My miscarriage investigations...and outcomes

Trigger warning: recurrent miscarriage, emotional trauma

I want to preface this post with this: every test and treatment I describe here was based on my own body, history, and circumstances. They may not apply to everyone — please speak with your doctor about what’s right for you. Many of these tests and appointments also involve out‑of‑pocket costs.

My loss history

I was unhappy with the seemingly blasé attitude of medical professionals during my first miscarriage. “This just happens, and there’s usually no reason it would happen again, so you just try when you’re ready”.

I mean, it’s the truth, hard as it is, and most women do not miscarry again on the next pregnancy, so it makes a lot of medical sense.

But in the moment, it feels like being hit in the face with ice water. You’re raw, vulnerable, emotional, and in so much pain you can’t imagine going into another pregnancy and ‘hoping’ it goes well…just because ‘it probably will’.

For most women though, that is the pathway forward. There is nothing to be done but accept miscarriage as another part of the cycle of life. Some babies are not compatible with life. Some bodies are not ready, for reasons we will never know. I'll never know what happened with Shannon, lost to us at 7 weeks and 3 days, and I have had to make peace with that.

And even after a total of four losses in a row and a myriad of medical investigations, I can say that the hard reality is this: ‘try again and hope’ is still the best policy after a single miscarriage.

But what happens after two? Or more?

Doctors said the same thing - "try again and hope" - after my second consecutive loss. I disagreed - I had three healthy children previously, and to me this was starting to feel like a pattern worthy of investigation - but I had to fight for it. The guidelines for general practitioners in Australia were to investigate after three. Research is evolving though, and some guidelines now suggest it’s reasonable to start after two, so I’d recommend pushing for it if it feels like what you need.

The information below is the progression of investigations into my losses after Kelly (my second loss), Riley (my third) and Callen (my fourth consecutive loss). I also share the treatments we tried and what ultimately worked in my case. I’m sharing this in case it helps other Mamas advocate for their health care needs in the face of recurrent miscarriage. I’m so sorry for your losses if this is happening to you as well, and I hope you find some clarity.

Investigations and Testing

After I’d lost Shannon, I saw an integrative doctor. He specialises in postnatal depletion (and I was nearly two years post-third child), so the testing below was not all specific to miscarriage - it also looked at hormone balance and commonly depleted minerals in light of past pregnancy and breastfeeding:

• serum biochemistry and haematology
• hydroxycalciferol (vitamin D)
• chromium, copper, zinc and manganese
• B-histamine
• thyroid function (TSH, thyroid peroxidase and thyroglobulin antibodies)
• androgens (testosterone)
• prolactin
• rubella serology
• urine culture
• 24 hour urine cortisol
• vitamin B12
• hepatitis A and B
• blood group and antibodies
• C‑reactive protein
• DHEAS

After Kelly’s loss in the first trimester (at a similar stage to Shannon), I requested a referral for a specialist who might help shed more light. The integrative doctor suggested a haematologist/immunologist (dual specialist) for studies into bleeding disorders and immunological causes for miscarriage. I did have a history of post-partum haemorrhages, and an innate sense that this could be an immune-related cause, so this made sense to me. Tests included:

• bleeding studies (INR, PT, APTT, fibrinogen, thrombin clotting time, Factor XIII, lupus anticoagulant)
• coagulation investigations (Factor V Leiden, prothrombin 20210 G>A)
• factor assays (Factor VIIIc, vWF:Ag, vWF:RCof, vWF:ACT, ABO and Rh(D))
• C‑reactive protein
• Homocysteine
• autoantibodies (beta‑2 glycoprotein IgG, cardiolipin IgG)
• iron studies (iron, transferrin, TIBC, transferrin saturation, ferritin)

No abnormalities showed up, and the only recommendation that could be offered in the face of unexplained recurrent miscarriage was to try aspirin (blood thinner/immune modulant) and progesterone pessaries as precautionary support in the next pregnancy.

I took the medications religiously in the next pregnancy, after months of pre-conception care with supplements discussed below. After losing Riley anyway (a little further along, at 10 weeks), my need to know why intensified. I sought out an obstetrician, who recommended:

• hysteroscopy under general anaesthetic to check uterine and cervical structure;
• MTHFR genotyping, then
• serial beta-hCG and progesterone testing and early ultrasounds (6 and 8 weeks) to monitor development in the next pregnancy (and provide further information on patterns of loss in the – allegedly unlikely – event of another loss).

I was an undermethylater (MTHFR mutation positive), which can be a problem for folate metabolism, but I’d always taken the type of pregnancy multi-vitamin that had methylfolate (5-MTHF) instead of folate, so the babies should’ve been protected from that perspective.

I will also note that I had karyotype testing and culture on the ‘products of conception’ (medical term – I called them my babies) from the second miscarriage onward. No abnormalities were found after I lost Kelly, but they didn’t have adequate tissue to know for certain. I was told this was more likely after a 'natural loss' like ours (tissue recovered at dilation and curettage is more reliable for testing purposes). Riley’s karyotype came back as having a chromosomal abnormality incompatible with life (Triploidy XXX). The report defined this as being a common abnormality not associated with higher risk for subsequent abnormal offspring. No bacteria were isolated.

