Reproductive Immunology Treatment Results in Birth after Miscarriages

hope for recurrent miscarriagesCase Study: Reproductive Immunology Treatment Success after Four Miscarriages

Unless otherwise indicated, the names of patients and some details about this reproductive immunology treatment case study have been changed to protect their privacy.

Hi,” the woman’s cheerful voice answered. “You have reached the Copelands, John, Dianne, Peter, Sam and Heather. We’re not home right now, but if you’ll leave a message, we’ll call you back as soon as we can. Thanks.” Then, the bubbling voice of a little girl, singing just enough off key to be truly adorable, “You are so beautiful to meeeeeeee! BEEP.”

The caller could not help but smile as he left his message. There is something about the voice of a happy child, the joyful exuberance, the youthful tone, so like music to the ears. How different that message would have been without Heather; empty in comparison, incomplete.

Like thousands of other children now alive and bringing joy to and receiving it from their families, Heather almost wasn’t. Over the course of several years, her parents, John and Dianne, diligently tried to start a family. Their effort, commitment and dedication in the face of severe difficulties, had repeatedly led them to the brink of emotional despair, revealing the depth of courage that love and the desire to love can create.

Getting pregnant was not a significant problem for Dianne. Giving birth, unfortunately, was. Before she sought our assistance, Dianne experienced multiple miscarriages (MM), what doctors call “Recurrent Spontaneous Abortions” (RSA).

Dianne had miscarried four times before giving birth to Heather. For no apparent reason, each child growing in her womb would appear healthy and normal one day, but be gone the next, leaving a feel­ing of emptiness and sadness and unfulfilled potential. The Copelands began to fear the worst; that for them there would be no children – flesh of their flesh and blood of their blood -‘ created out of their love and brought forth into this world.

We tried to begin a family when I was 39,” Dianne says. “We weren’t sure I could get pregnant at that age, but my gynecologist said to try and see. Six months later I was pregnant.

John and Dianne were elated. “We told everybody,” Dianne recalls. “Our doctor was thrilled for us. We felt so fulfilled and, well, successful. We began to dream of our new future. We weren’t dewy-eyed romantics, but we were sure happy.”

Twelve weeks into the pregnancy, Dianne began to spot.

Slightly worried, she called her doctor who reassured her that some spotting was to be expected. Dianne, never the passive patient, wasn’t so sure.

What I read caused me to panic,” Dianne remembers. “Before I could think about doing anything about my condition, the worst occurred.”

Miscarriage #1 at 12 Weeks – Shock, Grief, and Thoughtless Comments

Dianne woke up saturated in her own blood, “I was totally pan­icked and frightened. We live in the high desert and we were one hour from the nearest hospital. John picked me up and carried me to the car. It was awful. The road was icy. We had to drive carefully. I thought we would never get there. I had an ultrasound (a test using sound waves that permits the fetus to be imaged) and it confirmed that I was losing our baby.”

After the miscarriage, John and Dianne were in shock. It had all been so sudden and unexpected, Then, after the shock came the grief.

We were numb with grief,” Dianne recalls sadly. “Plus; there was this overwhelming and profound sense of failure. I had to call everyone and tell them the news. All of our friends had children, and they had all been so happy for us.”

The couple’s grief was compounded by some people’s lack of tact and thoughtlessness.

They would say things to try  and make us feel better  like, ‘Oh, it is for the  best.’ Or, ‘Be thankful.  This was nature’s  way of telling you the  baby would have been deformed.’  Or, ‘You were probably too  active.’ Then there was ‘Oh, you can always try again.’ We did­n’t see it as ‘God’s will.’ We had lost a child. We had lost a dream.” (Dianne suggests that the best condolence in such circumstances is a simple, “l’m so sorry. Is there anything I can do?”)

Dianne’s doctor gave her a physical, took some blood tests, and told Dianne she appeared healthy, that her reproductive organs seemed normal, and that the miscarriage was probably a fluke. His suggestion: “Try again.

Miscarriage #2 at 6 Weeks – Sometimes the Father Suffers Most

Within a few months, Dianne was again happily pregnant. But after six weeks, she lost her second baby.

It was harder on my husband than on me,” Dianne says. “I was kept busy with taking care of my physical needs and dealing with my medical condition. In a sense that was a blessing because at least it took a little bit of my mind off of our loss. But John didn’t have that ‘distraction’ to fall back on. He grew very depressed. I became quite worried about him.”

John’s reaction is not surprising. As unexpected as it may sound, it is often the fathers who have the worst time after a miscarriage.

Fertility Clinic Referral and Testing

Faced with a patient suffering from recurrent spontaneous abortion (RSA), many obstetricians are not quite sure what to do. Dianne’s doctor fit this mold. Even though Dianne had no trouble conceiving, he referred her to a fer­tility clinic designed to help couples who could not get pregnant . (This is a frequent response by doctors faced with treating mul­tiple miscarriage. Why? There are a lot of medical specialists who treat women with troubles conceiving, but few who focus on mis­carriages. This is one of the inadequacies about the current sys­tem that RIA is working to change.)

The physicians at the fertility clinic put Dianne through a battery of tests. One, a laparoscopy, involved inserting a small, flexible tube into Dianne’s abdomen, through which the physicians were able to view her ovaries and Fallopian tubes.

