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Suggest treatment for difficulty in conceiving

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Posted on Tue, 19 May 2015
Question: My husband and I conceived naturally in two months last year from the start my HCG numbers never doubled and at 8 weeks the heartbeat stopped and I suffered a miscarriage and had an D&E and recovered well no complications. Then after waiting three months we started trying again but because of my travel schedule at work we kept missing my ovulation times. So In March on my 43rd Birthday March 12th we decided to try a scheduled IUI it worked on the first try and my pregnancy was conformed on March 27th my HCG numbers doubled then slowed stopped doubling I had a normal ultrasound at 6.3 weeks with a heartbeat then at 7.3 weeks heartbeat at 140 then at 8.3 weeks on 4/27 there was no heartbeat. This is my second missed miscarriage where the heartbeat stopped at 8 weeks. Based on the measurements of my last ultrasound the Dr. stated the Heartbeat stopped a few days ago I listed my HCG numbers below is there any test I can have or should have to see why I miscarried the last miscarriage the test was inconclusive and based on the HCG numbers is it most likely a chromosome issue. My husband and I would like to try one more time and I know my age is against me I did have my egg quality and quantity I had a FSH of 8.3 and my Anti Mullerian Hormone was .87 so I still have a few good eggs. Just want some feedback if I should try again and what other test I should have my hisband has super sperm so no issue on his part here was my hcg levels
3/27-159
4/1-1959
4/9-8368
4/13-11,305
4/17-15,129
final 4/27 37,393 at 8.3 weeks
progesterone was 18.5 on 4/3 then dropped to 8.3 started supplement on 4/22
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Answered by Dr. Mahesh Koregol (2 hours later)
Brief Answer:
PGS

Detailed Answer:
Hi,

You are right.

The most possible reason for your miscarriages is chromosomal abnormalities at your age with low AMH indicating low egg reserve.

Best option would be to go ahead with IVF / ICSI and preimplantation genetic screening(PGS) test on embryos to detect a normal embryo and transfer the same.

This is to rule out specific chromosomal problems.

Let me know if you have any more questions.

Regards
Dr. Mahesh Koregol.

IVF and Infertility Specialist
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Mahesh Koregol (1 hour later)
We are trying to avoid the IVF route because of the cost and I have been able to conceive naturally. I was wondering if there is any blood test I could follow up on.
doctor
Answered by Dr. Mahesh Koregol (12 hours later)
Brief Answer:
Low molecular weight heparin

Detailed Answer:
Hi,

You don't need any blood test as no blood tests can identify the problem accurately.

If you are not willing for IVF, try once more naturally. If you have miscarriage again, please think of PGS as I discussed.

When you get pregnant this time, you can start on low molecular weight heparin injections.

Let me know if you need anymore help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Mahesh Koregol

Infertility Specialist

Practicing since :2000

Answered : 3807 Questions

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Suggest treatment for difficulty in conceiving

Brief Answer: PGS Detailed Answer: Hi, You are right. The most possible reason for your miscarriages is chromosomal abnormalities at your age with low AMH indicating low egg reserve. Best option would be to go ahead with IVF / ICSI and preimplantation genetic screening(PGS) test on embryos to detect a normal embryo and transfer the same. This is to rule out specific chromosomal problems. Let me know if you have any more questions. Regards Dr. Mahesh Koregol. IVF and Infertility Specialist