Pregnancy After Miscarriage

Pregnancy After Miscarriage

Transcription :

Speaker 1:

But I felt everything. I felt all the symptoms and I felt pregnant and I just didn’t want to believe it.

Dr. Marc Sklar:

Hi, there. I’m Dr. Marc Sklar, the fertility expert, and welcome to Fertility TV, a YouTube channel dedicated to your fertility and helping you get pregnant naturally.

Dr. Marc Sklar:

Today’s episode is going to be a little bit different. As you might know by now, I’m a natural fertility expert, and I help couples get pregnant through my online virtual programs and consultations. Today I’m going to be reacting to a video that someone recorded about their fertility journey, and she had five miscarriages and failed IVF cycles.

Dr. Marc Sklar:

I’m doing this because I want you to understand what potentially you could do on your journey, so that you could see what you could be doing differently to get different results. She did end up getting pregnant and having a healthy pregnancy and having a baby. So in the end, this is a story of happiness. But I want you to know that even though it’s a little bit sad throughout the story, there is hope for her because she did succeed in the end and hope for you. Let’s join in right here.

Speaker 1:

So I came back at eight weeks, and they told me that there was no heartbeat. They diagnosed me with a blighted ovum, and they said that I would miscarry. I couldn’t believe it at the time, because you just never think that something like this could happen to you, and I’m a very realistic person. I know that nothing in life is guaranteed and I knew that there was a chance that it wouldn’t work out. But I felt everything. I felt all the symptoms and I felt pregnant and I just didn’t want to believe it.

Speaker 1:

So I went to three different ultrasound clinics after that, to have it confirmed. Then at 10 weeks, I started to miscarry naturally, which is the most unbearable thing that any woman can go through. If anyone who’s watching this and who’s been through that, I’m so sorry.

Dr. Marc Sklar:

First, I want to comment here and just say this breaks my heart. Every time a woman comes in and tells me her story about going through a miscarriage, it truly breaks my heart. It’s painful. It’s difficult. It’s challenging physically, emotionally for the relationship.

Dr. Marc Sklar:

The two things that I want to point out here is that she mentioned that she was feeling all these symptoms, and all these symptoms are totally normal and common during a pregnancy. But I also want to caution all of you who do get pregnant and don’t have a lot of symptoms, that doesn’t necessarily mean it’s a bad thing or a bad pregnancy. You could be just one of those patients who doesn’t have a lot of symptoms, and that’s okay, too.

Dr. Marc Sklar:

The one positive thing, although it is really difficult physically and potentially a lot of pain, is that she went through the miscarriage naturally, that she didn’t have to take any medications or she didn’t have to do a D&C. I do think longterm, that’s better for your fertility journey and just is better for your uterus as well.

Dr. Marc Sklar:

Now let’s listen back in, as she continues her journey. She mentions that after this miscarriage, she actually did have to go through a D&C, unfortunately, because there was some leftover tissue, which is not that uncommon. Hopefully, it doesn’t happen too often, but it can happen. So now her and her husband have decided to take a little break from trying, which is appropriate and good. So let’s listen in.

Speaker 1:

… on and off for, I don’t know, six months, and it just wasn’t happening. I don’t know. Maybe because of my fear, because of my depression. I don’t know.

Speaker 1:

So we decided to go to a fertility clinic here in Toronto. We did that the summer of 2017, and they did a bunch of tests and analysis. Our genetics were fine, or they were compatible, and they didn’t see any serious issues with either myself or my husband.

Dr. Marc Sklar:

So here she went to a fertility clinic to do some testing, which is absolutely appropriate.

Dr. Marc Sklar:

Now it’s important that we all recognize that there’s a lot of different testing that can be done when you’ve had a miscarriage. The first types of tests that we’ll do is genetic testing called karyotyping to make sure that there’s nothing going on with either partner that could make it more common for you to have a loss. But there’s an extensive amount of testing that can go beyond that as well and often that is not done, or at least not done so early.

