3 Frist Trimester Losses - PCOS and hypothyroid 33 yo female

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Reply Posted on: Sep 21, 2014 at 5:18pm
Hi Dr.Braverman,We have had three early pregnancy losses with IVF. No know blood clotting disorders or genetic issues ( all testing done by our IVF clinic). Hysteroscopy, MRI revealed no issues with uterus.Sep 2012- clinical PCOS was put on metformin 1500 mgApril 2013 - Got pregnant via IVF and miscarried at 5w1d after early ultrasoundOctober 2013 - 3 out of 9 embroys were PGS normal - testing done at IVIgen lab. Transferred 2 good embryos and got pregnant.Miscarried at 5 weeks 5 days, after a twin pregnancy seen in early ultrasound ( 109bpm, 128bpm heartbeats). Diagnosed with Hypothyroidism at the Embryo Transfer time and was put on synthroid 50mcg.we are assuming we lost the twin pregnancy during to hypothryodism. Do you think it can cause that ?July 2014- Fresh IVF - 5 PGS normal out of 13 embryos. Miscarried at 11 weeks and 4 days after couple of utlrasound. Two incidents of subchorionic hemorrhage in between. was put on emprical Lovenox 40 mg once daily, baby aspirin and prednisolone 5mg till 8 weeks by our IVF clinic.thyroid test results during week 10 of pregnancy, the dr reduced LEVOXYL does from 88 to 75 mg following these resultsFree T2 - 2.41 pg/ml Normal ref range(2.00-4.40)Thyroxine T4 - 14.3 ug/dL High ref range(4.5-12.0)TSH - 0.200 mIU/L Low ref range(0.270-4.200)Did the low TSH (hyperthyrodism) caused the miscarriage this time ?Do you think we should have continued (lovenox, baby aspirin and prednisolone till 12 weeks next time ? What else should we be investigating at this point ?we are awaiting fetal tissue testing results and researching our next steps and came across your site.Do you think immunological issues at play here ? Can you help us with our case ? we are not in NY area so we need to schedule a 10 min consult.

Thanks in advance

Dr. Braverman

2026 Posts
RE: 3 Frist Trimester Losses - PCOS and hypothyroid 33 yo female Posted on: Sep 22, 2014 at 6:31am
We have had sevaral cases of late pregnancy losses in patients with PCOS , this can sometimes be one fo the most inflammatory diseases and lead to late pregnancy complications if not treated correctly . We have great success with this syndrome and I do recommend that you contact me for a 10 minute consult so we can discuss what we would do for you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

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2 Posts
Reply RE: 3 Frist Trimester Losses - PCOS and hypothyroid 33 yo female Posted on: Sep 22, 2014 at 1:12pm
Thanks doc for the quick response. I have scheduled the 10 min call but its not until end of october.

You mentioned PCOS can cause late losses but all our 3 losses have been in the first trimester 2 week 6 and one week 11.

She was put on metformin 1500 mg since she clinically diagnosed with PCOS back in late 2012. Are there other medicines to manage PCOS for women undergoing IVF/FET with RPL history ?

we were on the following meds upto week 8
Predinisolone - 5mg - once daily
Lovenox -40 mg once daily

Metfromin - 1500 mg ( continuing )

Dr. Braverman

2026 Posts
RE: 3 Frist Trimester Losses - PCOS and hypothyroid 33 yo female Posted on: Sep 22, 2014 at 1:15pm
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.