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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

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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.

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.

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?

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.

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.

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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