Speaker 1:

Also they found out that I have a genetic predisposition to have clotting, so that could’ve been one of the reasons why I had the miscarriage. So they wanted me to go on baby aspirin to thin out my blood.

Speaker 1:

They also found polyps in my uterus. They also found that my uterus had a dip at the top, which was making the size of my uterus much smaller than an average woman’s uterus.

Dr. Marc Sklar:

Those are three important things that we need to take out and isolate individually.

Dr. Marc Sklar:

First, she was found to have a blood clotting disorder. So the common treatment from a conventional medical perspective is to prescribe baby aspirin as a blood thinner, which can absolutely be helpful. I want all of you listening to know that there’s a lot of things that you can do naturally as well to thin the blood to support this process, one of which is actually taking fish oils. Fish oils are a natural blood thinner and can have a real positive effect on this as well.

Dr. Marc Sklar:

The second piece that they found for her were polyps. Now there is some controversy. We’re not sure if polyps actually cause a miscarriage, but since they found it, we want to remove that. For those of you who don’t know what a polyp is, it’s basically like a little skin tag inside the uterus.

Dr. Marc Sklar:

Third, they found a septum or septate part of the uterus. They found that the uterus is actually not in the right form. The back of the uterus should look like this with a nice opening and hers is actually the opposite. There’s a piece of the uterus, so instead of doing this, it goes like this and dips down. Most pregnancies actually happen right here in the back third of the uterus. So this can be a contributing factor, not only to implantation, but also to holding a pregnancy. So that also needed to be, or needs to be, addressed in some fashion.

Speaker 1:

I also had, at the time, a deviated septum, and I had it confirmed by three other doctors. I asked my fertility doctor what he thought about it, and he said it’s definitely something that he wanted me to fix before I would try to get pregnant again because it would limit the amount of oxygen that would go to the baby.

Speaker 1:

So that October, I had two surgeries. In the beginning of October of 2017, I had a surgery to remove the polyps in my uterus. Then at the end of October 2017, I had a surgery to correct my deviated septum. I gave myself a little bit of time to heal.

Dr. Marc Sklar:

The deviated septum is not a uterus issue or reproductive issue. It’s an issue in the nose, in the nasal passage and when that happens, you can limit the amount of oxygen that you’re intaking. So her physician was concerned that when she was pregnant that that might minimize or decrease the amount of oxygen that the baby was trying to get. So she had multiple procedures at this time to address both of those things and that’s very common, right? If we find physical issues, both in the uterus or outside, then we do want to address them.

Dr. Marc Sklar:

The other thing is, many of you might be saying, “Well, why the deviated septum? Why do this now? It’s not part of the uterus.” Well, first, our body is connected. There’s all sorts of things that can affect and influence our ability to conceive and hold a pregnancy. Her physician had the forethought, which was great, to be able to understand the whole picture, which is really, really important and often ignored.

Dr. Marc Sklar:

Additionally, she’s already taking the time to recover from a surgery on her uterus. So why not take this opportunity to do something else, correct any other issues and use this time to heal, so that way, when she’s ready to move forward, she can do that as well? I think this was a wonderful idea to take care of simultaneously.

Speaker 1:

… to heal from my surgeries and in December 2017, we decided to try to conceive again with the clinic. We had a medicated assistance, which means that I was given drugs and hormones to help normalize my cycle and promote a healthy pregnancy and sustain a healthy pregnancy and help with conception and all of that. If any of you have ever been through that, you know how not only time consuming it is, but it’s very emotionally and physically taxing. So we did that.

Dr. Marc Sklar:

This is where she started to go through fertility treatments at her fertility clinic, and she’s absolutely correct. For those of you who don’t know, it is emotionally and physically taxing and difficult, then this is where we need support. This is where I would encourage her, or any of you in a similar situation, to have a good support system around you, not just your partner, but others, at least one or two other people that you can count on.

