In Vitro Fertility Goddess

Desperately Seeking Causes of Miscarriage

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If there is one word in the English language that strikes fear in my heart it's the big M -  ‘Miscarriage'. I've suffered three of them you see and frankly it's a noun I'd rather not hear again as long as I live.

The other is ‘Just try again'. OK that was three words but they have the same impact, especially when said by the doctor you were seeing for the miscarriage.

I remember only too well the first time I was told to do this. It was by a doctor wearing golfing pants and he'd dropped in after my D&C the night before.

Being the Thursday before Easter and all, he was in a bit of a hurry. Couldn't blame him really for speeding off in his imported European car with golf set sticking out the back while I sat at the window of my room and sobbed.

I did blame him for his parting words though: "Just try again." I repeated them over and over to myself wondering what on earth they meant, they sounded so light-hearted, so flippant, not at all in the spirit of the grave situation - the loss of my baby- at all.

For a start the word ‘just', as if it's all I had to do, it was simple. But it wasn't simple at all. I'd been trying for eighteen months already and this pregnancy was the culmination of those efforts. And ‘try', well, I wasn't really up to trying anything, not even the sandwiches the hospital caterers had left by my bedside. I was feeling a little too overwhelmed by my loss, the shattered dreams of the future to even think about getting up the energy and courage to ‘try again'. 

So I was left with no answers, just an annoying mantra that sounded like it was sponsored by a sports corporation. Eventually, after almost a year and with the help of fertility drugs I managed to get pregnant again. And to my horror, started miscarrying again. This time it was me wearing the sporting pants, baggy enough to contain a bunch of maxi pads when I presented at the doctor's office.

Again, there were no explanations or answers, just the advice to keep trying. This time, dissatisfied and more prepared, I fronted my gynaecologist who'd put me on the fertility drugs and demanded to find out if there was an underlying cause for the miscarriages. Unless you are officially ‘recurrent', meaning three miscarriages in a row, it was not procedure to test but he agreed to. Only because I refused to leave unless he did and it's not a good look for a fertility clinic having its patients escorted out by burly uniformed men.

As it happened the tests found a thyroid imbalance that was thought to be causing the miscarriages and when it was fixed I went on to have a healthy baby. Both doctors were surprised as they'd simply put me in the ‘over 35' boat (apparently a sinking one), meaning that women over 35 are more likely to miscarry and do so more often due to genetic causes that are outside of medical science's jurisdiction. It's all due to Mother Nature not wanting us to have kids when we're older.

So when I read that the American College of Obstetricians and Gynaecologists is pushing for women to be tested after two miscarriages I thought, Hallelujah! At last we're looking at answers and possibly prevention, not just Nike-style catchphrases.

As Kelly Maguire, a counsellor for Resolve who has experienced four miscarriages herself before having two healthy babies says, ‘It's almost as if you want something to be wrong so you can treat it."

She wisely adds, "My experience is, it's all up to you and how much you push your doctor."

Hopefully we soon won't have to be pushing doctors (as if we don't have enough to contend with) but until then there are things you can do if you miscarry.

This is a tough and pretty unpalatable one but if it's possible to save some miscarried tissue it can be used for genetic analysis.

After a second miscarriage a woman could be tested for possible imbalances of hormones, including thyroid, prolactin and progesterone, as well as for polycystic ovarian syndrome.  Also underlying autoimmune disorders can be treated for example with aspirin to stop blood clotting.

And there may be underlying infections e.g., uterine that may be treated with antibiotics.

Then of course there are the known environmental factors such as smoking, excessive caffeine intake and alcohol.

There are many recurrent miscarriages that will not have found causes even after extensive testing. But if at least some can have identified causes, especially when treatable, then we can make some headway in preventing further miscarriages.

And at least then we may get back some feeling of control and not be forced to sob helplessly as the doctor drives off in their BMW.  

Jodi Panayotov