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Great. Now what? More miscarriage related stuff.


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So as you most likely already know after my third loss just last month (one ectopic like 15 months ago followed by almost back to back 1st trimester miscarriages this past June and September), my doctor was going to do testing on the tissue we collected to try to determine why.

 

Well, I just got a voicemail from her saying the tissue did not grow so they couldn't continue. So no testing could be done on it, but her gut feeling was it was something genetic,

 

I tried to call her back but just got the answering service.

 

So. Now what? I'm on Metformin, she gave me oral progesterone this last time around, I've had my thyroid tested more than once. She did the day 3 FSH test back in March and that was "normal."

 

Do I just try again and see what happens and hope I don't lose a 4th baby? Is there something else specific you guys think I should ask her to test me for?

 

November's cycle is going to have me at 39 1/2 years old and December marks two years and three losses since dh agreed to try for just one more. It's just so frustrating. Does anyone have any concrete suggestions for something I should be asking my dr to do/test for ASAP before I just try again? Blood clotting disorders was one thing I'd read about... I don't know. I can't even believe I'm thinking of putting myself through all this again! I have to admit, it's all getting old! :(

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First off I'm sorry about your babies. I've had 3 losses myself (2 first trimester miscarriages and an ectopic) and it is devastating. My repeat loss panel came back completely normal except I had borderline high homocysteine. I googled the crap out of that and came up with MTHFR gene. I asked my doctor to test me for it (it wasn't included in the original panel) and turns out I am homo or have two copies of the gene.

 

Long story short, I am currently 38 weeks pregnant, and I've done injections of blood thinners the whole pregnancy. I startd with Lovenox, and am now on twice a day Heparin. This was in addition to a specific supplement of methylated folic acid, b6,and b12, and a baby aspirin every day. I'll never know which med did the trick , but if I am lucky enough to have any other pregnancies after this one I will follow this protocol again.

 

May be worth asking for the test! You never know.

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I'd strongly consider having a consultation with one of the few reproductive immunologists. They specialize in recurrent pregnancy loss. Most of them conduct consultations long-distance (on the phone). Reproductive immunology is controversial and not particularly well-known outside of a small subset of specialists.

 

Some websites:

this yahoo support group http://health.groups.yahoo.com/group/immunologysupport/

Dr. Carolyn Coulam http://www.illinoisivf.com/physicians.html

her lab, Millenova http://www.millenova.com/tests/preglosspan.cfm

The Sher Institute http://haveababy.com/causes-of-infer...e-factors.html

the clinic of the late Dr. Beer http://www.repro-med.net/repro-med-s...d=34&Itemid=11

 

Yes, clotting issues are one possibility to test for. They are easily treatable (BTDT).

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:grouphug::grouphug: I had a barrage of testing done after my 3rd miscarriage in a row, and nothing turned up. I was told it was likely a genetic issue as well. No advice really, but I do understand the frustration surrounding not having answers and the fears of trying again. I did go on to have two boys after that, but I have no idea what made those pregnancies different than the previous 3 other than I got pregnant just 2 weeks after losing a child and the second boy I got pregnant with while I was nursing, so maybe it is a hormone related thing?

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Maybe autoimmune issues?

 

 

 

I had three losses, one miscarriage and two ectopics, over a period of fifteen years (first pregnancy and 2nd pregnancy were12years apart) before I had my son. It was a terrible struggle. I was 39 yo when I had him. I took Femara and lots of vitamins, gave dh tons of vitamins and wheatgrass, along with progesterone and finally had a successful pregnancy. I did lose a fourth baby two years later.

 

 

 

You just never know. Your next pregnancy could be fine. I was ready to try again when my desire to have a child outweighed my fear of loss. After my fourth loss I was 42. I knew that was the end. Very hard for me as I wanted two kids.

 

 

You will have decide what you can live with. Not trying again or tring and knowing you did everything you could. :grouphug:

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due to my placenta issues and losses my RE is doing recurrent loss testing- you should ask for the same!

 

Plasminogen Activator Inhibitor 1

Protein S Activity and Antigen

Protein C Activity and Antigen

Antithrombin III Panel Activity and Antigen

Prothrombin G20210A Gene Mutation Analysis

MTHFR Gene DNA Mutation Analysis

Lupus Anticoagulant Evaluation

AntiCardiolipin Antibody- lgG, lgM, lgA

Leiden V Factor Mutation Analysis

Serum Chromosomes

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Maybe autoimmune issues?