In the face of this information - no testing for Shannon, inconclusive testing for Kelly, and an actual diagnosis for Riley that seemed to confirm doctor’s theory of ‘unlucky genetic accidents’ - it seemed we needed to accept her loss as a bad spin of the genetic wheel and try again, just ‘hoping’.

After my fourth consecutive loss – Callen - also in the first trimester, I was not prepared to risk my heart again unless we found an answer and a treatment. I knew deep down there was something more going on. One genetic accident was confirmed, but four in a row felt like too much of a stretch.

The obstetrician suggested looking into a fertility and reproductive medicine specialist he knew with extensive experience in recurrent miscarriage. Additional testing included:

• Male and female STD screening (e.g. HIV, syphilis) – note I’d already had this as part of routine early pregnancy screening on multiple occasions, so we were confident this wasn’t the cause, but the specialist’s thoroughness meant retesting with both partners
• Seminal fluid culture and fertility indicators (volume, viscosity, sperm concentration, morphology, motility)
• DQ Alpha Gene Testing for both partners – a controversial cause for recurrent miscarriage but one of the only things we hadn’t yet checked.

The DQ Alpha Gene Testing showed a partial match between us. The fertility specialist advised this could mean that my immune system was treating a pregnancy as a threat. It made sense - even with three living children - because immune sensitivity can develop over time, much like developing an allergy to strawberries as an adult when you weren’t allergic as a child.

Supplementation and Recovery

Under naturopathic guidance, between each of the pregnancies I had used supplements tailored to my situation, to try to repair and replenish before another attempt:

• N‑acetylcysteine: antioxidant sometimes used in unexplained recurrent miscarriage
• Magnesium: supports metabolic health
• Coenzyme Q10: may improve reproductive health and egg/sperm quality
• Nicotinamide riboside: precursor to NAD+, used for fertility and metabolic support

My husband also used a pre-conception men's multivitamin and the coenzyme Q10.

I also worked on nervous system recovery with herbs (e.g. St. John’s wort, withania, saffron) and psychological support, addressing prolonged stress responses that can affect pregnancy. For blood loss recovery after miscarriages, I used nourishing foods like meat broths, leafy greens, beetroot and aloe vera, plus herbal blood builders.

Fear was inevitable in each pregnancy, but having emotional and physical supports in place - both to prepare for each pregnancy and to recover in the aftermath - helped me cope.

Pathway Forward

Treatment to overcome the DQ Alpha Gene partial match involved an immune‑modulating protocol: steroids, melatonin, aspirin, clexane, intralipids, naltrexone, tacrolimus, and lymphocyte membrane immunotherapy (LMIT) - using my husband’s white blood cells injected under my skin.

LMIT was only available through a single doctor in all of Australia, and we had to travel to Melbourne twice for the pre-pregnancy treatments. I'll note here that Brisbane was offered as the (only) alternative location - a satellite clinic, with trained nursing staff who could administer the injections after the fresh blood was sent to the Melbourne laboratory for processing and returned to them. Brisbane was geographically closer, but the appointment availability wasn’t right for our timing.

In vitro fertilisation was offered as an adjunct, to ensure healthy embryo selection, but we chose not to pursue it.

In the first trimester of pregnancy, three further LMIT boosters were recommended. We managed two - and the doctor’s team agreed two was better than none.

The protocol was costly and time‑intensive, but it worked — our daughter Caitlin was born healthy 11 months after we started the LMIT (after a complicated pregnancy and even more complicated birth). And she is worth every minute of stress I endured.

Reflection

I’m deeply grateful for the care I received and for the endurance and resilience we both dug deep for as we navigated years of appointments, tests, and heartbreak. The emotional toll on the two of us, and on our children, was immense. The grief I felt was overwhelming. After losing Callen, I had reached breaking point and we had to face deciding whether to stop trying altogether, or to find answers before one final attempt at a baby. There wasn’t another option I could manage after two years of emotionally shattering losses - the powerlessness, the hopelessness, the emptiness.

We were lucky to finally land with the right specialist for our circumstances, and to find a diagnosis at all. Diagnosis isn't possible in all cases - before that DQ Alpha Gene test came back I was holding my breath. We had no further tests to run, and I knew we may end up with no choice but to accept 'recurrent miscarriage of unknown cause' as the answer.

Before I fell pregnant for the eighth time, I still had to consider the possibility the baby may not survive, in spite of our best efforts and intensive treatments. If that happened, I knew I would need to turn toward a different future — to gather my strength for my other children, explore foster or adoption options or accept we'd remain a family of five, and return to my own healing. It would have been unimaginably hard to move on without our much longed for baby, but sometimes life redirects us, gently or not, and the path we never wanted becomes the one that carries us forward.

For anyone walking this path: your journey may look similar or different, but your inner strength is extraordinary. You can trust you will know what is right for you as you navigate this storm. Whether your way forward involves hope, treatment, acceptance, or a new direction entirely, my wish is that sharing my story helps you feel less alone in yours. Please reach out to me any time with questions - if I can help, I will.