What tests might be done after a miscarriage with Donor eggs & sperm?

[CXCYCZ]

just found out my 6 week 4 day embryo with a heartbeat didn’t make it to 9 weeks 5. Seems it got to about 7 weeks then faded away. Found out yesterday at the 9 week scan. Not sure I’m really processing the loss yet. I tend to go practical first then the emotions hit me like a truck later!

I’ve asked the clinic about next steps, when can I go again as I have more frozen embryos. They have said they want to have a consultation and maybe do more tests. What are they likely to be talking about. Implantation doesn’t seem to be a problem, I’ve always had good thickness of lining and my cycles are still regular. What would they be testing me for and is it not just a case of bad luck if the first transfer was a chemical and the second a ‘missed miscarriage’ ?

The thought of more tests on top of waiting for the bleed/intervention makes me feel so low. The longer I wait the harder it is going to be to start over again.

[DreamingOfTwo79]

Hello CXCYCZ, I am so sorry you are going through this painful experience, I understand you are going through IVF solo but I really hope that you have a strong support network around you right now. I have no experience of MC with donour gametes but have lost four babies and underwent the following tests: Thrombophilia screening (for blood clotting disorders), thyroid profiling (higher TSH levels or certain type of thyroid antibodies can contribute to MC), anatomy checks for uterus and ovaries (ultrasound scans in my case but ladies on this forum also recommend 3D saline infusion sonography and 3D HyCoSy) and EMMA/ALICE to check your endometrial microbiome for signs of infections or chronic endometritis. It is also worth trying to preserve your baby's tissue as you're going through the physical loss (sorry, no nice way to put this) and to get this tested for chromosomal abnormalities, the NHS typically only do this from your third loss onward but you can also get this done privately. Wishing you a lot of strength for these next few weeks and months, I know you are keen to try again as soon as possible but try to be kind to yourself and allow yourself time to heal as well, it is a delicate balance and only you will know what you need, there is no right or wrong way. Best of luck to you, you're in my prayers. X

[Elmo13]

Hi CXCYCZ,

Couldn’t read this and run. I’m so sorry for your loss and sending you love.

I had a missed miscarriage around a month ago at around 8 wks, and a D&C about 3 wks ago. I was feeling pretty panicked and fearful for the worst case, and like you, just wanted to avoid more delays and get on with the next cycle.

Now I’ve processed it, I’m taking a step back to do some testing and give myself the time to heal and move forwards. Please take the time you need to process everything as this is an incredibly difficult thing you’re going through.

I can’t add anything to what DreamingOFTwo79 has suggested, but just want to wish you the best of luck. Xx

[Boo718]

I am so sorry your going through this. Did you get the embryo pgd tested? I am on the double donor path and we had a few embryos last year we decided to get them tested and although they were all top quality, they were all abnormal. I also had the era emma and Alice tests after 2 chemicals xxx

[CXCYCZ]

hi thank you all. I have no idea what tests the clinic did on the embryos. But they have been frozen now. Can you test them once they are frozen? I am beginning to think there is something wrong with them so will ask the clinic what tests they can do. But I’m guessing they can’t unfreeze just to test and then freeze again so it would be at the point of transfer. Other than that it’s just the waiting game. I’m thinking let it happen naturally rather than a D&c. Would that be quicker to try again. I already had fibroids removed so am worried about more procedures. Just wish the clinic would talk to me now rather than leaving me hanging. They want to wait for the follow up scan with the nhs next Friday and they think it will have gone by then but I’m still testing positive so until I test negative I suppose I won’t bleed. Funny old world. I’m now testing looking for a negative!

[DreamingOfTwo79 in reply to CXCYCZ]

The test for chromosomal abnormalities is called PGT-A (previously PGS) and can be done on Day 5 frozen embryos. I doubt that clinics do this of their own volition as it is a costly procedure and you will of course need to weigh up the cost and risks vs benefits (potentially shorter time to pregnancy and reduced risk of miscarriage after transfer as the assumption is that euploid embryos have a higher success rate of live birth but it is still no guarantee). My consultant advised that embryos can survive a freeze/thaw process up to 6-8 times, however there is always a risk present that your embryos won't. We have to take so many decisions throughout this process, do your clinic offer counselling sessions that might help inform your decision?

As for management of your looming MC, I chose natural management for all of my four but ended up having a D&C for my fourth as my body wouldn't release the baby until I was 12 weeks (five weeks after diagnosis of the missed MC) and then I retained placental tissue which had to be removed surgically. Having experienced it once, I would choose surgical management should I ever find myself in this situation again as I found the blood and tissue loss at 12 weeks traumatic. It is a very personal choice, I am always afraid of anything involving anaesthesia and invasive methods but surgical management is considered very safe and has the advantage of the physical recovery being potentially quicker leaving you mental headspace to focus on your emotional healing process. Good luck for whichever way you are most comfortable with. X

Lastly, any pregnancy tests will still show positive until about two-three weeks AFTER you experienced the actual loss, i.e. bleeding and all the tissue being expelled. If you continue to test positively after your bleeding this is a sign that your body retained pregnancy tissue and this might need to be removed surgically if the body doesn't manage on its own.