 

I had three losses, one miscarriage and two ectopics, over a period of fifteen years (first pregnancy and 2nd pregnancy were12years apart) before I had my son. It was a terrible struggle. I was 39 yo when I had him. I took Femara and lots of vitamins, gave dh tons of vitamins and wheatgrass, along with progesterone and finally had a successful pregnancy. I did lose a fourth baby two years later.

 

You just never know. Your next pregnancy could be fine. I was ready to try again when my desire to have a child outweighed my fear of loss. After my fourth loss I was 42. I knew that was the end. Very hard for me as I wanted two kids.

 

You will have decide what you can live with. Not trying again or tring and knowing you did everything you could. :grouphug:

 

That was my first thought as well.

 

I had three 2nd trimester miscarriages in a row and then carried to term, as well as one in between children #3 & 4. They tested the babies and didn't find anything. I was never so scared as when I was carrying my last little one. I wanted to try again afterwards, but dh was adamant that that wasn't going to happen. He was too afraid of losing me as well.

 

Anyway, after that last pregnancy I developed quite a few autoimmune issues, and I have a feeling that that's what the problem may have been all along. Of course I'll never know for sure.

 

:grouphug: It's so hard. I hope you find some answers. :grouphug:

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Most likely any tests you have will be negative...especially if you've given birth to other healthy children. As my miscarriage specialist told me, "One healthy birth may be a fluke. Two or more are not."

 

My four miscarriages were determined to be a genetic defect "incompatible with life", and he put my odds at 50% for any given pregnancy. My next one after the four miscarriages was successful. My SIL (the defect lies on my dh's side) was not so lucky. She wasn't able to have a successful pregnancy with my BIL, and unfortunately their marriage crumbled as a result.

 

So really, it depends on how willing you are to go through another possible loss. Miscarriage increases with age anyway, so that might compound your problem, and make your chance for a good outcome less likely. If I were you, I'd find a good miscarriage specialist, get the maternal tests they can do, and have him or her discuss your odds very frankly. I loved that my doctor did that for me, because I knew going into my fifth attempt that my chances were a bit dismal. It helped me to really not worry about it. Whatever will be, will be, and there was really nothing I could do to change it. And seriously, I did NOTHING for that pregnancy...no progesterone, no baby aspirin, no metformin, nada. I knew in the end it wouldn't matter, if I was going to miscarry, I would in spite of all the "stuff" to try and prevent it (because I had...four times). And, that was the pregnancy that actually "stuck" and gave me my wonderful son.

 

So if you decide to do it again, do it with the understanding that it might not work out. If you can handle another loss, then keep trying. If not, call it a day.

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I think that you just really need to ask yourself how far you are willing to go at 39 1/2. I am not sure I would have the energy both mentally and physically to keep doing it. You deserve to be happy and have your baby but medicine may not be able to give you the answers you need without a whole lot more suffering and that troubles me.:grouphug:

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I'm really sorry. :( I would discuss with your doctor more testing and ask he about the possibility of using fertility drugs, there is some belief that Clomid can give you a stronger egg or ovulation. I don't know how much truth there is to it, but it may be worth looking into, as well as the peogesterone. God bless.

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I'm really sorry. :( I would discuss with your doctor more testing and ask he about the possibility of using fertility drugs, there is some belief that Clomid can give you a stronger egg or ovulation. I don't know how much truth there is to it, but it may be worth looking into, as well as the peogesterone. God bless.

 

clomid can have bad side effects too (drying up CM, etc) and cause multiples. Plus if her issues isnt her egg, it wont fix the issue.

IF she needed help ovulating, personally id try Soy Isoflavones or Femara as their side effects are far less.

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November's cycle is going to have me at 39 1/2 years old and December marks two years and three losses since dh agreed to try for just one more. It's just so frustrating. Does anyone have any concrete suggestions for something I should be asking my dr to do/test for ASAP before I just try again? Blood clotting disorders was one thing I'd read about... I don't know. I can't even believe I'm thinking of putting myself through all this again! I have to admit, it's all getting old! :(

 

You could just go ahead and take daily baby aspirin while TTC and if you conceive through your pregnancy (you have to stop at 36 wks) as long as it's not contraindicated by the meds you're already taking or anything else. I have had multiple subchorionic hematomas (blood clots between placenta and uterus). OB didn't want to do testing since I'd had successful pregnancies. After bleeding through numerous pregnancies and losing a baby at 17 wks due to a SH I just started taking it when TTC again and would never do any differently. Subsequent pregnancy on baby aspirin resulted in my healthy full term 7 lb 7oz DD & I had no clots during the pregnancy. :grouphug:

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So as you most likely already know after my third loss just last month (one ectopic like 15 months ago followed by almost back to back 1st trimester miscarriages this past June and September), my doctor was going to do testing on the tissue we collected to try to determine why.

