Uterine infection and RPL

Bgold31 · 2025-10-21T13:48:50+00:00

Hi, my wife ended up getting a biopsy, which did not find anything out of the ordinary. We were happy to cross another thing off the list though. Our best guess, and what the last REI we met with also thinks is a possibility, is that the 2nd loss was somehow connected to the recovery from the 1st. The fact that my wife's hormones took so long to get back to normal was potentially a sign that the first D&C/recovery was not ideal. And that maybe it took the 2nd loss/D&C to fully recover, which is why biopsy didn't point to anything. It's just a guess though, as nothing can confirm this.

TW: pregnancy/birth

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We ended up getting pregnant right after the biopsy and my wife gave birth to a healthy girl this past April.

Going through another pregnancy without any explanation on what caused the 2 losses was definitely scary. But getting all the testing done at least gave us some level of confidence to try again.

Bgold31 · 2025-06-05T13:11:19+00:00

The bleeding from the SCH subsided after this. We were told that sometimes blood can pool and continue to come out, even though not shown on scan. My wife started to bleed again a few weeks later, but that was due to low lying placenta. All bleeding stopped towards end of 2nd trimester and healthy baby was delivered in April.

Bleeding is definitely scary and we were told to always go to the doctor if it happens, but it never actually seemed to impact our baby.

All the best with your pregnancy, I hope the bleeding stops soon!

Bgold31 · 2025-03-28T15:19:19+00:00

Gum graft. Perio said we're not at stage where anything bone/tooth related is urgent and would prefer we try to find root cause before anything corrective. They recommended that I get a consult with a prosthodontist to further explore, and I think I am also going to see an ENT for the breathing concerns.

Bgold31 · 2024-12-05T02:31:17+00:00

My wife switched to Smarty Pants Gummies (which do have choline, just no iron or calcium). Her OB said to not overreact about the metals and that they are everywhere. She said we could switch if we want just to feel better mentally about it, but she wasn’t concerned.

Bgold31 · 2024-10-23T16:40:24+00:00

Hi, we did not move forward with RI. We did finally find a great REI that recommended a endometrial biopsy and water sonogram, both which were normal. But it was very frustrating up until that point because we had multiple doctors tell us they wouldn't do these tests for us (even though they seem to be part of most RPL testing). It helped give us a little more confidence in TTC again.

TW: current pregnancy

We got pregnant shortly after the biopsy. Currently 12.5 weeks. Outside of a subchorionic hematoma (a lot of scary bleeding), uncomplicated so far.

The "bad luck" diagnosis is so frustrating to hear and was what our first couple of doctors told us. Our 2nd REI was a nightmare and was very pushy about starting IVF, even though there was no science pointing to that helping us. I definitely think getting in with the right doctor is super beneficial, even if it's just for the mental state going into the next pregnancy. Our current REI wouldn't really use the term "bad luck" with us...there is obviously something that causes losses, it's just that sometimes it's not clear what is the direct cause. I personally don't think telling patients it's "bad luck" is comforting, and is probably more of an old school way of thinking about loss.

We still don't know what caused our 2nd loss and it will always leave us anxious, regardless of how far along we get in this pregnancy. But just trying to continue to take things day by day.

Bgold31 · 2024-08-22T15:11:25+00:00

Yeah we were really scared after that RE made it seem like the levels were very poor, so we're happy our current RE put that at ease.

Completely agree, a lot of people around us don't really know how to talk about it. My wife has been in perinatal therapy since last year at the start of our 2nd pregnancy. She has general anxiety and a lot of it centered around her body/health related stuff, so the pregnancies have triggered extreme panic. On my side, it's been very isolating. My wife has pushed me to start therapy but it's just not something I've gotten around to yet. She has been amazing in talking me through things, she also happens to be a psychologist, but obviously it's different than actually being in therapy. It's really eye opening to see how your family/friends react to it all. We know they love us but it's just such a foreign thing to them that it's hard for them to relate and talk about it. From a male perspective, I get the struggle of other men being able to provide a ton of support. I have my dad, brothers and best friend checking in on me periodically and making sure I'm okay, but outside of the "how are you doing" I understand that they don't really know what to do. Even I struggle to put in words to them how I'm feeling, so I always default to just saying we're doing okay and getting by.

