The early miscarriage

I mentioned in my brief catch up blog that we had unfortunately had a miscarriage at the end of January. We had only been TTC since December and had got lucky almost immediately, as we did with Project #1. For some reason, I felt particularly anxious this time – I know I was paranoid last time, but this time I did zillions of pregnancy tests, often more than one a day, pretty much from the day I found out (at only 9dpo) until the miscarriage. All the time, the lines were getting darker, but not by much. Every day I expected them to start fading, so when I started spotting at 5+5, I was extremely worried.

By the morning of 6+0 I’d had a lot more bleeding and was sure I was miscarrying. My GP kindly managed to get me squeezed into the Early Pregnancy Assessment Unit for a viability scan that afternoon, where the staff were absolutely fantastic. The nurses were reassuring, kind, but professional. Unfortunately whilst waiting for the scan, I felt like I was having labour pains, went to the toilets, and miscarried. Obviously I was devastated, and the scan confirmed no visible pregnancy, but in some ways I was relieved to at least have an answer after 3 weeks of ‘not quite right’ness.

As I was already in hospital but no pregnancy had been sighted on scan, I was diagnosed with ‘pregnancy loss of unknown location’ which put me in the ectopic risk bracket. I had my beta-HCG levels taken via blood test, which came back at 677 – way too low for the 6 weeks I should have been, so my suspicions that things were not progressing properly all along were right.

Unfortunately since then, the HCG levels have not dropped as the should have done. It’s sod’s law really – I had an embryo cooking for less than 4 weeks yet it’s already been 4 weeks and the HCG is not back to zero! I’ve had no further physical problems or symptoms, so I’m just having regular bloods now. This time, I’ve been left for a fortnight without a test, so I’m taking the odd pregnancy test in the hopes it goes negative sooner rather than later, then we can get back on the TTC wagon again!

Emotionally I think we’ve come through it all ok. The few days of not knowing and then the day it happened were the worst; since then we’ve been ok really. I’ve had moments of sadness and worry, but mostly frustration at another delay in getting our longed-for sibling for P#1. One day soon, I hope!

The bubble of hope

January 2013

When I was in my late teens and early twenties, I used to view with pity those women who panicked about getting married and having children before they turned 30. How silly, I thought, to plan their lives around one birthday, or see it as some kind of failure if they didn’t manage these things ‘on time’.

When I was in my early twenties, I found out that I had a genetic condition. Some genetic conditions are fairly straightforward – you either have it, or you are a carrier. In some ways, I view myself as a carrier, but it’s a little more complicated than that. I have what is called a ‘pre-mutation’ on one section of one of my X chromosomes. If I pass that chromosome onto a child (instead of my other, healthy chromosome) then the child may also have a ‘pre-mutation’, or there is a 30% chance of it mutating further into ‘full mutation’ which would mean that child has Fragile X Syndrome. It is a little known syndrome, and yet surprisingly common and accounts for an awful lot of severe developmental delays and learning difficulties, particularly in boys. This news didn’t overly alarm me – I had years and years to work out what to do, and I was single at the time and not exactly broody. Only then I also found out that women who had the pre-mutation were prone to ‘premature ovarian failure’ – ie I am likely to have early menopause and was advised to try and start a family before I was 30. Great. Suddenly those women seemed a little less pathetic!

How Fragile X is inherited. Image with thanks to The Science Museum.

Fast forward a few years, and I meet and marry an amazing man. Before we even got married, we decided that we would like to start trying for a baby in 2013. We have both been getting increasingly broody, but have patiently waited and also discussed the genetic issues with our GP and have since had an appointment with a genetic councillor. We were given the following options:

  1. Not having children – not an option we liked!
  2. Have children naturally and accept the 15% risk of having a child with Fragile X Syndrome – not something we feel we could cope with, and we have a family member with the syndrome so fully understand just how challenging, difficult and damaging that can be.
  3. Have something called PGD – pre-implantation genetic diagnosis – which is IVF where the embryos are tested before then being implanted. There is only one hospital where this is possible on the NHS, which is in London. The time, costs of travel, amount of drugs, the ‘interference’, the pressure of MAKING it work, the limit on number of cycles… we haven’t totally ruled it out, but neither my husband or I feel we can face that right now. We also found out that PGD only screens for the one condition, so there would still be all of the ‘normal’ health risks of any other child conceived naturally.
  4. Conceive naturally, and then have the embryo screened (not just for Fragile X, but many other genetic conditions would automatically be screened for at the same time) either by CVS (Chorionic Villus Sampling – more on that later) at around 11 weeks, or amniocentesis at around 16 weeks. Depending on the results of the screening, we would be able to consider terminating the pregnancy. We do not underestimate the psychological impact of that, but we feel that this is the option for us at the moment.

So here we are, nearing the end of our first cycle of trying to conceive naturally, playing the waiting game. My heart is desperate to get a positive pregnancy test as soon as possible, but my head is constantly cautioning me, trying to prepare me for the fact that there is still that 15% chance that a positive pregnancy test may result in a termination. We are trying to approach this practically and objectively, but the fact is that this journey is going to be difficult and potentially heart-breaking. I know we will not be able to fully enjoy the first trimester until we know whether we can proceed or not. We don’t feel we can tell any friends or family until we get an ‘all clear’ because we don’t want them to worry or keep asking questions. At the same time, we are trying to be positive and there is a tiny bubble of optimistic excitement that my sensible head just can’t pop!