Miscarriage/Fertility Update

Hi everyone,

I thought I should probably do a miscarriage/fertility/trying to conceive update here for those of you that I haven't touched base with. I also want to publish these details because if this journey ultimately ends up like any other hard thing I’ve been through, once we get to the other side, I’ll look back and barely even be able to remember the details and the specifics of the hard parts that once seemed so unforgettable and consuming. 

If you're just starting to follow along, we had miscarriages in April and in August/September of this past year. You can read about miscarriage #1 here and miscarriage #2 here.

I was able to get in with two different ob gyns here in Virginia finally. Both of them referred me to a high risk ob gyn and an endocrinologist. I haven't met with the endocrinologist yet, but I did meet with the high risk ob gyn- who I will be seeing after a future pregnancy is confirmed and from there on out. 

Fun fact- my ob gyn and high risk ob gyn (and hopefully where our future baby will eventually be born!) is right by George Washington's boyhood home, haha.

Prior to meeting with the high risk ob gyn, one of the ob gyns told me that she is 99% sure that the miscarriages are caused from my Factor 5 Leiden blood clotting disorder. This aligns with what I've always been told to be aware of since I had a blood clot in 2011 and was diagnosed with Factor 5 (thanks, dad...). She said that I need to start Lovenox blood thinning shots IMMEDIATELY as soon as I get another positive pregnancy test. She was frustrated that my previous doctor didn't start these shots immediately after my first miscarriage. She said they can run a million tests to look into these miscarriages further, but she knows it's my clotting disorder.

I took those Lovenox shots way back when I had a blood clot in 2011. Unfortunately, I was so medically queasy then (I have come so so far, thanks to all of my other major medical issues since then!) that I refused to do them myself. In fact, I had to go to an infusion center daily for the nurses to give me those shots. I remember walking in, seeing everyone around me getting chemo, and I had to keep my eyes down so that I could handle getting my own (easy in comparison) Lovenox shot. In fact, one time the nurses needed to extend the timeline of the prescribed shots, but they didn't have the doctor's official order. I sat there, they said they couldn't legally give me the shot for that day and that I would have to do it myself, and I refused. I physically could not do it. I sat there for probably an hour and a half before an angel of a nurse snuck in, made me swear I wouldn't tell anyone, and she secretly gave me the shot. I was so grateful for her...but, I guess that just shows you how difficult it was for me to do the shot for myself, even in a very serious and dire situation.

Anyways, after this current-day obgyn prescribed me these same Lovenox shots to take as SOON as I find out I’m pregnant, I was thrilled to now have an action plan from the get-go and to be changing what had caused issues with my previous two pregnancies. Shane will have to do these shots (hopefully easier for him to do than when he had to apply my ointment on my 3rd degree burn years ago...) and I'll just have to learn how to do them on the days he's out working in the field or gone for training. I've had 2 close friends (who live far away, sadly) have to do these shot for their pregnancies too, so at least I have their support.

However, I saw the high risk ob gyn AFTER seeing the original ob gyn, and while they work very closely together and I was super impressed with them both, the high risk ob gyn negated what the other ob gyn said about starting the Lovenox shots right away. She said that it can be dangerous for me to start them too early if my next pregnancy turns out to be an ectopic pregnancy or if I (God forbid) miscarry again. She said to first wait until a viable pregnancy is confirmed at a 6 week ultrasound for a future pregnancy. This reasoning, and pause on starting Lovenox, is what my previous ob gyn in North Carolina said too. 

I triple checked with the doctor to actually ensure that the documentation was there to say that I can get in for an ultrasound at 6 weeks. From my experience, most doctors won’t do an ultrasound and confirmation before 8-10 weeks, and I can already anticipate the go-around they will give me when I try to schedule a 6 weeks ultrasound. From the pregnancy groups I was in from my apps during my previous pregnancies, I read so many threads where women were just paranoid and/or curious and didn’t want to hold off on “meeting” their healthy baby so they insisted on earlier and frequent ultrasounds…just for fun. That scenario is not me, so I wanted to make sure I don’t have to fight that fight when the time comes.

