A small reprieve

This miscarriage has gone on for much too long. Much longer than the first. The last time it happened I bled for just over a week and it was done. This time it has been almost 4 weeks, with a few days off here and there, followed swiftly by a period at the end just to make sure I was completely and utterly exhausted.

We saw our consultant last week. He was very lovely and very sad to hear our news. We spent time discussing our options for the next cycle, and what might be happening for me to keep miscarrying. We are all of the opinion it is likely due to “bad” embryos that my body is doing the correct thing in expelling. We’ve really only had 2 cycles (discounting the one last year where a sub-optimal embryo was put back under less-than-ideal conditions), so we’re still well within the realms of normal failure rate – NICE guidelines recommend 3 free IVF rounds on the NHS for a reason.

Nonetheless, I’ve been directed to the hospital for some blood tests just to be sure there’s nothing else going on here that could be easily diagnosed. I think this is primarily to rule out immunological complications.

Our immune systems are built, trained, and released like a covert special-ops unit to identify and apprehend any foreign entities invading our bodies. In healthy individuals, immune cells with fantastic names such as “natural killer cells” are able to recognise the difference between our cells and cells that don’t belong to us. This is how they kill bacteria but not, say, our own lungs. There are illnesses where this recognition software breaks down, and resulting autoimmune diseases occur when immune cells attack the host body by mistake. These can be fatal if not diagnosed and treated. (For any House fans out there – yes, it’s Lupus!)

When an egg is fertilised in the uterus, or in a petri dish, half of the genetic material is from the woman, so is recognised by her immune cells as “friendly” and not to be attacked. But the other half is from a man – rightly recognised by the woman’s immune cells as a foreign invader. This can, in some women, cause their immune cells to attack the “foreign” embryo and placenta. An over-keen immune response can therefore inadvertently cause miscarriage.

So I’ll be tested for an over-achieving immune response. If I have one (which is unlikely as I had Toby – who is half John – with no such problems), then I can be prescribed drugs such as aspirin and heparin that both have immuno-suppressant properties. They would work to dampen down my immune response and give the embryo a better chance of survival. But as I say, we think this unlikely.

Steroids are also sometimes used for the same reason, but seem to be given more liberally even if no immunological issues are found. So I have the option of taking some next cycle. However, there is little evidence that steroids actually help, and some studies even suggest they can be detrimental if used to treat someone without diagnosed immune symptoms. This is because a small amount of inflammation and immune reaction is actually necessary for implantation, and removing it can potentially cause all sorts of issues down the line. So this needs to be weighed against any potential benefits when the time comes.

So for now I’m going to get the blood test done and wait for results (around 2 weeks) before discussing things again with our consultant, and only then will we start again.

I still haven’t been for a run.

But we’ve been kayaking twice!

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