So long, pregnancy #4

We had our 6-week ultrasound today for pregnancy #4.  It did not go well.  There wasn’t much of anything to see — a bunch of irregular lumps that might have been bleeds and might have been products of conception but no gestational sac, yolk sac, or fetal pole.  The OB gave me the option of waiting and coming back in a week for another ultrasound, but admitted that she thought there was basically no chance that it was a viable pregnancy, so she gave me a prescription for misoprostol to take this weekend.

I knew, going in.  I’d had some extremely light spotting on and off, and zero pregnancy symptoms.  Even with the encouraging betas last week, I’ve been pregnant enough times now that I just knew something was off.  I usually get stretchy round-ligament-type feelings, and I’d gotten them the week after the positive HPT, but then they tapered off.  I’d had some tenderness while nursing, and it tapered off too.  But even though I expected it, it’s not much easier to deal with.

I just feel the overwhelming weight of needing to (1) get through this miscarriage, (2) go through the whole long process of trying to conceive again, and (3) going through another anxious pregnancy where I’ll be freaking out at every stage.  It just feels like too much right now.  But there’s no getting around step 1 — my only hope is that it won’t drag out too long (like it has the other two times, says my pessimistic self).  I can’t say I’m really looking forward to step 2 either — I just hope that awful ovulation pain doesn’t come back.  And while step 3 is a necessary mile marker on the way to the goal of having another living child, I’m really not looking forward to it either.  I’m just so tired of everything conception- and pregnancy- and miscarriage-related.  God, I can’t wait for this phase of my life to be over.

The other set of decisions I’m having to make is how aggressive to be with follow-up.  I put in a call to my RE’s office this afternoon, although I haven’t seen them in 8 months so I don’t know if they’ll get back to me quickly or have me come in for an appointment before they’ll talk to me.  I need to decide whether or not I want to ask for testing of the products of conception, for example (probably, since I always think that more data are better).  I had a lot of testing after the 2nd-trimester loss of our daughter, but I will probably make an appointment with the RPL clinic at my RE’s office for a consultation to make sure there’s no other testing they recommend (they encourage consultations after two consecutive losses).  For example, it seems like it wouldn’t hurt to have my thyroid and some other things checked again, since they haven’t been checked in several years.  My guess is that everything will come back normal, and they’ll just tell me to quit breastfeeding and send me on my way, but you never know.  My OB did tell me she’d recommend progesterone next time as a precaution (the RE had me on it for my pregnancy with my son, so I’m no stranger to it).

Breastfeeding is a whole other can of worms.  I know that it probably makes sense to wean before we try again.  While there’s no really good evidence, there’s circumstantial evidence that it can lead to difficulties with implantation, and so it seems like a sensible step to take now that my son is 20 months old.  But… he doesn’t want to wean, and I don’t want to wean, and the whole idea is just making me feel a lot more miserable.  It’s like, on top of dealing with dead baby #3, I now have to face the prospect of making my one living baby miserable and bringing an end to one of the few things that has gone perfectly right during my reproductive years — depriving myself of a beautiful part of my relationship with my son just on the off chance that it might help me not kill another baby.  It’s just not fair, dammit.

Well, as many of the readers of this blog know all too well, even with recurrent losses the odds are still reasonably good (though not great) that next time will be a success, so probably the main thing to do is just move on with getting un-pregnant and then trying to get pregnant again.  I can only hope that it will go quickly and not drag out for another eternity.

21 thoughts on “So long, pregnancy #4

  1. My Perfect Breakdown

    I am completely and utterly heart broken for you right now. O will honestly say that your betas were so good that I was convinced this one would work. I’m just so sorry my friend.
    For what it’s worth I strongly support starting progesterone 3 to 4 days after ovulation. I don’t have any of the research anymore, so I cannot easily share it with you, but low progesterone is definitly linked to early miscarriages. If your not pregnant progesterone will just delay the start of period for a few days. But if you are pregnant it is critical to implantation and long term viability.

    Reply
    1. lyra211 Post author

      Thanks, that means a lot. I know, my betas were great. Just goes to show that they can be misleading, I guess. After all, this is the second pregnancy I’ve had with great betas and a bad outcome, so I’m starting to wonder whether I’ll even bother next time. Probably, because I’ll generally take all the reassurance I can get. But it sure feels like false reassurance, given everything I’ve been through.

      That’s interesting about starting right after ovulation. My OB had said she’d start it as soon as I had a positive pregnancy test, but I’ll definitely bring up the idea with the RE and see if she’d want me to start it with ovulation in case it helps. I mean, it could be a coincidence, but my one successful pregnancy was also the only pregnancy that I was on progesterone, so it definitely won’t hurt and might help…

      Reply
      1. My Perfect Breakdown

        Our RE never put me on it. In fact when we showed up at his office with all the academic research printed out he just tossed us aside (a large part of why we ultimately when to Dr. Bravermen in the usa). Anyways, it’s critical I’m implantation so taking it after implantation has started just doesn’t make logical sense to me. I know lots of REs will have patients take it after ovulation is confirmed (which does mean you’d probably have to use opks if you don’t already). Anyways this is all a bit fuzzy for me now since it’s been so long but I know progesterone is super important. You may want to ask your RE to test your day 21 progesterone to get an idea of what your numbers are naturally as it should spike after ovulation on it’s own. (I’m pretty sure it’s day 21 that they test).