So...that was extremely frustrating to then feel like our plan is right back where it was in April after our first miscarriage. So really, as we go forward with hopefully another pregnancy soon, nothing will change until 6 weeks. In our previous pregnancies, we had the issues at 6 weeks (first miscarriage was at 9 weeks but baby stopped growing at 6 weeks and the second miscarriage was around 6 weeks). She said she would do further chromosomal testing if we (God forbid) have another miscarriage. 

She did request more bloodwork (I'm keeping a tally of how many doctor appointments, bloodwork, etc. this pregnancy journey is requiring) to check on my Factor 5 and another blood clotting disorder, so we'll see if the results of that end up giving more helpful information.

The high risk ob gyn also said that miscarriages are caused by automimnune disorders/thyroid (but mine is under control, so it shouldn't be causing these issues now) and many believe from Factor 5 Leiden. However, she also said that Factor 5 Leiden doesn't directly cause miscarriages (which goes against all other research I've seen), but it causes pregnancy complications which in turn can cause a miscarriage. She was slightly leaning towards these miscarriages for us being random, but I find that very hard to believe with all the other physical factors I have going on. I would ideally like to see another high risk ob gyn too for another perspective, but this one is the one that all our nearby doctors refer to for the DC area, so we'll stay on this route for now.

I know someone who has Factor 5 Leiden and she had 5 successful pregnancies by taking a baby Aspirin daily. My ob gyn said that is what I would be doing if my case wasn't more severe with already having had a blood clot, so...I'm going to take it upon myself to take a baby Aspirin daily once we do get a positive pregnancy test, up until I can start my Lovenox shots. There is no harm in doing this, and I believe that something needs to change from what we were previously doing. I've had enough experiences in the medical field (as a patient only, of course) that I know sometimes I need to be my own advocate and I need to trust my gut since I know my medical experience and history better than anyone- especially with moving around and therefore switching doctors so frequently. SOMETHING isn't working up until the 6 week point, so SOMETHING needs to change before then. I’m done playing this game of trial and error with a baby.

I also feel like I need to reach out to my previous holistic doctor/nutritionist/hormone/ob gyn in Houston who managed my autoimmune disorder after being diagnosed at age 25. She is just the perfect blend of a doctor with all the skill sets that I'm currently needing, and I do believe that there are probably holistic things with my disorders that are being overlooked that will be able to help us with this healthy pregnancy endeavor. I just pray I don’t have to go off dairy again, haha.

I am also curious about reaching out to a fertility specialist in the area (and has an office in Houston too!) just to see what they would suggest. They see patients after a. being diagnosed with autoimmune/thyroid b. having a clotting disorder c. having 2 or more miscarriages. I haven't made moves with these yet, but I'm wondering what their initial approach might be.

Besides those factors, I'm trying to just stay positive and remember what I can control.

This process is somewhat reminding me of when I was trying to force meeting a serious boyfriend/husband before Shane. I tried so hard to make it work in my own control, on my own time, and when I finally just let go and let God, it naturally and effortlessly fell into my lap the exact way that it was supposed to, in the BEST way of course! I thought I knew best but I (very obviously) did not. 

Of course, there are physical steps that I need to continue to take with this pregnancy journey, but I also feel like I need to just be reminded that I can't control it myself and I need to somewhat let the mental overly-planning/control part of the process go. Does that make sense? I look at my little chart and I know exactly what month if I were to conceive would lead to what month of a due date (I pretty much have this memorized since going through this since first getting pregnant last February. When's your birthday? I can immediately tell you when you were conceived, haha), but I'm kind of feeling like I need to try my best to ignore all that for awhile and just let whatever happen, happen.

Until then, I'll be trying to still stay positive and hopeful through prayer and through the support of those that are closest to me. I look forward to the day when I won't be needing endless support from you guys. <3