Friday, August 11, 2006

Note to self part, er, I don't know

I've got my appointment at the recurrent miscarriage clinic next week so this is a (to be updated) list of questions I want to ask:

Clotting factors: which tests will they do? Check they are doing the MTHFR as they couldn't do that locally.

Chromosomal factors: when will they test Mr Spouse for the balanced translocation? Can he have the blood taken locally?

Elderly reproductive system factors: is it worth me getting my FSH done again (the gynae said not, since it was only taken in January - I imagine she's right - perhaps next year)? What about an antral follicle scan - would this show a decreased ovarian reserve and would that be affecting the miscarriage?

Immune factors: are they still doing this trial of steroids? Does this require a biopsy? On a) day 21? b) a barrier contraception cycle? This will be yes to a) but no to b).

What about this new study of four-drug therapy for recurrent miscarriage? I realise it was a study with no placebo group but would they approve me trying the treatment? If no, would it do any harm to try aspirin (the gynae said it wouldn't)? Progesterone? (I have actually ordered some progesterone cream, partly because - of course - I hope it will help us conceive, but also because I have heard it's good for premenstrual cramps, which continue to plague me some months).

Which aspects of the therapy (steroids, aspirin, folate and progesterone) could I start at day 14 of my cycle, given our difficulties conceiving? If she says "none", would it be worth going onto the higher dose of folate anyway?

If I have another miscarriage, and it's not too fast, is it worth my having and ERPC to try and test any tissue? Would they be able to keep the tissue locally or would I have to go down there?

Oh, and about those cramps - is it possible they are conception cycles, with attempted implantation?

I'm hoping this is going to be an interactive post - if anyone can think of any questions I should ask, I'll add them in.

Notes from the notes:
I have looked into Foresight, but I think we are doing, or have done, everything anyway (vitamins - though there's no evidence anything except folate helps; stopping smoking - neither of us ever did; testing for STDs - got that sorted; heavy metals in hair - erm...)

Agnus castus - I understood that was for short luteal phases, which I don't have. But I'm prepared to be corrected.

The progesterone cream arrived today (about 6 dpo) and is very, er, creamy.


DD said...

I've heard FSH levels can flucuate quite a bit in even 6 months, so I would push that.

I just found out that I shouldn't do progesterone until at least 3 days post ovulation as it can impact it negatively.

That's about as much info I can give with any kind of confidence.

perceval said...

Oh Katie, this takes me way back to when we were trying for Ruth ...

the only thing I would add is whether there is any evidence that nutritional therapy such as the Foresight programme or the herb agnus castus work.