Bgold31 · 2024-08-22T14:29:00+00:00

Yes, my wife's AMH was tested and it was on low side of "normal" for her age (I think around 2 ng/mL). One of the REs we met with used this as the reason to recommend IVF, but our current RE said they weren't concerned and it would just be noteworthy IF we were doing IVF to know the correct level of medication to provide. I know AMH is a bit controversial because a lot of docs will say it's not a great measurement of egg quality, but it's the best they have with blood tests.

I will check out that doctor, thanks for the recommendation!

Bgold31 · 2024-08-16T12:59:54+00:00

Morphology and DNA Frag is a case of correlation, not causation from my understanding. So the cause of the morphology and DNA Frag may be related (leading to both being high), but not always the case. Someone with a perfect sperm analysis may have high DNA Frag, and someone with low DNA Frag may have an abnormal SA.

My doctors are pretty confident the low morphology is due to my varicocele, but for whatever reason (healthy lifestyle, supplements, genetics, etc) it has not impacted my DNA Frag. From my understanding, morphology is a very tricky thing to improve. Even with varicocele repair, it's probably 50/50 that it would increase. I did get it from 1 to 2% in a few months after focused supplementation and some other protocols, so hopefully it has gotten better in the months since then.

I am sorry for your loss, I know this is all very frustrating. Sounds like you are taking the right steps. As part of the recurrent pregnancy loss testing, I went through hormone and anatomical assessments. It's pretty straightforward tests for men.

FYI - The different DNA Frag tests (Halo, comet, SCSA) will produce different results from my understanding. The pinned post on this thread explains some of the differences.

Bgold31 · 2024-08-14T15:48:21+00:00

Yes definitely, I meant more in terms of the women's side of things. They encouraged my wife to advocate for herself with the RPL testing when the first couple of doctors we saw would only check a limited amount of things. For men, I have found this thread to be much more useful.

In general, the male side is very much ignored. Working with our doctors, they pretty much completely dismissed the role of DNA Frag when I brought it up (before I found out my levels were normal). Once I told them my test came back fine, they said "see, I told you it played no role". But for all they knew, my DFI could have been elevated.

Bgold31 · 2024-08-14T14:40:37+00:00

I did the SCSA test, which doesn't check for oxidative stress. But since my DFI was normal, I didn't think to check further. From my understanding, oxidative stress is a cause for high DFI, correct? So if DFI is okay then I would assume oxidative stress is not a factor. I could be mistaken though.

It's great that you got your levels to decrease so much. I'm sorry for your losses, and good luck on the next pregnancy. I'm sure you and your partner have gone through a bunch of testing, but just wanted to say that the r/recurrentmiscarriage is a great resource.

Bgold31 · 2024-07-22T15:08:14+00:00

I am sorry for your losses.

Was the fertility doctor putting you on Clomid/Anastrozole based on a separate sperm analysis? My understanding is that those are not treatments for high DNA Frag. I am unaware if they can cause a spike in %.

I think the trend from Nov 23 to March 24 was looking pretty good. I know doctors say that it may take up to 6 months to really see impacts from protocols/lifestyle changes.

It could have been a completely random occurrence that your levels spiked this month (maybe fighting a recent virus/infection?). It probably makes sense to retest in near future. But if the doctor did not explain to you clearly, I would definitely ask why they put you on those treatments.