Dr. Marc Sklar:

Also support from other health professionals, acupuncturists, different people who can support you through that process, because it typically makes you more responsive to the procedure and treatment. It increases your chances. But also more importantly, it will allow you to process things emotionally and be more grounded throughout the process. So that is definitely something that I would recommend for all of you.

Speaker 1:

… and we did that for three cycles. Out of those three cycles, I had two chemical pregnancies, which means that the embryo would attach to my uterus and then it would detach and I don’t know why. Those three months were very difficult for me, so I…

Dr. Marc Sklar:

Chemical pregnancies are fairly common, unfortunately. But in her case, I think the biggest difference is that we potentially know why. We already understand that there’s several underlying issues, and some have been addressed like the polyp. But the blood clotting factors, as I mentioned before, I think could’ve used a little bit more support. Acupuncture is wonderful for increasing blood circulation and supporting implantation, as well, as I mentioned, the fish oils at this point.

Dr. Marc Sklar:

Possibly if I was able to have reviewed her case, I would’ve done some additional things to support the thinning of the blood and blood clotting. Maybe also would’ve done some additional testing. I’m not sure at this point, but possibly.

Dr. Marc Sklar:

But it still doesn’t make having a chemical pregnancy any easier. It’s still heartbreaking and difficult because it’s frustrating. You get a little sign, a little glimmer that there’s a possibility, and then it doesn’t hold. So that’s just emotionally draining as well.

Speaker 1:

So I told him my husband I can’t do this anymore, and I want a referral to an IVF clinic. So we got a referral from our fertility doctor to an IVF clinic in Toronto, and we started again with the analysis and the tests. My fertility doctor at the IVF clinic determined that the dip in my uterus was getting in the way of anything growing in there, and he thought that I would have to get another surgery to get it fixed.

Dr. Marc Sklar:

This is really important. This starts to show you the difference between one physician and another. She was seeing her fertility doctor, which was probably just her OB GYN, who does not have the experience and understanding when it comes to fertility overall to be able to give her the best advice moving forward. Finally, she was able to move forward and see a fertility clinic, which is different in every country, right? In some countries we have access to that more easily than in others, and so that is a factor here.

Dr. Marc Sklar:

But any fertility doctor, natural or conventional, would’ve said that this septate should’ve been addressed earlier and I believe it should’ve. They had the opportunity, actually, when they were removing the polyps, so now she has to go through another procedure, unfortunately. But it’s the right decision because I do think and have seen that this septate uterus can affect the ability for implantation to happen, which is potentially why those chemicals were happening. Because if it’s implanting in that back portion, then it can’t hold because that piece of the uterus is not healthy, and it’s not getting the same blood innervation as the rest.

Dr. Marc Sklar:

So she had the procedure done to fix the septum in the uterus, and now she was starting the IVF process, which is where we’re going to pick up from here.

Speaker 1:

… from the woman as possible to get as many healthy embryos at the end of the retrieval process-

Dr. Marc Sklar:

She’s having the retrieval of the IVF.

Speaker 1:

… so that we have as many chances as possible to conceive with one round of IVF.

Speaker 1:

I went through the retrieval process, which is another very, very difficult, grueling process emotionally and physically. I was injecting myself with hormones every single day, taking drugs, all of that. Thankfully, we had a lot of healthy eggs retrieved. After the eggs were retrieved, they were fertilized, and we had to wait until they matured and got to a certain stage. I think it’s called the blastocyst phase or whatever, and luckily we had a lot that made it to that stage.

Speaker 1:

After that point, we decided to do PGS testing, which is genetic testing on the embryos because we thought that maybe one of the reasons why it wasn’t working was because there was something wrong genetically with the embryos.

Dr. Marc Sklar:

So she’s gone through a full retrieval cycle for IVF. She’s stimulated her ovaries, they’ve retrieved the eggs, they’ve fertilized them, they’ve allowed those embryos to grow. Now before freezing, they’re going to biopsy a piece of the tissue, the cells. They’re going to send that for genetic testing and then freeze those embryos to be able to have a frozen embryo transfer later.

