This past week, April 20-26, was National Infertility Awareness week. According to statistics, it is estimated that 1 in 6 individuals globally experience infertility, which is defined as “the inability to conceive a child after one year of regular, unprotected sexual intercourse,” according to the World Health Organization. Some sources include repeated miscarriages in this definition.

Statistics show that the majority of miscarriages (between 50-80%) are caused by chromosomal issues in the baby, either from a “bad” egg or sperm or both. It’s a technical process, but egg and sperm go through their own cellular divisions regularly, and if anything goes awry during that process, an embryo can end up with the wrong number of chromosomes. This leads, in most cases, to miscarriage.

The other percentage of miscarriages are of various causes, but many specialists believe that progesterone can play a part (more on that later).

Our journey in exploring repeat miscarriages

After our second consecutive miscarriage in July of 2023, we knew we had a choice to make – either continue “trying” again in hopes of a successful pregnancy, or explore a potential cause for our repeat losses.

According to our midwives, most doctors do not refer out after a miscarriage for further testing unless there have been at least three consecutive losses. However, they explained this thinking was beginning to change, and they could now refer after two losses.

We decided to visit a Reproductive Endocrinologist (RE) at the recommendation of our naturopaths and midwives. An RE is a medical professional who specializes in reproductive health, often with an emphasis on IVF (In-Vitro Fertilization). Knowing this, we prayed and decided beforehand that we would not pursue IVF, but wanted insight into how we could increase our chances of a natural, viable pregnancy.

Meeting with our RE and initial results

I did some research regarding REs in our area and found one that had good reviews, with a few reviews mentioning conceiving without needing IVF intervention.

At our first meeting, our RE went over the basic statistics regarding miscarriage and infertility and the types of blood tests and treatments available to us. We decided that I would undergo a sonohysterogram to determine if I had any blockages/structural issues preventing a successful pregnancy, and my husband and I would both take a karyotype, a type of blood test to determine if we had any issues with our own chromosomes that could cause miscarriages.

The sonohysterogram revealed an endometriosis cyst, which they decided would be too risky to remove, as it sat on an ovary. Studies show that removing ovarian cysts can disrupt egg quality.

The karyotype came back clear, showing that our miscarriages had at least not been caused by any genetic issues either of us had!

Blood tests

Additional blood tests that my RE and naturopath (more on him later) ran included CoQ10, anti-mullerian hormone (AMH), progesterone, folate, MTHFR gene, and a thyroid panel.

CoQ10 is a coenzyme responsible for cellular health. Research shows that taking an adequate amount of CoQ10 can increase AMH, the hormone tested for egg (and sometimes sperm) quality. My AMH levels were slightly low for my age, so it was recommended that I start taking CoQ10 to help increase my chances of having a healthy egg without any chromosomal issues.

Progesterone is the hormone responsible for maintaining a pregnancy. I had received testing for this during our second miscarriage, and afterward during my normal cycle, to see where my levels were. They consistently came back on the lower end of normal. Our RE explained that after chromosomal issues, low progesterone could be the second leading cause for miscarriages. Levels can fluctuate each day and week of pregnancy, so he advised taking progesterone regardless, as it can’t hurt.

The plan was I would track ovulation the next time we “tried,” using ovulation test strips. Two days after a positive ovulation test, I would begin taking progesterone suppositories and continue the supplementation if we received a positive pregnancy test a few weeks later (which we did!). He recommended continuing progesterone supplementation through the first 12 weeks. I ended up continuing the progesterone for the majority of our pregnancy at the recommendation of our naturopath.

Healthy folate levels are responsible for a baby’s development in the womb, especially of their neural tube during the first 6 weeks. A theory I had researched was that low levels of folate could cause neural tube defects, leading to miscarriages. My folate levels came back great, however.

The MTHFR gene is responsible for utilizing folate in the body (among many other processes), and women with defects in this gene, it’s believed, could have issues with fertility. I received testing to see if I carried this gene and was having issues in this area. I was already on supplements to help with this area through my naturopath, and continued those leading up to pregnancy.

My thyroid was an area I was already working on with my naturopath, who had me taking a small dose of desiccated thyroid medication. I credit this with our success in getting pregnant three times! According to research, it’s important for TSH levels to be below at least 2.5 for pregnancy. I’ve personally heard so many stories from women who had trouble conceiving, started taking thyroid medication, lowered their TSH number and found themselves pregnant within a couple months.

There are numerous other areas that can be tested when dealing with miscarriage and infertility, but these were the major ones I experienced.

Conclusion

An infertility diagnosis does not have to be the end of your pregnancy journey. In our experience, we needed to go beyond the conventional medical setting to get answers.

Our RE was very helpful in spelling out the known science and latest research behind repeat miscarriages and completed important testing. Our naturopaths were our ultimate teammates in exploring our options and examining areas the medical community overlooked. They also gave us hope for a successful natural conception, something that was very important to us, and listed more avenues we could explore even if we experienced another miscarriage.

We are so thankful for all the wisdom we received on our journey. Our double rainbow baby is a joy and gift from God, and we never want to take a moment with her for granted. We hope this post can be a guide for anyone still praying for their rainbow.