R.M. (Reproductive Musings)

Come on, admit it, you want the medical details. Just how hopeless is this case? It ain’t good. Here’s the thing. Somewhere between one and two percent of women will be diagnosed with recurrent miscarriage. Of those so diagnosed, about half will eventually be found to have some underlying medical issue (a clotting problem or autoimmune disorder, a hormonal imbalance, an anatomic abnormality, or lesions, adhesions or damage from anything from endometriosis to a botched D&C.) But another half will be “idiopathic,” meaning that the idiots making the diagnosis can’t figure out what the idiot patient did to get the Idiot in charge so pissed off. That’s my case folks, the ugly angry half of the last percent: idiopathic recurrent miscarriage.

Allow me one more longer aside on terminology. I vastly prefer the term recurrent miscarriage to HSA. Take the politically-charged A-word. I support a woman’s right to choose without reservation; I’d just like keep it crystal clear that, when it comes to miscarriage, no choice is offered. “Spontaneous” is accurate as far as it goes, but come on. My idea of spontaneous is a quick skinny dip on a hot day in a sparkling secluded lake. Miscarriage, on the other hand, is a plunge into despair. And habitual? Please. Just because something happens over and over doesn’t make it a habit. Surfing blogs? Now there’s a habit. Drumming your fingers? Yeah, OK. Chocolate? More please, my favorite addictive habit! But miscarriage? I promise you, I am not addicted to losing my dreams. Quite the opposite, in fact. So let’s all play nice and agree we’re going to call it RM and leave it at that.

Right. So. My husband and I are ready to try again and we’ve consulted with a slew of doctors. There’s Dr. Smart-Cookie Sweetie-Pie, my personal favorite, one we’ve been seeing for a while. She couldn’t stop my last miscarriage, but then again neither could God. I think I’d like to keep working with her, even though she doesn’t take my insurance. (Here in Manhattan, where M.D. stands for Material Development and R.E. stands for Really Enriching, it seems that no one does take my insurance.)

Then there was Dr. Awards-All-Over-the-Walls, a bad combination of insecure and arrogant in my opinion. Plus I didn’t like his advice. Among other dumb ideas, he recommended I do a Clomid-challenge test. As another doc put it, 3 genetically normal fetuses are all the proof you need that you ovulate. After him came Dr.Well-Connected, who knows everyone and everything, but still couldn’t come up with anything very new in the way of treatment suggestions. Also he thought the ultrasound wand was a light saber. He was so aggressive with the wand that when I finally screwed up my courage for a hysterosalpingogram or HSG (that’s the Hot Searing Green dye test for anyone lucky enough to remain among the unitiated) it actually wasn’t half as bad.

Finally I went to see Dr. Eminence Gris, bringing my complete fat file of negative results from all of the tests the first few doctors had ordered and hoping to get some definitive recommendations. He turned out to be a graying old guy who instructed me to strip completely for my exam (my husband wasn’t there for this one) then opened my paper gown to the waist, pulled it down off my shoulders in a fetching “oh my, this crinkly lingerie just keeps slipping off on its own” pose and left me hanging there in the open air for several minutes while he checked my pulse, listened to my breathing, etc. Amazingly, that routine did not lead him to any stunning new insights about the causes of my miscarriages. Instead he, like the others, said “well, since we have no clues it must be autoimmune. So let’s give you heparin.”

That is where the treatment plan stands, pending another consultation with Dr. Cookie Pie. I’m around day 21 of this cycle (we’ve taken enough precautions that there will be no anxious testing this month, I promise) and am already starting to feel incredibly keyed up about the next one. Day 14 (or 16 or 18, my body will not be rushed) is D-Day as in do the deed day. This is where you come in. Please, if you wander by and read this blog any time in the next few weeks, leave me a comment and tell me your story. I’m especially interested in hearing the one about your aunt’s friend’s sister, who had a great and wholly unexpected success with delivering a live baby in the fourth attempt. Cause from what I hear, and yes I've become a statistics junkie, my chance of another miscarriage now hovers somewhere around 60%.