Dr. Marc Sklar:

Now, all of this piece, I think this is an important piece, and if I was in her shoes, I would’ve been moving towards IVF as well. When you have all these losses and these challenges, you want to move forward on your fertility journey, so this makes a lot of sense.

Dr. Marc Sklar:

She didn’t mention any other support that she was getting at this time. So, again, this is where I would highly recommend working with a natural fertility expert to help support you in this process, both through the IVF process to make it more effective and easier so you minimize those side effects, both emotionally and physically, but also to help support your body to respond as best as it can through this process.

Speaker 1:

Out of seven embryos that made it to blastocyst phase, five came back from PGS normal. That just goes to show that there’s nothing wrong with our genetics, with our embryos. For the most part, they are healthy.

Speaker 1:

After that, I decided to take two weeks off after the retrieval because my body just needed to recuperate, and I needed to just make sure that I was in a really positive, emotional and mental state.

Dr. Marc Sklar:

This is important on two points. One is the genetic testing. For someone like her and her husband who have been going through losses, you want to confirm that it’s not an issue with the embryo and here, this does confirm that.

Dr. Marc Sklar:

Now I think we all could’ve potentially already seen that because she did some other testing and she knew that there were multiple variables already at play that potentially contributed to the losses, but this now confirmed it. So she’s got five healthy, genetically normal embryos, which is awesome.

Dr. Marc Sklar:

Then she did another great thing, which is she took some time off to rest, recover and rejuvenate both mentally and physically. Now she said she took two weeks off. I typically prefer that patients take a little bit longer and the couples that I work with and coach take a little bit longer in this process. But regardless, though, the thought process is correct here.

Dr. Marc Sklar:

So now she’s moved forward with the transfer of the embryo, and we’re going to catch in or jump in right here.

Speaker 1:

… days before coming back for a pregnancy test.

Dr. Marc Sklar:

So she’s on her two-week wait now. Okay. So she’s had the embryo transferred, and she’s on the two week…

Speaker 1:

… and the first cycle, I had all of the pregnancy symptoms, and I had no idea that a lot of these drugs that they’re giving you can really emulate pregnancy symptoms, like one for one. So I was so optimistic and so positive that I was pregnant and I wasn’t. It didn’t work, and I was devastated.

Speaker 1:

My husband and I decided that we would try again. I waited for my period and as soon as I got my period, I went back to the clinic and we started our second…

Dr. Marc Sklar:

So, a couple of points here. First and foremost, I think before I had mentioned about symptoms, right, when you’re pregnant, and when you are going through fertility treatments and you’re giving all these hormones, especially post-transfer where there’s a lot of progesterone being given, it can replicate the symptoms around a pregnancy and so we’re made to believe and feel like we’re pregnant.

Dr. Marc Sklar:

Now I don’t want to say that there’s anything wrong with that. If you’re given progesterone, that’s what’s going to happen, but I don’t want any of you to get false hopes because of it. I’ve had many women that I work with who have had plenty of symptoms and have not been pregnant, and also I’ve had plenty of women that I’ve worked with who have had no symptoms and been absolutely pregnant. So don’t put a lot of weight in those symptoms, especially if they’re giving you hormones and progesterone in this case.

Dr. Marc Sklar:

Additionally, she had her negative cycle and then she went right into another one. Again, I would’ve probably preferred that we wait a little bit here. I think that’s really useful for many of you watching is just a little bit more of a break as you’re going through each stage of this process.

Dr. Marc Sklar:

Now she did one retrieval cycle where she got five embryos that are frozen, and now she’s doing multiple transfer cycles of those embryos. Some might look at that as one IVF cycle, and some might look at that as multiple IVF cycles.

Dr. Marc Sklar:

So we’re picking up and she’s had another transfer. She was having a lot of the same symptoms, but she was trying to stay grounded so she was sure that she wasn’t pregnant. As I press play here, you’re going to hear that she’s pregnant. The nurse had called to let her know that she’s pregnant.

