Experiencing Miscarriage

A woman on the Choice Moms Over 40 discussion group posted this weekend after learning from her doctor that the heartbeat of her 8-week baby in utero was gone.

She was processing her grief with women, wondering if she should attempt another IVF (she had done 12 IUIs in one year with a clinic before they pursued a new option), and speculating whether there was something she could have done to prevent the miscarriage. Her concerns are common.

For any women — and there are many of us — who face miscarriage, I wanted to express, as I did to this woman, great sorrow over your loss.

If you are looking for greater understanding as you process, I wanted to also point out these articles available on this website:

From one of our San Francisco-based doctors in the Choice Mom network:

Why do miscarriages happen?

This podcast interview with an Atlanta-based doctor also addresses questions about miscarriage

I asked Dr. Steve Nakajima, a reproductive endrocrinologist at the University of Louisville (Twitter@DrSteveNakajima), to respond to her question about how and when IVF might be tried again. His response: “It sounds like this woman was fortunate to conceive, but the fetal loss rate is high in this age group. The most common reason for her miscarriage is a genetic abnormality in the oocyte (egg) and/or the sperm that led to faulty development of the embryo. It is unlikely that she did anything to precipitate this loss. If she can emotionally consider another conception, I would advise her to try IVF again within the next 1-3 months. Oocyte aging is accelerated in women over 40 years, so the next 18-24 months are her best chances of conceiving again.”

As to the question of whether there is a danger to the body in having IVF cycles close together: “There appears to be minimal risk in performing multiple cycles of IVF. If the patient doesn’t have a live birth by 42 years old, her next step would be to consider IVF using donor oocytes (egg donation).” He also added: “As is in all cases, this response is based on my experience and expertise in the field of reproductive endocrinology. It is not intended to replace or be used as a substitute for a complete medical evaluation. I encourage her to follow-up with her physician for specific diagnostic tests and/or therapies.”

Dr. Nakajima also offered some thoughts on the basic protocol options that are recommended based on age factors alone — not taking into account the very particular factors that can be discovered from fertility testing. You can read that article here.

My thoughts are with all of us who deal with miscarriage alone — but not alone, because our Choice Mom community is here for you.

— Mikki


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