      2. RJ

        To add to MPB, my only successful pregnancy I used progesterone from 3dpo. One other pregnancy I took it once I found out I was pregnant but that one ended in miscarriage. I feel fairly strongly that it helped, although I have other issues so who really knows.

      3. Mamalife

        Ive been on PIO shots for both pregnancies. Thats the forst thing RE’s do here as soon as you are pregnant. if you cycled with them, they put you on it sooner.

  2. Erin @Splitmom

    Noooooo!!! Miscarriages are hideous, and I have no good advice to get through it, accept mourn that baby. I’m sorry. One thing I will mention, which you may know from your own experience, is that when you MC naturally it takes WAY longer to ovulate again. My last MC was natural, but I my HCG levels were being monitored via blood draws to rule out ectopic pregnancy and I was Peeing on a Stick at home, hoping against hope that I was just one of those women who bleeds a little in early pregnancy (curse google). Anyhow, my HCG levels were high enough to get a +pregnancy test almost 2 weeks after I started bleeding (slow drip). Once my levels were close to 0, my body started its normal cycle. Long story short, if you want to move this along to another ovulation and chance of pregnancy, it may be best to take the pill, however horrible the thought. I’m so sorry for you and your little lost baby. Progesterone was the only way for me to maintain pregnancies, so I hope it does the trick for you. Hang in there.

    Reply
  3. Erin @Splitmom

    Noooooo!!! Miscarriages are hideous, and I have no good advice to get through it, accept mourn that baby. I’m sorry. One thing I will mention, which you may know from your own experience, is that when you MC naturally it takes WAY longer to ovulate again. My last MC was natural, but I my HCG levels were being monitored via blood draws to rule out ectopic pregnancy and I was Peeing on a Stick at home, hoping against hope that I was just one of those women who bleeds a little in early pregnancy (curse google). Anyhow, my HCG levels were high enough to get a +pregnancy test almost 2 weeks after I started bleeding (slow drip). Once my levels were close to 0, my body started its normal cycle- I ovulated 4 weeks after the start of my MC, and started my period 6 weeks and 2 days later. Long story short, if you want to move this along to another ovulation and chance of pregnancy, it may be best to take the pill, however horrible the thought. I’m so sorry for you and your little lost baby. Progesterone was the only way for me to maintain pregnancies, so I hope it does the trick for you. Hang in there.

    Reply
    1. lyra211 Post author

      Thanks, Erin. Yeah, I definitely found that it took forever last time too. I was so annoyed, because the ultrasound tech told me after I miscarried without intervention that my uterus was empty and I should get my period again in 4-6 weeks. Well, she clearly missed something, because two weeks later I passed more tissue, and then didn’t get my period until 9 weeks had passed. I definitely want to move things along this time, so I will probably take the pill. My only worry is that it will be incomplete and they’ll have to do a D&C, which I’d really like to avoid because I have a small amount of scarring from my first D&C that I don’t want to make any worse. But I think that risk is relatively small, so I’ll probably go with the medication and just hope that for once I have a little bit of decent luck and it all just clears out the first time. There really wasn’t much in there on the ultrasound today, so I’m hoping what little there is will just get the heck out and make room for another pregnancy.

      Reply
  4. RJ

    I am so so sorry to hear this. You and your family are in my thoughts.

    I’ve used misoprostal 3 times and found it to work quite well. All 3 times I took 2 doses 24 hours apart. Never had any retained tissue. I hope you have success with it. I also recommend taking 600mg Motrin before starting. It helps with the cramping, as does a heating pad.

    Lastly, I have wrestled with the breastfeeding and weaning question. We would like to try again but my lil girl loves nursing and I am not willing to give that up (bc, like your experience, it’s the one thing that has gone well in this journey). I too look forward to no longer trying to reproduce and we haven’t even started trying again.

    Wishing you all the best. This sucks.

    Reply
    1. lyra211 Post author

      It’s nice to hear a misoprostol success story — I’m trying to stay off the internet. I took it to induce labor in my 18-week loss, but obviously that was different. I’m hoping that since I’m only just 6 weeks and there’s not even a clear gestational sac it won’t be too horrific, but we shall see. I just took the 3-tablet dose, along with 600mg Motrin, so wish me luck. And good luck to you on your weaning conundrum as well. I guess the best we can do is to just enjoy that special phase of our relationship with our little ones while it lasts.