Speaker 1:

I asked her, “Are you sure?” She said, “Yes, your HCG was 114. That’s amazing.” I’m like, “It doesn’t make any sense.” She told me that it’s good a good thing and that they wanted me to come back on Monday, which was yesterday, to do a repeat blood test to make sure that my HCG level was going up because every 48 to 72 hours, it’s supposed to double. So the weekend, my husband and I [inaudible 00:18:46].

Dr. Marc Sklar:

This is an emotional piece. She’s been pregnant multiple times. It’s hard to trust anybody, your body. It’s hard to trust the pregnancy because she’s had multiple failures, so this reaction is really common.

Dr. Marc Sklar:

But I want to explain to all of you what she’s going through, right? So she had her pregnancy test, it came back positive, over a hundred. I look for on the first pregnancy reading that we’re at least at a hundred and then every 48 hours, we’re looking for that to roughly double. As long as it goes up about 75 to 80%, we feel really good about that. So she’s waiting for that second reading to know how those numbers are increasing her pregnancy hormone.

Dr. Marc Sklar:

So this is really emotional piece here. When she got the call from the nurse for the second HCG, which I told her we wanted to at least hopefully double or if not 80%, it had gone down. So she was miscarrying again and it’s just tragic. I’m emotional just listening to her going through this. This is the sort of thing that, unfortunately, patients go through, and we all really need a lot of support during this time. Fortunately for her, she does have the support because her parents are there for her, so let’s listen in.

Speaker 1:

In my life, I’m so grateful for having an amazing husband and amazing family. You just can’t help but feel like I’m a failure. I know that if anyone is going through the same thing, I know that you feel like that, too. I know.

Dr. Marc Sklar:

So I want you to know, as much as she feels like it’s her fault and she feels like a failure, if any of you are going through that same feeling and I’m sure it’s common, I know it’s common from working with so many of you, you’re not. These are things that are often beyond our control. Don’t bear that burden. These things can be supported and it can be changed, and you can see the results that you’re looking for.

Dr. Marc Sklar:

But it’s hard, it’s difficult. But she has the motivation and the determination to keep going, and I hope all of you do, too. Because that’s really the most important piece of this, is that you’re going to keep going to get the results that you’re looking for, and that you have the support that you need to get those results.

Dr. Marc Sklar:

So in the end, what happened after her last loss was that she took a couple months off. They took a vacation, they reconnected with each other, with themselves, and they really just focused on healing, healing emotionally and mentally. That was really, really important for them because at the end of those two months, they got a positive pregnancy test and this was the pregnancy that actually held. They followed their HCG and everything was doubling. She did her ultrasound and saw a heartbeat. She had a successful pregnancy and delivery and she’s got a beautiful little girl.

Dr. Marc Sklar:

So first and foremost, congratulations to her for sticking with it, but for finding the fortitude mentally and emotionally to get through it all because it’s such a challenging time. But also really, I love her story because she shared it with everybody. These are things that often are held and we keep quiet and we don’t really share, but we all need this sort of support.

Dr. Marc Sklar:

So I really encourage all of you to reach out for the support that you need, both physically to treat the physical issues that are going on, but also the mental issues that are going on. Because it’s that mental fortitude and emotional piece that are really going to get you through those tough times now and in the future.

Dr. Marc Sklar:

So that’s really important and I want to be here as a support for all of you. So, first thing, if you found this video useful and helpful, and you want more like this, then please post your comment below and let me know. Then I want you all to know that my team and I are here for you. We’re here to support you in any way that you need. If you would like that personalized coaching to help you figure out what’s going on and to create a good plan to support you through that process, then you can do that by applying for a discovery call with my team. The link for that is below in the comment section to do that.

Dr. Marc Sklar:

Hopefully, you found this video useful. I want you all to be healthy, to be safe and to be fertile. See you in the next video.