Thank you to our episode sponsor Peanut, you can meet likeminded women, trying to conceive and find support. Be sure to visit peanut.app.link/fertilitypoddy or via your app store.

 You’ll hear from Dr. Ingrid Gran, Senior Research Fellow in Reproductive Medicine and a Consultant at The John Radcliffe Hospital in Oxford talking about the reasons why miscarriages happen, explaining in more detail about chromosomal abnormalities and it’s linked to female age. Listen in full here

Zara Dawson shared her heartbreaking experience of having to have a medical termination which you can hear in full.

We also heard from Jen Coates, the Director of Bereavement Care at Sands, the Stillbirth and neonatal death charity  explaining just how challenging dealing with Baby loss is for everyone involved and the peer to peer support they have created with bereaved parents who become ‘Befrienders’ and that they also have an app you can get instant access to get the much-needed support you need. Listen in full here.

We also talked Dr. Adrian Lower talking about Asherman’s Syndrome which is caused by the surgical procedures women have to go through when they have a miscarriage,  it was part of a conversation was part of an earlier one with Guest host Katy Lindermann Emilie Jones-Ransley listen in full here

And we also asked Kelly Da Silva, who has founded the Dovecote Childless Support Organisation about the immune tests she had ahead of further fertility treatment and how she then went ahead with treatment with immune therapy as well as intralipid infusions yet still miscarried and decided to stop treatment. Listen in full here

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Welcome to our final episode of the miscarriage series. Thank you for listening over the last few weeks. From your feedback, we know that you’ve found this series informative and importantly, it’s made you realize that you’re not alone.

In this final episode, we want to find out why miscarriage happens and so we chat to Dr. Ingrid Granne – Senior Research Fellow in Reproductive Medicine and a Consultant at The John Radcliffe Hospital in Oxford, where Kate also worked a few years ago.

The common causes of miscarriage

Ingrid tells us that the most common cause of miscarriage is due to genetic mistakes in the early stages of cell division, meaning that the pregnancy is unable to develop past the first few weeks.

The age of the woman has a significant effect on the risk of miscarriage. By the time a woman is 45yrs 1 in 2 pregnancies will end in miscarriage. Diabetes and thyroid are also associated with a miscarriage along with increasing weight. Hormonal and immune factors may also cause miscarriage.

The research

Ingrid has been involved with genetic research into miscarriage that will be published soon. There appear to be genetic factors that predispose some women to miscarriage more than others.

Investigating miscarriage

Ingrid says that there is a move to start investigations after 2 miscarriages rather than 3. This will be welcomed by so many women. Looking at the chromosomes of a pregnancy can be very helpful, especially in helping women understand that there is nothing that they did that would have caused the miscarriage.

For recurrent miscarriage, the most useful test is for Antiphospholipid syndrome – a blood test that looks for antibodies in the blood to identify this autoimmune disorder. Other investigations are looking for inherited tendencies for blood clots by a thrombophilia screen. Testing Thyroid function, chromosomes, and the anatomy of the womb are also important tests.

Baby Aspirin and Progesterone

Interestingly, Ingrid doesn’t recommend baby aspirin as there is evidence that it might have the opposite benefit.

A recent study looking at bleeding in early pregnancy showed there might be a benefit in taking progesterone, especially in women who have experienced recurrent miscarriages who are bleeding in early pregnancy. Ingrid believes that in the coming years it may be routine for these women to be prescribed progesterone.

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Welcome to another ‘Meet the Makers’ episode where we chat to Louise Zeniou from Cradle. When we spoke to Louise, she had been having a busy few days with various media interviews, and in-between her busy schedule she managed to sneak in an interview with us whilst sat on the floor outside the toilets in Pret!

Louise has a personal experience of what it feels like to go through early pregnancy loss when she became ill and diagnosed with an ectopic pregnancy. As she was so ill, she was rushed into hospital and had surgery immediately. She talks about the amazing care she received, but after surgery she missed the most basic of items such as a toothbrush and a hairbrush.

The Comfort Bag

From her own experience, Louise started the Comfort Bag Project with the aim to support hospitals, so that in those early moments of pregnancy loss women and men can be provided with toiletries and other products to give them a little comfort and importantly dignity. In the bag, Louise also includes a personal message to give immediate words of comfort following a loss and the ways bereaved parents can connect for support once they have been discharged from the hospital.

