Recurrent miscarriage question

Wisdom from Wisot Wednesdays


With eight previous miscarriages what tests should I DEMAND?

Q. I have just lost my 8th baby due to early pregnancy loss. All losses have been at 11wks or earlier. The hardest part was there was a great heartbeat and a perfect looking baby. My OB/GYN said I was having a textbook perfect pregnancy. Of course I let my guard down, got excited and lost the baby almost 2 weeks later. The OB who did the D&C said she would have testing done on the placenta. What tests is she talking about? And more importantly we want to have a baby and are ready emotionally to try again, so what tests should I have done before we try again?
Kelly

A. I am so sorry to hear about your repeated losses. You can be sure that your enthusiasm had nothing to do with the loss. The test the doctor wanted to do on the placental tissue was probably to examine the chromosomes to see if the baby was normal or abnormal. That could provide clues on what is causing the problem and how to deal with it.

Once you recover from this miscarriage you might want to see an Ob/Gyn who treats recurrent miscarriage or a reproductive endocrinologist to review your history and see what tests are appropriate. Yours does not sound like the typical case and I really can't tell specifically which tests should be done from this information. Generally the tests will check the following issues:
• the chromosomes of both partners
• the quality of the woman’s eggs with hormone tests
• abnormalities of the uterus
• infection with an organism-ureaplasma
• progesterone levels/development of the uterine lining
• abnormal antibodies in the woman’s blood
• heredity blood clotting problems in the woman

By the way, when anyone approaches a doctor I would recommend that one not start the interaction by “demanding” that something be done. Start by listening to the doctor’s advice and then add any “request” you may have with the reason you want something done. The best doctor-patient relationship is one of mutual concern, cooperation and trust. If one does not feel that their doctor is concerned about their problem, not willing to reasonably cooperate or they do not trust the doctor, it is best to find another doctor.

Arthur L. Wisot, M. D.