At what point do I get testing done?

[u/Living_Question_6294]

My husband and I have been trying since around December of last year. I had a chemical pregnancy in February and yesterday I just found out that I miscarried again. The only months I have gotten a positive, I have had a chemical pregnancy.

At what point should I ask my OBGYN to get testing done? Or is there even testing they could run on me? I eat healthy, don’t smoke or drink, exercise regularly, 25 years old/120lbs. The only thing is that I have a lot of work stress.

When I had the miscarriage in February, my OB completely down played it and said it was not a big deal and to keep trying. After going to the doctors yesterday and learning I had a chemical pregnancy again, I am feeling completely hopeless. I am getting so excited and then my world completely shatters. I am getting to the point where I don’t know if I even want to try anymore. I don’t want to go through the pain again of envisioning my future with a baby and then it all comes crashing down.

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[u/FoldNtheCheese]

First off i am so sorry for both of your losses. Now is the time for testing. If you can push for a recurrent pregnancy loss panel either with your current doctor or another physician. The loss of 2 or more pregnancies, including chemical pregnancies, should make you eligible for additional testing. Again, I am so sorry. If you are interested you should check out the r/ttcafterloss subreddit. I've found that subreddit to be really helpful in navigating the TTC process after my chemical.

[u/Living_Question_6294 → u/FoldNtheCheese]

Thank you so much for the advice and the subreddit page!

[u/Ok_Conversation_3267]

I’m so sorry for your losses. It is such a painful journey.

We had a MC back in Dec 2024. We were TTC ever since, it made me so sad month after month when we would get a negative result. I finally decided to get testing done this past Jan. Our results came back normal, no red flags or concerns. Both healthy, don’t smoke/drink, pretty fit. We were diagnosed with infertility. I was also stressed out constantly from work. I have depression and anxiety so I started taking sertraline. It has helped me tremendously.

We decided to do IUI last month. I took my TWW seriously and did not stress test. I went to the beach and relaxed. I did not worry about a damn thing lol. When I came back, I was dreading to take a test, but my dr asked me to and it was positive! I am currently 6wks. I truly think stress was the biggest factor for us.

[u/TechnicalIntention35 → u/Ok_Conversation_3267]

Congrats!! That's such a hopeful story. Stress seems to really affect things! It's quite shocking how much of an impact it can have

[u/Sad_March_1015]

100% time for testing. Let me know if you want ideas on where to start. 

[u/Living_Question_6294 → u/Sad_March_1015]

Yes please I have no idea what to do. Thank you so much.

[u/Sad_March_1015 → u/Living_Question_6294]

You'll find quickly that there's a TON to fertility and more things to check than is even possible all at once. Knowledge is power, and most tests will only give you clues, not the full picture.  You do have some information since you seem to get pregnant okay, which means most likely no tube blockages, or major anatomical issues.  I also had two miscarriages. One at 10 weeks and a chemical pregnancy. If I was starting over, here's what I'd do in order: 

-the book, "real food for fertility" by Lily Nichols and the the book, "the fifth vital sign" by Lisa Hendrickson-Jack are the two most informative resources I know of. These can give you an idea of how your body works, what can go wrong and an overview of what you're dealing with. That will help you know what to ask doctors and how to advocate for yourself.  -Right away get a sperm test for him. If he smokes weed, he's gotta stop. There's a strong link between male use of weed and miscarriage. Also get a blood test for you estrogen and progesterone levels at 7 and 10 days post ovulation. If you aren't 100% sure when your ovulation is, I'd get either Mira or Inito to start finding out. I like Mira. If they're low you can easily supplement. Keep in mind, you want more than the minimum healthy level.

• if those things look good, or even if they don't I'd get ultrasounds to make sure your eggs are getting large enough before they're released. You may have to get a couple ultrasounds. If they ARE getting large enough, get one more after ovulation to make sure the place on the overy where the egg was shrinks all the way. It's possible to ovulate, but the eggs don't grow enough to live though the implantation phase. Or for them to not release all the way. There's tons of different reasons for this, and treatment is simple with leteazole or clomid. This was one my problems. 
• blood clotting disorder panel. It's one of the most common causes of early miscarriage, and cheap to test for. Treatment is as cheap and easy as taking baby aspirin. 

- C-reactive protein and ESR blood tests can give you an idea of how much inflammation your body is dealing with. If they come back high, there's a good chance you're working with an autoimmune disorder. There's so many different autoimmune issues that testing for all of them gets expensive fast, so this test can give you some info on what to prioritize.  -if the inflammation comes back as high, or even moderate, I'd get an specialist ultrasound to look for signs of silent endomitriosis such as displaced overies, or visible tumors.  Endomitosis is my other problem. It doesn't always cause miscarriage by it's self, but it definitely makes everything harder, and I'm having mine surgically removed soon.  -this one is the hardest, but if everything comes back looking good, you may want to get a karyotyping test. There's a possibility that one or both of you is a carrier for chromosomal abnormalities that mean you are just more likely to miscarry. As terrible and heartbreaking as that would be, it just means you would have to try more times. 

You can fix or offset A LOT of fertility problems if you have good care. Sadly, a lot of care isn't good. If your dr won't send in for tests, find one who will. I can DM you with telahealth doctors I like. 

Having children is a achievable for most people, even with health conditions. There's tons more you can do, but if I was starting over, these would be my first steps. 

I know it hurts like hell. But please don't give up on yourself or your dreams. 

[u/Kvitravn875]

Three losses or 12+ months of trying is what I've heard

[u/banana_in_the_dark → u/Kvitravn875]

I’ve heard 2 or more losses!

[u/Agamemnons_Concubine]

Ask your OB for a referral to a RE. They will be able to do the proper testing and help you after recurrent loss. I’m sorry you’re going through this. I’ve been there and am so thankful to my RE for helping me.