 

Well, I just got a voicemail from her saying the tissue did not grow so they couldn't continue. So no testing could be done on it, but her gut feeling was it was something genetic,

 

I tried to call her back but just got the answering service.

 

So. Now what? I'm on Metformin, she gave me oral progesterone this last time around, I've had my thyroid tested more than once. She did the day 3 FSH test back in March and that was "normal."

 

Do I just try again and see what happens and hope I don't lose a 4th baby? Is there something else specific you guys think I should ask her to test me for?

 

November's cycle is going to have me at 39 1/2 years old and December marks two years and three losses since dh agreed to try for just one more. It's just so frustrating. Does anyone have any concrete suggestions for something I should be asking my dr to do/test for ASAP before I just try again? Blood clotting disorders was one thing I'd read about... I don't know. I can't even believe I'm thinking of putting myself through all this again! I have to admit, it's all getting old! :(

 

You could have yourself and dh tested to see what genetic anomaly you may be dealing with. You could look into having embryonic genetic testing done. That would make sure you are implanting viable embryos. (Some people do have moral issues with this procedure, and there are risks involved. I'm just putting it forth as a possibility.) Does your doctor think that the medications she has you on are necessary since they think it may be a genetic issue with the baby? I would think they would just make things worse by causing a nonviable pregnancy to continue longer. As far as blood clotting issues go, that would be on your end? If there is a genetic problem with the babies, I don't know that it would be a blood clotting issue. (Definitely no expert there though!) :grouphug:I know this is horribly painful. There is no ache like wanting a baby.

Edited by Lolly
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You could just go ahead and take daily baby aspirin while TTC and if you conceive through your pregnancy (you have to stop at 36 wks) as long as it's not contraindicated by the meds you're already taking or anything else. I have had multiple subchorionic hematomas (blood clots between placenta and uterus). OB didn't want to do testing since I'd had successful pregnancies. After bleeding through numerous pregnancies and losing a baby at 17 wks due to a SH I just started taking it when TTC again and would never do any differently. Subsequent pregnancy on baby aspirin resulted in my healthy full term 7 lb 7oz DD & I had no clots during the pregnancy. :grouphug:

 

I'm all in favor of this (as long as the OB is aware) and I have done this. FWIW, however, aspirin does not treat many types of clotting issues. Heparin is usually necessary. In other words, it depends on what the problem is, specifically.

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:grouphug::grouphug::grouphug:

 

I am so sorry you were not able to get results on the testing. One thing I will say is when the testing came back with a genetic problem I already knew I couldn't keep trying. It was just too much. Maybe the fact that you are still considering another try says it all.:grouphug:

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Nance, I hope you won't be offended when I say this, because I'm only saying it because I'm worried about you... but have you considered the possibility that maybe your body needs to rest and recover for a while before you try again? I am worried that you're putting too much stress and strain on your body.

 

Please don't think I'm suggesting that you should give up! I'm not!!! I just think you might want to take some time off from trying to get pregnant, and to use that time to eat incredibly well, get yourself in the best possible shape, and most importantly, find the very, very, very best high risk pregnancy doctor you can get.

 

I know you really want another baby, but I'm just thinking that your body may be better prepared to deal with another pregnancy if you wait 6 months or more before you try again.

 

It might also help on an emotional level, because you've really been through the war with this stuff. :grouphug::grouphug::grouphug:

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What was your actual Thyroid number?

 

:iagree:

 

Along the same lines, I found when i went to my RE that the RE has a number they are looking for where an OB is looking for a range. EX: The RE is looking for 45 as normal where an OB is looking for 20-50 as normal.

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I would pursue a consult with an RE with a good rep for dealing with pregnancy loss. I would probably consider traveling a few hours from home if necessary.

 

I would mentally try to decide if I was even remotely open to preimplantation genetic testing/IVF or a donor egg situation. If it is age related, or you are running into genetic issues due to AMA, they may suggest those as options. It can be tough to not get sucked into the fertility merry go round, but if you really want another, it may end up that you have to decide how far you are willing to go.

 

:grouphug:

 

eta: if you did oral progesterone last time, I'd really talk with your doc about taking prometrium vaginally or something like crinone gel. From my rounds on the infertility and PCOS rollercoaster, it seems to me that oral progesterone support isn't especially effective. If you are going to do it, I'd try to make sure you are using it in the most optimal way. An RE would be good to talk to. If you want, PM me. I have an RE practice I'd recommend but it would be a bit of a drive for you. Affiliated with a large teaching hospital and IME very good.

