and miscarriages

[Guest guest]

Hi ,

Welcome to our group and I am so sorry you have to be here. I am now catching up with my e-mails, so I am sorry this is so late. One thing you said about your story stood out to me. You said that you have been pregnant twice, once before and once after Ashermans? Is this correct? And you miscarried both times. You also said that there is no apparent scarring correct? It's true (I think Gwen and others have said) that it's difficult to know exactly if you have scarring without a hysteroscopy or an HSG. But, there may be other causes for your miscarriages other than Ashermans. I think it is important for you to explore all possible causes to your miscarriage problems. Ashermans may be the culprit for the second, but you may want to look into other possibilities. Cover all your bases...so to speak. Here are my thoughts.....

I have had many friends with multiple miscarriage problems that were easily rectified once diagnosed properly. One is a low progesterone level. This can be remedied easily with progesterone suppositories after ovulation or a better way is progesterone injections (which is what I had after IVF as a standard treatment). The progesterone treatments are carried out through 10 weeks of pregnancy.

The other cause that have attributed to multiple miscarriages with my friends are thyroid problems. In general, hyper and hypothyroidism are some of the most commonly misdiagnosed problems with women and their doctors. The problem is that most doctors test for TSH (thyroid stimulating hormone) only and not the other thyroid tests. Even my RE doesn't feel qualified to treat thyroid problems. The other problem that results in misdiagnosis is that often the thyroid tests come back in "normal" range. REs routinely test for TSH in their fertility workup. If it comes back in a normal range (~0.6 to 4.7 ug/ml) then they don't do anything. One RE at the university of Colorado says that he likes all his patients to be in a 0.5 to a 1.0 range in order to become pregnant. The third problem is that what doctors don't realize is that thyroid problems are diagnosed with laboratory tests and with a clinical diagnosis of symptoms. In other words, you can have close to normal tests but still have a problem due to your symptoms. This is because everybody has their own "normal" range. It is best to explain this with an example. My sister-in-law has had years of fertility and miscarriage problems. Her thyroid test always came back in normal range so nothing has ever been done. Then her symptoms became more apparent in recent years (symptoms vary widely from individual to individual and differ between hyper and hypothryoidism). She experienced hair loss, dry skin, mood disorders, constipation and a whole bunch of other subtle symptoms. She then saw a thyroid doctor (an endocrinologist who specializes in hormones other than those associated with the female reproductive process like our REs) who did a full blood workup. Even though her thyroid tests came back seemingly "normal" she was diagnosed with hypothyroidism. She is now being treated and is feeling tons better. It is too early to think about another child, but she is hopeful. My sister-in-law says that her doctor feels that her miscarriages may be attributed to her thyroid problem. She has lost three pregnancies including triples at 21 weeks. She does not want to try again, but she may if she feels like her body goes back to what it felt like years ago. She did have a live birth then. These thyroid problems can be insidious and very subtle and difficult to diagnose. I too am going to get worked up because I may have a slightly different problem. It's called post partum thyroiditis. I have had difficulty sleeping and I feel like my heart is racing (like I am on coffee) all the time. Two doctors felt that my tests are normal, but I know they are not for me and I know there is something wrong with me. I told my RE and he wanted me to see a thyroid expert. I will see him on Nov 7th. In summary, thyroid problems are very subtle and take years to develop and on medication it can take months to correct the problem (your body takes a while to adjust).

Anyway, sorry for the long winded explanation but I am a firm believer in thoroughly checking out all the possible causes for our problems (and those I just described are 2 that I know of). There may be others. I also feel that we have to take our treatments into our own hands and that our doctors tend to think within their own worlds and rarely venture out (and many of the gals in this group can agree with this). It is unfortunate for us but we have to be our own advocates.

I hope this is helful to you and others. Good luck to you.