QuestionI have been trying to conceive for 4 years and in that time have had 3 miscarriages. I have had many tests and examinations including hycosy, hysteroscopy, thyroid (TSH, T3 borderline), immune (borderline NK Cell activity, on steroids, but hasn't helped yet) etc. My cycle is regular but quite long at about 34-36 days, ovulating around 18-21 days. Each month that we ttc (and only when we ttc) I get symptoms including stabbing pains in the lower abdomen which then stops a few days before menstruation. Are my cycles too long and is the egg and uterine lining to old at this point? If so is there any way or shortening the cycle? Thanks for your time. Electra in London.
AnswerHello Electra from the U.K.
You have not give me enough information to do a detailed analysis of your situation. However, your cycles are certainly long, but that does not lead to miscarriages. The difficulty with long cycles is timing intercourse, which you have been able to do well and achieve pregnancy. So that is not necessarily a problem. The miscarriages are not related to uterine lining. If the uterine lining were not sufficient, implantation would not occur and pregnancy would not occur.
Have you had genetic testing? You don't mention that. How old are you? Age plays a significant role in embryo quality and miscarriage rates.
One way to shorten cycles is to use fertility medications and undergo ovulation induction. In addition, I would recommend progesterone supplementation in the cycle so that you have adequate progesterone to support the pregnancy. Finally, I use aspirin 81mg per day starting at the beginning of the cycle, Heparin 2000 units twice per day starting at the beginning of the cycle and Medrol 16 mg per day starting at the beginning of the cycle and decreasing at the time of ovulation.
I would recommend that you see a fertility specialist if you are not already seeing one.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