Edited by Momof3littles
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I don't know what testing to ask for as I never got it done. I had three MCs and my midwife suggested that I get tested if we were going to keep trying. We decided that we were done having children before I got any testing.

 

I have been researching how diet can affect overall health and there is some serious evidence pointing towards GMO foods and other non-natural foods messing up the reproductive system ( your whole body, really. ) Before you try again, I would suggest a few months of eating completely clean and incredibly nutritious foods. Even if that isn't a problem, you would start your next pregnancy with a well nourished body and that would make it much easier to just be pregnant.

 

:grouphug:

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I had back to back miscarriages so when I got pregnant with Jax, my midwife put me on baby aspirin and progesterone, just as a safety net. I carried him to term with no problem, same regimen with Piper. I was told that it can't hurt anything. It seems as though the ectopic would be a completely different problem than a m/c, couldn't a normal embryo get implanted in the wrong place :confused:?

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Thanks, all, and sorry I didn't respond sooner. The doctor finally gave me a prescription today for the labwork and I'm going to go tomorrow morning. It lists:

 

Anti-thrombin III activity

Prothrombin Gene Mutation

Protein S Activity

Protein C Activity

DRVV, Factor V Leiden Mutation

Cardiolipin Ab w/Reflex to IgM, IgG

Homocysteine

Maternal Karyotype

 

I don't even know what most of that stuff is, will have to research a bit later. Hopefully there's nothing missing on there I should be doing!

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Thanks, all, and sorry I didn't respond sooner. The doctor finally gave me a prescription today for the labwork and I'm going to go tomorrow morning. It lists:

 

Anti-thrombin III activity

Prothrombin Gene Mutation

Protein S Activity

Protein C Activity

DRVV, Factor V Leiden Mutation

Cardiolipin Ab w/Reflex to IgM, IgG

Homocysteine

Maternal Karyotype

 

I don't even know what most of that stuff is, will have to research a bit later. Hopefully there's nothing missing on there I should be doing!

 

I don't know if there is anything else, because this isn't my area of expertise, but I am VERY glad you are doing this. You need to try and find some answers if you want to continue trying. You shouldn't have to keep going through all of this if there is a way to fix it! :grouphug:

Edited by RaeAnne
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due to my placenta issues and losses my RE is doing recurrent loss testing- you should ask for the same!

 

Plasminogen Activator Inhibitor 1

Protein S Activity and Antigen

Protein C Activity and Antigen

Antithrombin III Panel Activity and Antigen

Prothrombin G20210A Gene Mutation Analysis

MTHFR Gene DNA Mutation Analysis

Lupus Anticoagulant Evaluation

AntiCardiolipin Antibody- lgG, lgM, lgA

Leiden V Factor Mutation Analysis

Serum Chromosomes

 

Anti-thrombin III activity

Prothrombin Gene Mutation

Protein S Activity

Protein C Activity

DRVV, Factor V Leiden Mutation

Cardiolipin Ab w/Reflex to IgM, IgG

Homocysteine

Maternal Karyotype

 

 

I bolded what we have in common from my RE for Preg Loss vs what you are having tested. :) Red is what I have that you dont and unbolded is what you have that I dont.

 

HTH!

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Only you know if you could handle another loss if it happened again. I am glad I didn't stop trying after all my losses, but I know if I had lost another one, when I got pg with dd5 I would have been a very broken person. I did undergo genetic testing after my 6th loss. It was a simple blood test and they mapped out my chromosomes to see if there was a problem with one causing my losses and preterm deliveries because the dr's could not figure out why. I never had the tissue of the losses tested, they were all very early losses. We still have never figured out what has caused me to have 6 losses and 3 preemies. We may never know. But it does become a discussion with yourself to determine if you think you are strong enough to try again and risk another loss, or if you grieve for what will never be and stop trying.

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I bolded what we have in common from my RE for Preg Loss vs what you are having tested. :) Red is what I have that you dont and unbolded is what you have that I dont.

 

HTH!

 

Thank you for these suggestions! (And thank you everyone for the comments/support!) When my doctor calls me with results of the original panel I already had done, I will mention these to her.

 

I started my first period yesterday since the loss (32 days post m/c) and hope to get results early this coming week so I can find out if it's 'safe' to try again this cycle!

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Thank you for these suggestions! (And thank you everyone for the comments/support!) When my doctor calls me with results of the original panel I already had done, I will mention these to her.

 

I started my first period yesterday since the loss (32 days post m/c) and hope to get results early this coming week so I can find out if it's 'safe' to try again this cycle!

 

:grouphug: Good luck. Still thinking about you.

