I have had three miscarriages…
Dear Professor Winston,

I have had three miscarriage at the time near the same week of pregnancy – 2 at 6.5 weeks and 1 at 6.3 weeks. Is there something during that development stage that would stop the growth and heartbeat. All three had heartbeats detected and then days later no heartbeat and or growth.

Medical history – currently 40 years old (miscarriages at 38, 39, and 40). Last pregnancy awaiting genetic testing results of conception product and the other ones were not tested. History of uterine adhesions but on last HSG right before last miscarriage no adhesions detected. Any thoughts?

Blood clotting issues or infection of lining issue?

Thank you in advance.

Brandy 

Dear Brandy,

Without access to the results of very thorough tests, it is difficult to give a definitive answer to your extremely distressing situation.  But possibly, if none of the standard tests for recurrent miscarriage have shown anything, the most likely cause must be in the quality of the eggs you are producing.  This, I am afraid to say, is likely to be age-related.  An assessment of your AMH and also possibly repeated FSH levels might be revealing – if the AMH is low this is highly likely to be the problem.  If a number of FSH tests are done and any one of them level is above 10 – 12 units this would also be highly indicative.  Unfortunately for lots of reasons, an FSH level can be very variable and a result below 10 does not though rule my first diagnosis out – but above 10 it is highly likely.

This kind of miscarriage history is much more common in women over 38, but it may always be a possibility with continued trying that you may get lucky.  In general, in my view IVF is not indicated.

My apologies for the limited information.

Best wishes,

Robert Winston.