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When you've been on that rollercoaster of pregnancy and loss, it can feel quite terrifying to get a positive pregnancy test. Instead of the simple, open hearted jubilation you felt when you got your first ever pregnancy test, this time you are more likely to feel an undercurrent of worry, a lack of confidence, a fear.
Will this one work?
When will you know if this one is sticking around?
We work with many women who have been through pregnancy loss, often multiple pregnancy losses. We don't just help them to recover and rebuild their energy reserves to allow them to try again, we do our very best to try to work out if there is anything that we can do to minimise the chance of a loss happening again.
Often there is.
Many of the things that we check are not going to checked by your GP. Even if they knew what to look at and how to check it, they probably wouldn't be allowed to.
So what kinds of things do we find most commonly in cases of recurrent loss:
Thyroid health: thyroid issues are known to increase the risk of early loss - but you need to understand a bit about the figures you are looking at to know when and if there is something significant going on, to know when to refer to an endocrinologist and why. It isn't unusual for someone to declare that their thyroid is all fine because their GP said so, for us to run some basic tests and find that it isn't. There is a difference between 'normal' thyroid function and thyroid function that is good for fertility. There are some specific thyroid issues such as Hashimoto's that are not picked up by a GP because they are not allowed to run the appropriate level of test.
Infections: one of the other things we commonly find when working with a recurrent pregnancy loss case is infection. Again, this would usually be missed by a GP or an IVF clinic as they don't run the in depth tests that we run.
High Sperm DNA Fragmentation: we also keep an eye out for any sign that sperm DNA fragmentation may be an issue. Often it will be in the picture if the man is smoking or a recreational drug user, if he drinks a lot or if there is any sign of infection or inflammation in the semen analysis.
All of these are usually relatively straightforward to resolve, and that should change the outcome of the next pregnancy.
Sometimes it is more complicated than that and we need to take a deep dive into microbiome issues, mould issues, reproductive immunology issues etc. But that's the exception, not the norm. If it does look complicated, we have the most incredible network of experts to call on to help us to get the difficult things resolved.
There will come a point at which we think it's a good time to try again.
A BFP is the first step towards seeing whether all the work you have done is enough - and it can feel like a huge leap of faith.
Buying a pregnancy test can be triggering for someone who has been struggling with infertility - but for someone who has recurrent pregnancy loss, taking the test and finding it is positive can be unbelievably triggering.
We're here for that.
We're not just here for pre-conception, we are here to support and encourage you as much as you need for as long as you need it. I will be your number one cheerleader, pep-talker and sounding board. In my clinic room you can talk openly about all your fears and worrys (rational and irrational ones!).
Some will need extra support for the first trimester as they learn to trust their body and accept that this one will stay, but will fly solo after that.
Some need a little bit of support throughout.
Some pregnancies are deliciously straightforward - even after multiple losses before working with us.
Some are much more complicated and need much more support (whether that is emotional support to help with anxiety or perinatal depression, support with some of the physical issues that can crop up during pregnancy, or support for the pregnancy itself).
Sometimes it still goes wrong, and we can go back to the drawing board with any new information that the pregnancy gave us and draw up a new battle plan.
We're here for all of that.
If you have been struggling with unexplained pregnancy loss (or multiple pregnancy losses), consider building a team around you before you try again.
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