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Have you been tested for any blood clotting or vascular disorders?

 

A Reproductive Endocrinologist I saw for help with relactating for my adopted child (3 miscarriages and then 2 full term pregnancies the first normal, the second life threatening to us both ) thinks based my my medical history I might have a blood clotting disorder like thrombophilia (sp?) that caused them. I couldn't follow up with testing at the time because I was in the middle of an international adoption and that diagnosis would've disqualified me. I also have Raynaud's Syndrome which he suspects is related. I'll go in for testing when I turn 40.

 

When I was pregnant with my oldest daughter, the midwife wanted to test me for incompatibility with my husband because I'm O+ and he's A+. I don't remember the medical term for it but it was done because some women's bodies with O+ blood will respond to some babies from an A+ father in a way similar to organ rejection. As I recall (It was 17 years ago so I'm a little fuzzy on the details) if the test had come back that that was our situation it would've required a specialist and in utero blood transfusions. That sounds scarey but it's nice to know that there are treatments available with some success. Maybe even more today.

 

I'm sorry you lost your other babies. I know it's really hard. I also know life after miscarriages can be everything from very sad to paranoid. If you're having a hard time, it's OK to talk to someone about it. Don't carry it around by yourself. There are people who understand.

Edited by Homeschool Mom in AZ
clarification
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My SIL had lots of miscarriages and they found out her body was attacking the sperm and the fetus. This is probably covered under the testing, but I don't understand the terminology. She did end up with a healthy baby eventually and I believe she was on clomid.

I am sorry you are dealing with it. I was told I would never have kids, I know the pain.

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I started my first period yesterday since the loss (32 days post m/c) and hope to get results early this coming week so I can find out if it's 'safe' to try again this cycle!

 

I want to say this gently, but if it comes out the wrong way, I hope you won't be upset with me.

 

Are you sure you want to start trying again so quickly after this last loss? I would think that both your body and your heart could use some rest. Does your doctor think it's safe for you to try again already? And can you handle another loss so soon after the last one?

 

I hope and pray that you're able to have another healthy baby, and that when you get pg the next time, everything will be perfect for you, but I'm also worried about how you'll feel if something goes wrong. Are you sure you're up to that incredibly high stress level all over again?

 

I guess I'm just worried that you're rushing your body and your mind into this, but I guess that's probably because I'm sort of putting myself into your situation, and I know I wouldn't have been able to handle the heartbreaks you've suffered.

 

:grouphug::grouphug::grouphug:

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I want to say this gently, but if it comes out the wrong way, I hope you won't be upset with me.

 

Are you sure you want to start trying again so quickly after this last loss? I would think that both your body and your heart could use some rest. Does your doctor think it's safe for you to try again already? And can you handle another loss so soon after the last one?

 

I hope and pray that you're able to have another healthy baby, and that when you get pg the next time, everything will be perfect for you, but I'm also worried about how you'll feel if something goes wrong. Are you sure you're up to that incredibly high stress level all over again?

 

I guess I'm just worried that you're rushing your body and your mind into this, but I guess that's probably because I'm sort of putting myself into your situation, and I know I wouldn't have been able to handle the heartbreaks you've suffered.

 

:grouphug::grouphug::grouphug:

 

Because these miscarriages were relatively early on (just past 7 weeks for the one in June and just past 9 weeks for the one in September but measuring much less than that), and because they required no medical intervention, etc., my doctor did feel it was okay to just wait one cycle to try again. And because of my age, I don't feel I have time to waste in between. November 1st, I'll be 39 1/2 exactly (bday 5/1). They say past 40 certain risks increase even more. If I really want a baby, and I do, I don't have the luxury of waiting, I need to just go ahead and try again until I either succeed or decide I can't do it again and give up. If it goes wrong and I m/c again of course I will be upset, but I won't be less upset if it happens 4-6 months from now instead of 1-3 or whatever, I'd still be suffering a loss; I'd just be more stressed about the lost time and my increasingly advanced age the later it happens, know what I mean? I do honestly appreciate your concern for me!

 

Anyway, just called the doctor's office to ask if any of my results were in yet since it's been 6 days since I had the tests done, but she said none of them are back yet and that those types of labs usually take around two weeks. Blah.

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:grouphug:

 

Speaking as a woman who wanted more than one child I can totally relate to your feelings. :( I never had a mc though, so I am sure it is worse. I remember cycle after cycle hoping and praying and obsessing about ovulation and all of that.

 

I do remember the overwhelming relief when I gave up. It was as if God took the longing from me. I hope for you that you get a healthy baby this round or you find that peace.

 

:grouphug:

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