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Dr Owen
Dr Owen, Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 55754
Experience:  Board certified Ob/Gyn
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Hi there In desperate need of a bit of advice. To my surprise

Resolved Question:

Hi there
In desperate need of a bit of advice. To my surprise and delight, I discovered three months ago that I was pregnant at the age of 39. It was my first ever pregnancy - I met my husband late and we had been trying for about 18 months, off and on. Due to various factors including parental illness meaning we had to be apart for a while, we were only managing sex once or twice a month on average, which was very frustrating as I knew it was nowhere near enough to give us a chance. However, in April it somehow happened. Two early scans showed good growth and a healthy heartbeat, so despite a lot of anxiety about my age, I began to feel a bit more optimistic, especially as I had lots of pregnancy symptoms and no signs that anything was amiss. Sadly, though, I found out on my 12-week scan last week that the pregnancy stopped developing at eight and a half weeks (the day after my previous scan) and tomorrow I will have surgery to remove the tissue. Obviously I'm devastated but I want to try again as soon as we can. But as I'm now a few more months into my 39th year, my question is - would you recommend I have any sorts of tests to check there are no fundamental problems and maximise the chances I'll conceive again? I guess there's little point checking my ovarian reserve as it is bound to be low at this age, but I was wondering whether I should have my hormone levels checked to be sure I can sustain a pregnancy? I understand the miscarriage was most likely caused by problems with the developing embryo, but I'm worried in case there's a chance there's something wrong with my body that will lead to any future pregnancies ending too. I'm scared this was my one opportunity to have a baby.
Submitted: 3 years ago.
Category: OB GYN
Expert:  Dr Owen replied 3 years ago.
Hello,

Have you had any tests yet?
Customer: replied 3 years ago.

Hello. No, apart from a day 21 progesterone test last year when I was beginning to worry about not getting pregnant (I had a 'very good' result, according to doc, at the time). I should point out that I am in the UK where we don't routinely get to see an ob-gyn unless there is thought to be a problem - and the docs won't automatically check anything as a result of a single miscarriage. However I am willing to go private and pay for any tests that might be useful. I don't have PCOS, fibroids or underactive thyroid.

Expert:  Dr Owen replied 3 years ago.
I do have a few questions...
Did your husband ever have any kids with another woman previously?

Also, do you have any medical problems?

Are you taking any medications?

Expert:  Dr Owen replied 3 years ago.
Also, do you have regular periods that you can estimate when your next period will occur every month?
Customer: replied 3 years ago.

I have never missed a period but my cycle does vary in length a little - can be between 26 and 31 days.

Expert:  Dr Owen replied 3 years ago.
Well it does sound like you are healthy and I assume nothing much is wrong.
But you can have your GP run a few tests which are not that expensive just to make sure all is well and you do not need an ob/gyn for these.

1. blood tests: -
FSH - follicle stimulating hormone,
TSH - thyroid stimulating hormone - a very common problem in women - and easy to treat too with medication.
AMH - Antimullerian Hormone - just to check the Quality of the eggs
CBC - complete blood count - to check your platelents
Also - even some other basic labs such as a Fasting glucose, an Insulin level and a testosterone level.

2. I would check your uterus and ovaries with a basic ultrasound too.

3. Also, I would stay on a Prenatal vitamin too just to make sure you have all the proper nutrients your body needs such as folic acid / folate.

4. And, make sure you have a PAP smear that is up to day.

That really would be about all I would suggest.
I wish you the best
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Customer: replied 3 years ago.

Thanks Dr Owen. Yes, I'm hoping this was just bad luck and that if we make a more committed effort to conceive, it will be ok next time. Actually can I just ask one more thing - does the fact that my uterus is still holding onto the pregnancy suggest that I still have ok levels of progesterone, oestrogen etc for maintaining a pregnancy? Would I have miscarried earlier if I had this sort of problem, do you think? I'll ask my doctor about those tests.

Expert:  Dr Owen replied 3 years ago.
Yes the estrogen level will be okay - and as for progesterone the time to check this is at the time of a missed period - and if the level is 25 or more at that time -you have a good level. More than likely the progesterone level is okay.

I wish you well.
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