Monday, October 29, 2007

Searching Out the "Why"

Today, I noticed online that my insurance had received claims on my 10/13 ER visit. I figured if claims were submitted, then whatever was done with the tissue from the miscarriage had been taken care of. Either it was tested or not.

So I called the hospital. "Yes, you have a report from pathology that you can come by and sign a medical release form for." So, scared and relieved, I headed out the door immediately. I didn't know how to feel. Would we have an answer? I kept telling myself there may have not been enough tissue to test (although there looked like a complete, 6 week embryo there, seriously). Just like this (warning, it is rather graphic.).

Got to the hopsital, got the report. Irritating. Basically said, "Sectioning through the fragments reveal no obvious fetal parts or placental parenchyma." Bleh. The specimen was saved in formalin and reviewed on Monday morning, as it was about 31 hours old. Theoretically should have been fine. Honestly, the hospital here is NOT advanced at all. In the sticks. Behind the times.

Now thinking about it, I think all they were trying to do was histopathology (confirm that indeed there was a pregnancy). Which they can't even get right! Terribly frustrating, as if someone is trying to tell me I wasn't pregnant based on those remains. The dr on call even removed the placental tissue after the miscarriage as I was examined. Anyway, so it didn't help, but at least if it happens again I will say "I want a karyotyping - count the chromosomes! You have to send this off somewhere, but do it!" Of course, I'm concerned about them getting my tissue in there & testing that instead of the baby's if that happened. Don't know how to go about that. Maybe I'll never have to worry?

Now, here's something to go over. My husband's mom has had EIGHT miscarriages (3 miscarriages, 2 kids, 2 miscarraiges, 3 kids, 3 miscarraiges, 1 kid). Six live children, the last when she was 41 has Down Syndrome. She says the Downs is Trisomy 21 (94% of cases), not mosaicism or translocation (i.e. not genetic or hereditary). But you see, all this bothers me. J's mom: 8 miscarriages & a DS baby. J&me: infertility & a miscarraige. I want to get tested for balanced translocations. It's possible his mom or dad have a blanced translocation and the miscarried babies were unbalanced. Of course, I guess the DS doesn't support this anymore, but still. His mom did tell me they thought maybe her miscarriages were from low progesterone (but she never pursued shots - which I don't get after miscarrying so many times I'd go to hell and back to try to prevent it). She lost all between 8-11 weeks (with 1-13 weeker in there). Um, thoughts, you with experience? That seems late to lose from progesterone problems. My reading says if you have low progesterone, if you don't start taking it from the time of ovulation, it won't help. You have to start at conception. Am I right?????

I got the referral to a "local" RE (i.e. 94 miles away, which sucks b/c if it were 100 miles, insurance would COVER gas charges!). Can't get them to pick up their phone or return messages, but it's my ONLY choice. I at least want testing for that, clotting disorder, antibodies, if I can. Plus further testing on "unexplained" that WH won't do since they only do real basic stuff. We'll see. I don't like the clinic b/c it's so small (1 dr), but I'll take it over nothing. And apparently that's my choice.

I don't really feel like getting into my feelings. Today has been really good though. I cried, but not a sorry-for-myself or depressed cry. Just sad. I guess I like having something to work towards. Back on the TTC wagon. Oops, it's dark and husband will be returning from hunting. Must go fix dinner. More later.


Katie said...

If your insurance pays for it, I say get the testing done now. If your insurance won't pay for it, then you might have to save a little. It cost $560 for EACH of us, but it was worth knowing that nothing was wrong. Well, nothing they can pinpoint anyway.

Samantha said...

I'm sorry you couldn't get answers from your local hospital. For your peace of mind, I would also go ahead and do the testing. If nothing's wrong, it won't affect your treatment, but they find out something, it could be useful for future cycles.

andrea_jennine said...

All your MIL's miscarriages could certainly have been caused by a translocation, but I don't know if that's the only possible reason. Still, it doesn't hurt to get tested (esp. J). Low progesterone is typically caused by something going wrong with ovulation - most medical studies have showed that progesterone supplementation doesn't really sustain a failing pregnancy, since the problem is really with the egg that was fertilized. (Progesterone shots are used in IVF because the egg retrieval prevents the formation of the corpus luteum that signals our bodies to produce progesetrone.) And keep in mind that most of this reproductive science is relatively new, with studies beginning just over 20 years ago and getting refined all the time. Progesterone supplementation probably wasn't even on the radar screen when your MIL was miscarrying.

Loren said...

I'm sure a translocation is possible with all those miscarriages- I would get testing done if possible. With a DS sister in law, I'm sure you won't have a hard time convincing your doctor, even though I don't think they are related.
I'm glad you posted about your miscarriage "products" (horrible, I know- sorry for lack of better description). I,too, passed what appeared to be a 6 week old fetus, and wasn't expecting to see so much at that point. I couldn't believe how big it seemed, and I was confident in when I ovulated. I searched and searched, and everywhere I looked, it said that at 6 weeks you wouldn't pass much.
As morbid and scary as it all is, I wish there was more information on what to expect, and what we actually saw.
I hope you get some info from your doctor. I really hope it's not a translocation. Not knowing is the worst part.

Kim said...

I'm sorry that you didn't get what you're hoping for. I hope that you will have some progress, and hopefully answers, soon.

Laura said...

I am sorry you weren't able to get any answers. I agree about getting the testing - especially if your insurance covers it.

Just wanted to let you know I was thinking about you. :)

CAM said...

Interesting about the MIL. The translocation could be a possible direction to investigate. However, the Downs is in no way hereditary. I had a brother who was Downs and I have been to geneticist who have told me over and over that it is completely random to get the trisomy and not hereditary at all.
It sounds like you are mentally moving forward and that is great. Try to keep a positive focus as you get back on the TTC track!

Julie and Greg said...

i am late responding to this, but wanted to let you know that we got WPAFB to pay for all the anitbody/blood clotting panels. They also agreed to have DH's sperm DNA tested for fragmentation. Since I lost at 14w6d he counted it as a 2nd trimester loss and agreed to the panels. It saved us thousands having the base do it. we don't have the family history you do, so maybe you can use that angle and have them agree to the testing? we lost our baby on October 9th,2006 so I know exactly how you are feeling and remember exactly how I felt this time last year. It will get better but you will never forget your angel!