Miscarriage followed by ectopic

[u/groovkat]

Hi everyone 👋 31F, partner is 31M. I got pregnant for the first time in April this year, and sadly miscarried at eight weeks in May. Found out I was pregnant again last month, got diagnosed with a suspected ectopic/PUL last week, and was treated with MTX. This has been so emotionally and physically exhausting that I can’t imagine TTC again without at least trying to see what might be causing these losses, so I booked an appointment with a well-regarded fertility clinic in my area. To anyone who has been in this situation before and pursued testing with a fertility clinic, what can I expect for the initial evaluations? Obviously our treatment plan will differ from others depending on the results of the initial evaluation, but I’m just trying to get an idea of baseline testing that my clinic will likely do. I would also love to hear some success stories of people who have been in my shoes. I’m running pretty low on hope these days 🥺

[u/_fluffy-cat]

Had an 8 week m/c in November, treated with misoprostol (failed), d&c in December, followed by a PUL in March, treated with MTX. Did the HSG test in April/May, everything came back clear. They also tested AMH, came back okay for my age. 5 months after MTX I got a positive test, confirmed interuterine with a heartbeat at 9.5 weeks, no interventions used, just obsessively tracked with OPKs.

[u/Internal-Biscotti234]

So everyone's case is obviously different and I do think you're making a good call to see a specialist but it mayyyyyy just be "bad luck" unfortunately. I've been pregnant 4 times and the first was miscarriage and the third was ectopic. After the mc I did seek help from a specialist and I now start progesterone as soon as I test positive just to cover bases really. Since you had mtx it'll be good to have an hsg done to check if your tubes are both open, I did that even before ectopic, so I do know I didn't have a tube blocked before ectopic. Best of luck!!

[u/eb2319]

I’m sorry for your losses.

You actually may not get any awnsers about why these two things happened. It sounds like you have good fertility, honestly, so I would maybe expect to not get any real answers from fertility testing. You’ve been pregnant twice since starting to try which is a really encouraging thing despite being losses.

One miscarriage alone and one ectopic alone are kind of two separate things. The miscarriage is unfortunately super common and having one doesn’t point to any problems necessarily. An ectopic could be just really bad luck (usually is).

If the testing isn’t expensive, go for it! But most testing you’d need at this point, a family doctor can likely order and I would save some money. It’s mostly just bloodwork for initial testing. You need bloodwork done on cd 3, bloodwork cycle day 21 (to confirm ovulation but I don’t think that’s a question for you), amh. And a semen analysis. There’s really not a lot more based on your situation they will recommend and if they do I’d question their motives.

But you’ve been pregnant twice in 7 months, I’d say your fertility isn’t likely an issue, love. I’d first do this testing with a gp rather than waste time and money seeing a fertility clinic. That’s just my opinion though!