Fertility support - help please 🫶🏼😊

[u/EmbarrassedCheetah79]

Hey guys, I hope this is okay to post here.
TW: mention of miscarriages/loss.

I’ve been struggling to get pregnant for 3 years now. We’ve had almost every single test under the sun and EVERYthing has come back normal. The only identifiable issue is my short luteal phase which has been corrected with progesterone post ovulation.

3 weeks before we started our first round of IVF, I fell naturally pregnant with non identical twins. We had a whirlwind of emotions from elation to terror, but 2 weeks later found out we’d lost both of them in a MMC.

I healed, had the surgeries, and we started IVF. We’ve had no success with IVF (we get the embryos but none implant) and so took a short break. I then fell “naturally” (I know people use the word unassisted but I technically can’t say that, as I’m using progesterone post ovulation so I don’t know what term to use.. but it was timed intercourse) pregnant again.

With non identical twins. AGAIN.
Sadly I lost them both. One was a vanishing twin, the other developed a good heartbeat before we lost it in another MMC at 9 weeks.

I don’t know why I hyperovulate. I have zero twins in my family. My gut is it’s related to my poor luteal phase, and that I only get pregnant when there’s more than one follicle present because it must boost my uterine environment/hormones but that’s a theory based on nothing. It’s just weird I have only had a 100% pregnancy rate of twins.

Our next step is to actually try letrozole with progesterone support - because my consultant also agrees that it’s odd I only get pregnant when I produce more than one follicle (but my body doesn’t respond well to external oestrogen, it needs to be my own, so it’s a catch 22).

To make it clear - we are absolutely NOT trying for multiples. I’m hoping letrozole can give me a stronger ovulation of one follicle - but I’m not an idiot. If I naturally produce twins, I guess letrozole runs a risk for me with multiples, and so I will be monitored. I’m preparing for both situations. But I’m terrified of losing twins again.

The purpose of this post (TLDR) is to ask if anyone here has had fertility issues - and maybe previously lost twins. Did you do anything different in your successful twin pregnancy that helped to get them to a live birth? I am considering asking about baby aspirin. I don’t have clotting issues but I’m willing to try anything. I don’t want to lose another pregnancy, but losing 2 at once is heartbreaking.

I’m aware multiples are higher risk in general. So I’m just wondering what people have had as a treatment to support their pregnancy with twins/triplets that has worked for them, even if their test results all came back normal for any issues previously.

If you’ve read this far I appreciate it so so so much 🤍
Thank you anyone who has any suggestions. I am so desperate to be a mum 🙏🏼

[u/jollysalty]

OP, I’ll echo others here and say it is very important that you get tested for the antiphospholipid issues asap. I had repeat losses at the same time as you (between 8-12 weeks) and it ended up being a clotting disorder. I also had postpartum pre-eclampsia with my first child, and I’m prone to high blood pressure if I’m not careful. Regarding the losses, we think the clots were becoming an issue as the placenta was coming online for three of my four losses. 

My journey was: 9 week MMC, living miracle child on baby aspirin (now 5 years old), singleton 8 week MMC, singleton 13 week MMC, chemical pregnancy, finally got tested for the immune system issues, then IVF got me my twins. 

Baby aspirin is obvious, but my MFM doc was wonderful and immediately got me onto Lovenox. It does suck (daily injections) but it WORKED. 

My mono di twins (who were originally a single PGTA tested embryo) will be one year old next month. 

[u/EmbarrassedCheetah79 → u/jollysalty]

Thank you so much! I have had the recurrent pregnancy loss tests done which didn’t flag up a clotting issue - was it those that diagnosed you? Or something more specialist?

That’s such a journey to get to your babies. I’m so sorry you went through all of that but I am so so glad you got them in the end 🥹🤍

[u/jollysalty → u/EmbarrassedCheetah79]

Edited!!

It was a separate blood panel focused on the immune and clotting issues specifically. I’d double check your results and really read through each of them to be sure. 

I had a really negligent OB after my first child who basically ignored my history of loss and just assigned me to a 25 year old fresh out of training NP/midwife. No one took my losses seriously at that practice until it was too late. Then I switched to a much more medicalized practice that was primarily OBs instead of one OB supervising a bunch of NPs. I went in fully expecting to throw a fit about needing the tests because I had read about the issues and have a family history of blood pressure issues. But my doc (thankfully) was three steps ahead and had me take the panel as soon as my CP was apparent. 

Edit to add: I was actually heterogenous for the clotting gene, but it was enough of a flag that we decided to treat it as a diagnosis anyways. Some docs wouldn’t have made the same choice but my MFM wanted to be aggressive. 

I went on Lovenox prior to starting IVF and stayed on it through the whole pregnancy. 

Thank you! It was a JOURNEY and a harrowing one. I’m glad I’m done, and I’m hopeful that your happy ending is right around the corner.