      Reply
      1. RJ

        Good luck, I hope everything is going smoothly so far. And yes, the internet scared me a lot as well. It’s so hard not to google…

  5. simmi

    Oh this is not the update i was hoping for. I am so sorry. I had a D+E for my miscarriage, because the thought of delivering another dead baby was too much for me to process. My doctor said the Evacuation (suction) has less scaring risk than the Curtage… although honestly the though of suctioning out my baby was not easy to process. Not sure it’s an option where you live (i’m not US based), but just in case….And I also wanted to say that I am so with you on the ‘ready to be done this phase of my life’ stage. I wish it was full of glowing, happy me, but it’s not– it’s full of stressed, worried me who over thinks everything. So I have decided on a cut off– I told my husband we have another 2 years to go (at which point i will be OLD), and whatever sibling(s) my son does/doesn’t have by then is where we close the chapter. For my sanity, knowing there’s an end to this has been what’s been getting me through the last few months.

    Reply
    1. lyra211 Post author

      They do suction curettage at my local hospital, but I still got scarring with it the first time even though it was suction. I think the idea that it causes less scarring than the scraping kind has actually been debunked with more recent data — that’s my recollection from looking into it after my first pregnancy.

      Having a deadline sounds like a good thing. We’re not quite there yet… I’m turning 35 in a few months, though, so starting to reach the geriatric pregnancy stage. I’m wishing you all the best in your journey!

      Reply
  6. Mamalife

    I am so so sorry. As someone who faced the breast feeding issue while trying to get pregnant again and an RPL survivor, I can only say do what your heart asks you to do. I mean, when you ahve multiple kids, we need to make such decisions all the time, in such a way that in the end you dont feel regret over it. Its a hard one for sure, but only your heart can tell you.
    Take care, dear.
    Why does this shit take so much out of us that we hate the phase where in we try to concieve our children I wil never understand.

    Reply
    1. lyra211 Post author

      It’s nice to hear from someone who gets it. I don’t know what we’ll do… right now I’m thinking that maybe I’ll hold out until first week of January when I have a few-day work trip and try to make the separation part of the process. Seems less awful than just suddenly refusing to feed him at bedtime or in the morning one day.

      Reply
  7. jwhitworth7

    Oh I’m so very sorry. I am so saddened that you are going through another loss. Your perspective that the possibility of another successful pregnancy happening is in your favor is a positive one but I totally understand the physical and mental exhaustion that comes along with a loss and then trying again. I know that having the products of conception tested with the pregnancy right before Luke’s gave me piece of mind that it was in fact a chromosomal issue and not some underlying thing. If they give you that option it may do the same for you. Also, when I was seeing an RE before Luke’s pregnancy (because of the miscarriages) they put me on vaginal progesterone the day I had a positive test. My OB said that it isn’t shown to save a pregnancy and it’s kinda like giving a run down car a new paint job….it’s just a bandaid but it was something different I hadn’t done before and the RE (who was more specialized) advised. I was not on it with Olivia and was nervous about that. I’ll be thinking of you. I wish you did not have to go through this again.

    Reply
    1. lyra211 Post author

      Thanks, Jennifer. I think we are going to try to do testing with the products of conception, if I can collect them. Just took the misoprostol so we’ll see what happens over the next few hours. I’m glad to hear that Olivia’s pregnancy was a success even without progesterone — makes me feel a little less guilty, since there’s of course always a small part of me that wonders whether this wouldn’t have happened if I’d been more aggressive about going back to the RE.

      Reply
      1. jwhitworth7

        I’m thinking of you. Yes I remember wondering if I should go back to the RE in the early weeks of Olivia’s pregnancy and having conflicted feelings about not going and what if I miscarried, etc. We as mothers put so much guilt on ourselves but as you know this was in no way the cause of something you did or didn’t do.

  8. andthewindscreamsmary

    Gah. I’m sorry. I was so hoping for good news for you. None of it is fair, and it makes my heart hurt when others are struggling like this.
    I totally understand not wanting to wean. We are still going strong at almost 12 months and it brings tears to my eyes to think of weaning. Even for a good cause like adding to the family. It’s still hard.
    Keeping you in my thoughts ❤

    Reply
    1. lyra211 Post author

      Thanks. You’re darn right that none of it is fair. I’m just glad that if it has to end it’s ending early rather than stretching out to the 2nd trimester again. Those are pure torture, as you know all too well. I’m so glad that you and McLovin’ are still going strong on breastfeeding and loving it. It’s nice when something goes right!

      Reply
  9. hopingforatakehome

    I am so sorry to hear this. It is absolutely not fair what some people have to go through to have/build a family. Betas are pretty awful. Mine were higher with pregnancy #2 (that didn’t make it) and quite low and not quite doubling with Miss O who did. I was on progesterone and low-dose aspirin with her and not the other two pregnancies. I had a D&C with pregnancy #2 and it took me more than 8 weeks to get my period – apparently this was on the longer end after a D&C. That waiting period absolutely sucks, when you just want your body to get back to normal even though at that point you’re not exactly trusting your body to be normal.

    Reply

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