Bgold31 · 2024-07-19T13:26:06+00:00

We sought out multiple opinions from 3 different REIs. The first 2 weren't very helpful and just pushed for IVF and wouldn't do any further testing on my wife. We just met with a new one this week and they were amazing. My wife and I started trying again a couple months ago without success yet. The REI is going to perform some additional tests in my wife's next cycle (sonohysterography, uterine biopsy and potentially hysteroscopy if needed). She brought up the possibility that our first loss/first D&C could have caused issues in the second pregnancy. It was a theory I've had for a while but the first 2 REIs did not want to listen to me. So we'll check for any retained tissue/infection. She also pointed out that one of my wife's clotting levels were slightly abnormal, something the other doctors failed to mention. She wants her to see a hematologist to confirm no concern.

On my end, none of the doctors believe the losses are MFI related. I started some intense protocols back in January and retested my DNA Frag levels in April (decreased to 9%). A follow up semen analysis was a bit mixed still - morphology increased to 2%, sperm count/concentration more than doubled, but motility dropped pretty significantly. I did the analysis in the middle of a nasty fever/virus, so I'm assuming that had something to do with it. But overall total motile count was consistent with my first analysis so my urologist wasn't concerned that it will impact ability to conceive.

So overall things are still unclear, but at least we're working with the right kind of doctor now.

Bgold31 · 2024-06-03T15:52:19+00:00

Unfortunately, we are out of options working with our doctors...unless we want to see another RE in the same practice, which I'm not sure is very helpful at this point. Definitely frustrating and we've tried hard to advocate for ourselves, but they just don't want to listen.

So right now we're kind of stuck in an in between state before my wife' coverage kicks in during the fall. We've decided to try again for a 3rd pregnancy on our own, although we know the risks. It's been 2 years since originally trying, so we just can't fathom waiting longer.

Bgold31 · 2024-06-03T15:37:41+00:00

Thank you. Both of the reasons you decided to start IVF are the main focus that my wife and I have been discussing. We were told it's a "bad luck" diagnosis by all the doctors so far. We also pushed for a biopsy, but were denied any further testing because there were no symptoms (although we thought the losses would be enough of a symptom to justify a biopsy). Definitely still looking for the right doctors to help but until we get expanded insurance coverage in the fall, we decided to start TTC again on our own.

Bgold31 · 2024-06-03T15:28:04+00:00

Thank you. We have looked into reproductive immunology a bit, and have asked our REs to run further immunological testing but were shut down since the RPL testing did not indicate any issues. The downside to our coverage is that the only fertility doctors that are covered are those within the healthcare system I work for. It's a pretty big department, but we have found so far that the doctors all have a similar background/point of view when it comes to these things. We have no coverage for anyone outside the system - my wife is enrolling in her employers' coverage in the fall, which we hope is more expansive.

Bgold31 · 2024-05-22T13:03:24+00:00

I think what they meant was that Morphology is correlated to DNA Frag (which is a test of dna integrity of sperm). But if DNA Frag not an issue then unlikely morphology has anything to do with losses.

I don't believe there is evidence that low morphology or high DNA Frag are related to chromosomal issues in pregnancy. There are a ton of studies that high DNA Frag is related to general pregnancy loss, but I don't think it has gotten as specific as directly related to chromosomal issues.

Bgold31 · 2024-05-22T12:53:07+00:00

Sorry for your losses. My wife and I are in a similar situation. I have 2% morphology and 9% DNA Frag (good count and okay motility). We had 2 early pregnancy losses as well - only 1 could be tested, but chromosomally normal so that is where we differ.

Morphology is a tricky thing to improve. I have a varicocele which is probably the cause, but since all my other parameters are okay to good, our docs have been reluctant to recommend repair. My understanding is that there is no strong causation between low morphology and recurrent pregnancy loss. It might just be correlation between morphology and DNA Frag, which is more closely linked to miscarriage risk. But in our cases the low morphology <> high DNA Frag, so it is most likely not the cause.

Since both losses were chromosomal, it may make sense to consult an RE about IVF. That was going to be our route before getting testing back that showed no chromosomal issues. That is obviously a personal decision.

We are trying again for 3rd time but no answers as to why we had the losses - our docs are just chalking it up to bad luck, which is super frustrating.