Another test involved inserting dye into the uterus, which flowed into the Fal­lopian tubes. This procedure could reveal tissue abnormalities, such as fibroid tumors, which might prevent the growing embryo from implanting. (During the first 10 weeks of gestation, the embryo anchors itself to the uterus. If it is unable to do so, a mis­carriage will result.)

Dianne also had an endometrial biopsy, in which a small tissue sample from her uterus was taken to deter­ mine whether the depth and plumpness of her uterine lining would satisfactorily nourish the growing embryo.

“All of the plumbing was fine,” Dianne now says. “The doctors could find no apparent physical reason to explain why I could not seem to carry a baby to term. So they put me on Clomid (a med­ication designed to help create a better environment for the fer­tilized egg to implant firmly in the womb) and told me to, Try again.‘”

Soon, Dianne was pregnant for third time. “As time went on, we grew more confident,” she says. “Early in the pregnancy, I was taking hormone shots to help ensure that the my baby would implant firmly in my womb. That seemed to work well. When we passed the 12 week mark, it looked as if all our troubles were over.

Then, after sweating out the amniocentesis (a test of the amniotic fluid to determine whether the fetus has any abnormalities or develop­ mental disorders), we really began to feel good. We had a healthy, kicking son. We were certain we were home free. I let down my emo­tional guard. I began to allow myself to look for baby clothes. I bought some hand-made sweaters. john bought a baby back­ pack. We had never been so happy.”

Dianne and John decided to take a relaxing vacation before the baby came. Dianne’s gynecologist gave his ready consent. The baby was now 24 weeks along. He had a strong heartbeat, and both mother and son were doing fine. So, it was off to their favorite vacation spot, for a week of reading, slow walks on the beach, and the simple joy of doing nothing.

Then, on the flight, Dianne grew worried. Her womb had gone eerily quiet. “I suddenly realized that I hadn’t felt my baby kicking for many hours,” she recalls. “It really scared me.”

Miscarriage #3 at 24 Weeks on Vacation – Dianne’s Lowest Point

As soon as she and John arrived in Maui, they went to the nearest urgent care clinic they could find. The doctor listened for her baby’s heartbeat with a stethoscope. He frowned. He could detect no signs of life. He then arranged to get Dianne into a nearby ultrasound clinic. She and John rushed over, drinking a large bottle of water in the car on the way, so that the test could be performed .

“The technician took the test and then asked if I had been in an accident. I knew. I was heartsick. Then, he called my husband into the room and said bluntly, ‘Your baby is dead.’

I felt like I was going to faint. The room went black-and white. I don’t remember how we got out of there. I called my doctor, cried into the phone, while my husband made arrangements for us to fly home. It was a nightmare. I was told I couldn’t eat anything, that I would be going into labor within a few days as my body got about the task of expelling my dead baby.

This was the lowest point of my life. Waiting for the plane, my husband and I went for a walk on beach. All I could think of was that I was carrying around a dead baby. We had picked out his name, Michael Joseph. And now he was gone.

“We saw all of these happy children playing in the surf, and pregnant women seemed to be everywhere. We were in utter despair. Then, John said with more vehemence than I had ever heard from him, ‘When we have our baby we are bringing our child back to play on this very beach!”

Hope was beginning to seem like an impossible dream to Dianne. She flew home and her doctor induced labor. “It took 12 hours. All that pain for nothing. Plus, I was in the maternity ward. All around me were the joyful sounds of’ new life being brought into the world. An attendant came in who didn’t know what had happened. He smiled and asked if I had a boy or a girl.

‘I had a dead baby,’ I said bitterly. The poor guy. His face fell and he almost ran out of the room.”

Despite Miscarriage #4 at 8 Weeks, Dianne & John Keep Trying

Diane had a fourth miscarriage after 8 weeks of pregnancy. “I was told there was nothing wrong with me, that I was just having one of the worst unlucky streaks in medical history. But I didn’t believe that. I knew there must be a reason that my doctors did­n’t understand.”

Dianne read every book and article on miscarriages she could lay her hands on. “We saw it as this incredible and tragic puzzle that we had to solve.” That wasn’t all. In a common sentiment to most couples suffering from multiple miscarriages, John says, “We were thinking about giving up. But before we did, we wanted to know that we had done everything physically possible to start a family. If by the end of the year, we didn’t have a baby, we were going to give up.”

(Indeed, creating a family was something the couple very deeply desired, and so John and Dianne adopted a little boy named Peter.)

Testing, Diagnosis and Treatment by Reproductive Immunology Associates Leads to Birth

By this time, they had learned of our clinic and wanted to see if we could help. We diagnosed Dianne’s problem as immunologi­cally-based and commenced treatment, before, during and after Dianne’s next pregnancy. One year later, out of the ashes of their hopes, John and Diane’s dreams were fulfilled when Dianne joyful­ly gave birth to Heather, who weighed in at 7 pounds 2 ounces, after a normal gestation period.

Now, at age three, Heather brings smiles to the face of callers who hear her boisterous, “You are so beautiful to meeeeeee,” on the family’s telephone answering machine.

If you have experienced multiple miscarriages, physicians who tell you to just, “Try again,” don’t give up. Reproductive Immunology Associates is a thorough and very experienced reproductive immunology lab and treatment center. Contact us today – there is hope.

Photo by Claire Gibbons on Flickr. Some Rights Reserved.

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