Is it You or Me? What I Learned About the Real Reason Behind My Multiple Miscarriages

Before starting my IVF journey, infertility had been one of my biggest fears. I’ve always known I wanted to be a mom and the thought that I might not be able to do that left me feeling a sense of dread and sadness. During my early 30s, I had been diagnosed with PCOS and knew I would likely need help getting pregnant given my irregular cycles and lack of ovulation. Having PCOS and the fact that I didn’t ovulate always made me feel somehow less womanly than my female peers. “What kind of woman doesn’t ovulate?,” I’d think to myself. I often felt that my body was dysfunctional and incapable of doing the most basic of tasks that females can do – reproduce. Before we even started IVF, I took on all the responsibility for the possibility of not achieving what my husband and I had always imagined we’d do, which was to become parents. 

But then, after mine and my husband’s initial testing with our fertility doctor, we learned that my husband had low sperm motility, necessitating the need to go straight to IVF. I hate to admit it, but I felt relieved. I felt relieved that the burden was not all mine and that the problem with reproduction was shared between us. While I felt sad for my husband about his infertility, it now felt that we were on an equal playing field where both of us played a part in the outcome. After our testing, I thought we knew the reasons behind our infertility and this would make it easier to find a solution and get pregnant. But after two egg retrievals, one failed embryo transfer, two chemical pregnancies, and one early miscarriage, I learned that our story was a little more complicated. After mine and my husband’s initial testing with our fertility doctor, we learned that my husband had low sperm motility, necessitating the need to go straight to IVF. I hate to admit it, but I felt relieved. I felt relieved that the burden was not all mine and that the problem with reproduction was shared between us.

My husband often points out that when you’re undergoing extensive medical testing, you’re bound to find something wrong. When couples go through IVF or any other kind of fertility treatment, they’re often subject to tests and procedures most other couples don’t get when they’re trying to conceive. In my case, the testing I underwent revealed I had two gene variants that are often linked to implantation failure and early miscarriages. The initial reasons behind seeking fertility care and starting IVF seemingly went out the window as we came upon a new host of problems responsible for my losses.

The losses started after our first round of IVF when our embryo transfer failed. My doctor took a proactive approach and immediately tested me for blood clotting and autoimmune disorders. We learned that I had a gene variant linked to abnormal blood clotting called PAI 4G/4G. My doctor prescribed baby aspirin and we tried again. This time I got pregnant, not once, but two more times, only to lose them at 5 weeks. 

At this point after 3 unsuccessful IVF cycles, I started feeling the weight of my failures. Two of my friends had recently had children, one with her first and another with her third, and I found myself feeling moments of rage and sadness that they had what I so desperately wanted. I scoured the internet, trying to find answers to my problems only to go down rabbit holes and spiral myself into more worry. During moments when I was able to think clearly, I decided to do some research about the thrombophilia we had discovered I had. I decided to call in an expert in thrombophilias, a hematologist who worked at the hospital where I was working. After a lengthy conversation about my gene variant and its link to miscarriages, he prescribed Lovenox, an injectable blood thinner. We started it two weeks before my next transfer, and with high hopes, tried again. The losses started after our first round of IVF when our embryo transfer failed. My doctor took a proactive approach and immediately tested me for blood clotting and autoimmune disorders. We learned that I had a gene variant linked to abnormal blood clotting called PAI 4G/4G.

Shortly thereafter, I learned I was pregnant again and thought that, surely, this was the one that would stick – that the Lovenox had to be our answer. My husband’s aunt had recently passed away and we told ourselves that if the baby was a girl, we’d name her after her. I made it past five weeks and started feeling relieved that we would keep going. My husband and I took a trip to Montreal and without a care in the world, enjoyed the sights and restaurants, me being happy to not have a drink. From the outside, it seemed like all the stars were aligning. But then on our last night on vacation I started bleeding heavily, only to learn a few days later I had miscarried again, our first clinical pregnancy.

The next week, I fell into a deep depression. I lost all hope of anything working for all the failures I’d had and thought that I’d never sustain a pregnancy. My husband and I grieved, but not together. I talked with my therapist about the loss while my husband fell silent, grieving in his own private way. My husband’s silence made me feel that he had moved on from our miscarriage and that he didn’t feel the need to discuss it further. I later learned that he was hurting just as much as I was, we just had different ways of processing our grief. But it took time and healing to discover this.

After coming out of the fog, I tried to think of anything we might not have tried during the course of my treatments. Thinking back to my former work as an OB nurse, I remembered that some of my patients had suffered multiple miscarriages and had been treated for a gene variant called MTHFR. Thinking I had nothing to lose, I asked my doctor to test me and, lo and behold, I was positive. I went into my next embryo transfer on methylfolate and a higher dose of Lovenox and this time, I got pregnant and it stuck. I delivered a healthy baby girl nine months later, amazed we had found a medication cocktail that had actually worked. And just like my husband and I had originally planned, we named our daughter after my husband’s late aunt. I tried to think of anything we might not have tried during the course of my treatments. Thinking back to my former work as an OB nurse, I remembered that some of my patients had suffered multiple miscarriages and had been treated for a gene variant called MTHFR.

I learned from this experience that it didn’t matter whether the infertility was mine or my husband’s, what mattered was that we found a solution that worked and didn’t blame each other during the process. It made me feel better knowing that our failures were because of a problem with my genes and not necessarily my reproductive ability, as with my PCOS. Somehow this made me feel that I was just a person who was more prone to pregnancy loss rather than a woman with a flawed body who was failing her. In this sense, I felt that our losses were neither mine nor my husband’s fault, but rather a random glitch that could happen to any couple.

Knowing I have these gene variants gives me hope that, in the future, I can successfully have more children as long as I am treated properly. I feel grateful that with both my doctor’s early testing and my suggestion for further testing, my husband and I were able to find the real reason behind our IVF failures and get the right treatment. When I met my hematologist for the first time, he explained that he was happy I came in when I did, as other women before me had experienced many more losses before finding out they even had a gene variant like mine. I believe that more doctors should do this kind of testing early on, as these gene variants are common especially in women who’ve had one or multiple miscarriages.  Knowing I have these gene variants gives me hope that, in the future, I can successfully have more children as long as I am treated properly. I feel grateful that with both my doctor’s early testing and my suggestion for further testing, my husband and I were able to find the real reason behind our IVF failures and get the right treatment.

While both male and female factor infertility can contribute to miscarriages, recurrent pregnancy loss isn’t anyone’s fault. Once I learned about the real reason behind my miscarriages, I started to feel less responsible for them, as the problem was outside my control. Many women feel guilty after experiencing a miscarriage, as if they did something to cause it. But sometimes, we need to put our emotions aside so we can learn what is causing us to reject a pregnancy. The answer, many times, is something we can’t control, but more importantly, is something we can treat. When we can learn to not associate blame or responsibility with miscarriages, only then can we discover what our bodies are truly capable of.