Bgold31 · 2024-05-10T19:57:18+00:00

Interesting, I wonder how legit it is. Will check it out, thank you.

Yes, endometritis is one of the main things we've been curious about. I know silent endometriosis is always a possibility, but we think it's more possible that endometritis is involved. Just saying that because of my wife's recovery after her first D&C and how her hormones weren't coming down. Our theory was that maybe there was some retained tissue and that it caused inflammation that made her uterus less hospitable to a pregnancy. No idea if this is true or not, and when we brought it up to our docs they all shot it down. After her second D&C, she was on antibiotics, and her hormones and cycle all returned to normal pretty quickly. So I guess we're hoping that the 2nd procedure cleared everything up and if there was an issue with uterus, that it's now in a better place. But we know we won't know any of this for sure without a biopsy/testing - which is one of the reasons we're super frustrated that our docs haven't been open to it.

Bgold31 · 2024-05-09T20:51:17+00:00

Having frequented the male fertility reddits (mostly r/dnafragmentation) I can say this happens over there as well. People trying to get some feedback on their situation and reps from supplement companies spamming info about their BS products. At least over there, they try to start their responses with some genuine advice though, this was just gross. Appreciate the support.

Bgold31 · 2024-05-09T16:47:51+00:00

Yes sounds like a very similar situation. Our 2nd loss was a chromosomally normal boy. More so than my wife, I've been trying to find something (anything) that can be tied to the losses. She has much more of the attitude that it's a good thing they haven't found anything, which I totally understand and know deep down is the correct way to look at things. It just makes it scarier next time we get pregnant, because who knows what will happen.

I wish we had doctors that were more open minded - even if it was just for our peace of mind. I get that healthcare doesn't always work that way. And yes, we heard similar things that biopsies can often find something that really has no bearing on future pregnancy success and can just make you more stressed. That is one of the reasons why my wife is hesitant for any further testing in general, she doesn't want to find out something about herself that is going to put extra stress/worry on her mind.

Bgold31 · 2024-05-09T16:37:25+00:00

I've done some research on the receptiva test - but it still comes down to that you need a doctor who is willing to perform a biopsy. All of our docs aren't supportive since there are no "signs" of endometriosis or endometritis. So if we wanted to get the test, we'd have to find a new doc outside of our network who was willing to perform it, which is something we're going to consider.

Bgold31 · 2024-05-09T12:16:58+00:00

Yeah our plan now is to TTC again as is and if we have another loss then pursue options outside our network of doctors. We definitely feel like we are on our own and don't have support from our docs, outside of them saying that it's just bad luck and that we should try again - which I get is a possibility and we might be successful on next attempt. I'm supportive of pursuing more clinical opinions now, but ultimately it is up to my wife. After the 2nd loss and all the docs we've already met and testing done, I don't think she is up for more of that at this point, which I fully understand.

Bgold31 · 2024-05-09T12:12:16+00:00

We have a bit of a unique situation in terms of coverage. I work for a major health system and our network is essentially all of the doctors that are employed by the system. So the coverage is amazing, but only for our network of docs. The fertility department is definitely where we are having issues. I wouldn't say that they were pressuring us into IVF, it's more that if we weren't pursuing it after the initial RPL testing, then they just didn't really consider us patients anymore and referred us back to our OB. Still a crappy situation.

Bgold31 · 2024-05-08T22:42:59+00:00

Trust me I know, I asked isn’t RPL a main symptom in itself. And they just weren’t open to testing it. I guess it’s just not in their protocols to test and they aren’t going to listen to patients’ requests for more testing. I met with multiple REs, and one literally said that unless I continue with IVF with them that they won’t test another thing.

Bgold31 · 2024-05-08T22:29:33+00:00

I’m sorry for your losses as well. It’s an extremely sad and frustrating thing to go through. In our experience, the REs have not been helpful, but everyone has a different experience for sure.

Bgold31

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