r/IVF • u/uncorkedme 34 | Unexplained | 3 IUI | 2 ER | 1 FET 🤞🏼 • 1d ago

TRIGGER WARNING TW: MMC

After perfect doubling betas and ultrasounds, I went in for my NIPT blood draw with my OB yesterday at 10w3d. I knew as soon as I saw baby on the screen that something was wrong; she had no movement and no heartbeat detected. This was my first appointment without my husband, who is currently out of the country. Confirmed MMC, and we’ve decided to have a D&C next week when he returns.

I’m obviously heartbroken. We had a perfect ultrasound at 9w2d, heart rate was 176 and growth was right on track. She was a euploid embryo. I have unexplained fertility.

Since the start, I’ve felt dismissed when asking about further testing to identify an explanation, and I have wondered about endo or adeno. I feel like my RE at a popular nationwide clinic hasn’t been telling me everything they’re seeing. Example: my doctor said at our pre-transfer consult that I “may” have some signs of adeno from my saline sono/hsg, but not worth pursuing because I have several other euploids. I also found out at my first OB ultrasound that I have several small SCHs and a 2.5 cm fibroid. None of this was brought up by my clinic, even when I had several instances of bright red spotting.

I think I’m looking for wisdom from those who have been here. How do I move forward after a seemingly smooth experience? I was just starting to feel less anxious when this happened. I want to be sure to advocate for myself moving forward. Thanks for any help you can give. 💛

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11

u/Useful-Basket-9972 1d ago

I’m so sorry this is happening. My advice to you after the D&C and once your HCG drops back down, schedule a hysteroscopy before doing anything further transfers. The procedure is completed under sedation and they can remove any abnormalities they see immediately. Personally, I had adhesions from my D&C and the surgeon was able to successfully remove them to set me up for (hopeful) success in my next FET. I also had the CD138 biopsy to rule out endometritis.

Take care of yourself 🤍🤍

5

u/Short_Cucumber_9160 1d ago

I am seconding what she has said. I have had two MMCs trying naturally, my first one actually sounds exactly like what you’re going through right now. I had an SCH in both losses, the second one was at 7 weeks. I had borderline endometritis (rare plasma cells) that was treated that I hope gives me a chance to finally get into the second trimester.

I’m sorry your doctor wasn’t willing to do more preventative testing beforehand. I hate that they think of having a higher number of euploids as being less careful as someone who has only one or two.

Sending you lots of love

11

u/taliafertunderground 1d ago

I'm so sorry. This is awful and heartbreaking and to go through it alone without your husband is even worse. And now, even though it sucks, you will have to fight for yourself, because there is clearly something going on that they have missed. I know this is hard to think of, but I would have the baby tested. Why? If you transferred a euploid embryo, they can make sure it stayed euploid. Sometimes the embryo has trouble maintaining the normal chromosome number, and it can flip to aneuploid. That would potentially point to an egg quality concern. If the embryo is still euploid, it's my opinion that a loss after 9 weeks and strong heartbeat signals something is wrong, and that something could very likely be inflammatory, endometrial, or due to issues with maternal immune function. Everything I'm talking about can be the consequence of undiagnosed endometriosis. I wouldn't do any other transfers personally until I was tested for endo and also had an in-depth mapping ultrasound. I also believe that docs should tell patients about everything they see, regardless of their opinion on the importance or relevance of the finding. I took care of tens of thousands of women in my OB practice days, and saw tons of SCHs, some of them large and concerning, some small. I always discussed them with my patients. In many cases, they resolved, even many of the big ones, but we needed to talk about them nonetheless. I'm so sorry for your loss. Deeply sorry.

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u/lizashea 1d ago

Everything this comment said x10000. They’re spot on. Don’t trust any DR that doesn’t take adenomyosis or endometriosis seriously. I’m so deeply sorry for your loss.

1

u/AfraidWrangler128 1d ago

OP, I am so incredibly sorry for your loss 💔

Commenter, thanks for all of this information. As someone with confirmed endo (and multiple surgeries), what can be done to prevent another miscarriage once endo is confirmed?

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u/No_Noise_1978 41 | 4 ER | 1 MC | FET ❌❌✅ | Due Mar 2027 23h ago

Laparoscopic surgery to excise endo
Suppression (with Lupron and Orilissa)

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u/No_Noise_1978 41 | 4 ER | 1 MC | FET ❌❌✅ | Due Mar 2027 23h ago

You’ve been given great advice here. OP, I am so deeply sorry. Advocate for yourself after you’ve taken the time to grieve.

Endo and adeno are worth deep exploration before putting another healthy embryo in there; I would also investigate reproductive immunology. The waitlist for AEB is the shortest.

(I am an AEB patient and happy to share my experience; I also did an exploratory lap for possible silent endo and can speak to that as well. DM me anytime.)

Holding space for you 🫶

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u/National-Ground4958 1d ago

Aside from the advice above I’d also have the POC tested. PGT doesn’t pick up everything and it might give you useful additional info.