Bridging the unknown

You'd think by now, I'd be getting comfortable with falling on the wrong side of the odds... Not being able to get pg on own for > 2 years (way < 10%), having to do IVF (1%), losing the baby w/HB (2-4%), and now our miscarriage was not caused by any kind of chromosomal abnormality (well < 50%). But we aren't, so the investigation continues...

The most common causes of a miscarriage in the first trimester are:

Collagen vascular disease (lupus) - not an issue as far as we know

Hormonal problems - who doesn't have hormonal problems, right? I jest, but it's possible that even with my regimen of E2 patches (which ended before the m/c) and P4 supps (which we switched to from PIO after BFP) were not enough to sustain the baby.

Diabetes - not an issue as far as we know

Chromosomal abnormalities - the most common, but NA for us (at least this time)

Congenital abnormalities of the uterus - well I did, but it was fixed. I guess it's possible that this was still an issue, but it is very unlikely...

Other:
Immunologic Disorders - Clotting disorders fall under this one, and it is certainly possible that given my family history (which my RE is aware of- of my sister having a clot, which caused a PE which almost killed her, and now necessitates that she take blood thinners and wear medical support hose for the rest of her life). While on blood thinners, she has gotten pg four times in < four years, without batting an eye. I wonder if stopping the baby aspirin (as directed) after our u/s, may have had an impact on viability. Other disorders like MTHFR deletion and celiac also fall under this.

Untreated Illnesses Such as Thyroid Problems (Both Hyper- and Hypo-Thyroidism) - not an issue as far as we know

Polycystic Ovary Syndrome (PCOS) - though there was that lovely gyne @ Mass Gen who dx me with PCOS without doing any tests in college, I do not have PCOS.

Bacterial/Viral Infections - this is actually an area that really concerns me. In the months leading up to our pg, I was treated for both group B beta strep and HSV-1. DH was treated for pseudomonas. There is also the minute chance that I was exposed to malaria on our trip to India, and although I took malarone, they advise against becoming pg for several months after leaving a malorous area. We knew this was very very small risk.

Lifestyle (Cigarettes, Alcohol, Drugs, Environmental Toxins) - I'm so sure that this isn't our issue (I live like a nun), I'm not even going to get into it.

Tomorrow, I get my hCG tested again. It was 335 last Thursday and should be super low by now. I had basically stopped bleeding, but now have started again what seems like period bleeding, which is a good sign my hCG is now very low. We are going to sit down with our RE in the coming weeks and see what testing he will do for us (these are all simple blood tests) or if we'll need to go elsewhere for testing before we cycle again.