a pregnancy, Dr. Braverman’s clinic may be a good choice to explore. IVF is much more expensive than doing immunology treatment. And thanks for following my blog!

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    • Thanks so much for sharing your perspective! I think you make a good point, we could at least do the 10 minute consult with him. Where’s the harm in that? And maybe it would help us make a decision as to whether or not to pursue treatment with him right away.
      I said to my husband last night, part of me thinks we should try one more pregnancy with heparin with our local RE and see what happens before contacting Dr. B. That said, I absolutely know I will regret it if we have another miscarriage. Oh, the decisions are so hard sometimes! But, thanks again for your thoughts, I truly appreciate it! 🙂
      And, thanks for following me too! 🙂

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  15. My two cents would be to splurge on a visit to either Dr. Braverman or Dr. Kwak-Kim. Both are earning a stellar reputation for themselves the hard way (by paving the way using new medical research). A fellow loss mom just had a visit with Dr. Kwak-Kim after suffering her 3rd second trimester loss. So I don’t know if her treatment plan will be a success but I know she has a lot of hope for the first time in a long time. The heparin is a great plan. Apparently lovenox, in addition to being a blood-thinner, can also help in partially blocking an over-active immune issue, which means you may be able to avoid the steroids. Hope some of this helps!

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    • Thanks so much for your thoughts! I haven’t looked into Dr. Kwak-Kim yet, so I will do that now – thanks so much for giving me another name! I’m new to this idea of finding a specialist in the US, so I really appreciate it!
      I’ve heard the same thing about lovenox, which is part of why we are thinking of doing it with our next pregnancy, even if we don’t see the expertise of Dr. K or Dr. B.

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  16. R and I did every kind of testing available in Brazil and were told that we have a cross-match disorder (everything else came back negative or normal). We completed a highly controversial treatment while there, one which my current Dr. thinks was complete bunk, but then missed our 12-month window to try as we were without health coverage.

    I am now being told that I likely have endometriosis (the last of the last possibilities) and Dr. is recommending a procedure (plus, 3 others while inside) to confirm. I wan to do it, but R doesn’t due to all the health issues I had earlier this year. So we are current S.t.u.c.k. To make matters worse, I was just told by said Dr. that she will be leaving the practice (she’s been with us since our 2nd loss) and that if we are doing the procedure/surgery, she is scheduling now. She gave us a 2-week window (1 week down, I to go).

    I have been sad, confused, but mostly frustrated (see most recent post: http://bloomingspiders.com/2014/09/14/my-sacrifice-upon-autumns-altar/ ) as I don’t know if this is the end of the line.

    It’s challenging to suffer so much and have no answers.
    Blessing to you, friend, in your search for yours.

    With heart,
    Dani

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    • Thanks so much for sharing your perspective and experience Dani. I truly appreciate it. (Also, I just loved your blog post today – it rings so true to where I’m at right now).
      Good luck making your decision in the next week about whether or not to have the surgery. In some ways being forced to make a decision is hard, but in others at least you are able to move on sooner rather then later. For me, I always feel better when I have a plan, even if getting to the plan/decision is hard.
      Sending you lots of love as you work through all of this.

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  17. We tried letrozole for 3 cycles, two with IUI and one just naturally trying on our own with the drug. All three were unsuccessful. I was also curious why my doctor even suggested it, as I ovulate normally and to my knowledge, that is the main purpose of the drug, to force ovulation. I seem to think it may have had more to do with proving that wouldn’t work to my insurance company so we could move onto IVF… Anyway, I didn’t really notice any side effects at all, so it was great from that perspective, although I will say I developed a cyst after taking it for three months in a row and my RE said cysts are common on it. That cyst ended up forcing me to sit out several cycles before starting IVF, which obviously caused me much frustration. I wish I had some great advice for you; I’ll keep you in my prayers.

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    • Thanks so much for sharing! I think my doctor is suggesting going on it because he doesn’t’ want us to waste time not being pregnant considering our risks occur once we are pregnant. And, I’m pushing to know our next steps would be.
      I think you touched on one of the main reasons I’m not interested int taking the drugs – development of a cyst which will cause me to sit out one or more cycles. I’m curious what percentage of people end up with cysts? I suspect when I see that number (I’ll do some digging), it just wont make sense for me to take it.
      Thanks again for sharing – I so appreciate it!

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  18. I’m sorry if you already covered this. Has your RE suggested putting you on progesterone when you get a BFP as a precautionary measure? Maybe you are already on it, again, sorry, I don’t remember! My good friend had 4 miscarriages over 2 years and with her last pregnancy she figured “what the heck” and did progesterone suppositories after she got her BFP until 10-12 weeks. She has a healthy, 10 week old baby now. Both she and the RE can’t find any evidence to support her needing the progesterone (it was tested in previous cycles and always came back normal). But it was the only thing that was different for her 5th pregnancy. Could be a coincidence but makes one wonder.

    I think of you often. I admire your strength! Yes, 5 months may feel like forever for you guys…but you are still in the realm of “normal” for sure.

    Like

    • Thanks so much for taking the time to share an idea – I appreciate any and every thoughtful suggestion and supportive comment!
      We did the progesterone suppositories with our 4th loss (and the 5th chemical pregnancy as well). Even though it hasn’t worked for us, we will do it again because there is enough evidence to say that it may help in RPL circumstances and it wont hurt the baby or me.
      Thank you again.

      Like

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