How Cradle Supports the NHS

Cradle provides Comfort Bags to various hospitals across the country and it’s growing! From just starting out as one, Louise now has 73 volunteer ambassadors. Cradle also works with Hospital Trusts as the patient voice to help in the development of services and projects for bereaved parents.

Signposting

The role of Cradle is also to signpost to various support and counseling services to offer parents much-needed professional support.

Want to get involved?

Contact Louise for information on how you can become an ambassador for Cradle.

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How are you doing?  Hopefully, you are coping and taking things a day at a time, which we feel is the best approach. Somedays you are acing it and others... maybe not so and that is just fine! We're doing our best to keep sharing out content and hopefully, you know by now, We’re passionate about sharing real-life stories to bring fertility struggles to life.

So meet Kate Pleace who, like Podcast Kate, is a fertility nurse. Kate used to work at Bourne Hall Fertility Clinic in Colchester and found herself on the other side of the consulting room facing early menopause. Kate and her husband decided on egg donation and their treatment was successful the first time.

Progesterone Hypersensitivity

Kate started progesterone treatment to help support the developing pregnancy but unfortunately, things took a surprising turn when Kate became ill as a result of the rare condition Progesterone Hypersensitivity.  Kate and her husband made the difficult decision to stop her progesterone therapy and unfortunately miscarried a few weeks later.

The impact on physical and emotional health

Kate’s physical and emotional recovery took months and Kate felt consumed with grief, all the while she was still working. Eventually Kate sort help and advice from a specialist. This helped with many of her unanswered questions and how the progesterone treatment affected her both physically and mentally during the treatment. Kate recommends that if you’re concerned about any symptoms, however minor, it’s important to reach out to your clinic for help and advice.

Moving forward

Kate has now reached a really positive place in her life, and despite not having children her life is full of so many wonderful things. She says that her experience has made her a stronger person and she’s now doing things that she would have never done before.

It is important to note that Progesterone Hypersensitivity to the degree that Kate experienced it is very rare.

If you have any concerns about this, please speak to your clinic. Plus, do you have a story to tell? Have you gone through something more unusual? If so, please reach out to us, as we would love to hear and tell your story email info@thefertilitypodcast.com 

Definition: Progesterone Hypersensitivity is a rare disorder that has been scarcely, but worldwide reported. Symptoms can range from skin conditions such as urticaria and dermatitis to more severe reactions such as anxiety, weight loss, gastric and vasomotor symptoms.

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This week, we hear from our guest presenter Katy Linderman in conversation with Emilie Jones-Ransley. We asked Katy to have this conversation for us as both ladies have had infertility struggles, due to thin lining issues and talk about being members of 'The Thin Lining Brigade'

Missed Miscarriage

Emilie talks about her experience of missed miscarriage and the surgery she had to had, to remove it ( ERP C)and how after that she didn’t feel right two months later and she had to have further treatment. She explains how traumatic this period of time was for her.  Katy shares her experience of also having to have an ERPC and the issues around her hormones levels being high, 5 weeks later and how awful the experience was as your body still thinks you are pregnant.

Hysteroscopy

Medical procedures can cause scaring and Emile talks about how she only found out by chance after having further fertility investigations by chance. A conversation with her doctor about her periods being regular saw Emilie being booked in for a hysteroscopy, a procedure to look at your uterus with a tiny camera to check your lining.  This was seven months after her second ERPC.

Ashermans  Syndrome

Emilie found out that half her Uterus was full of scars which means there is a layer of scaring on the endometrium meaning it doesn’t shed properly. Both Katy and Emile talk in details about the types of blood changes in your period and how important it is to realise that if it has changed significantly as it could be a sign of Ashermans. Scaring almost makes it very difficult for an embryo to impact and it can also be dangerous and could cause a miscarriage. The scaring can be removed with a laser, however, in Emilie’s case, they punctured her uterus.

The A-listers

Specific Doctors who specialise in these procedures. Medical insurance does cover miscarriage and gynaecology - as these surgeries can be covered. The Ashermans Facebook group shares a list of these people.

Knicker Watch and IVF

Permanently wanting your period and wanting ‘red blood’ when you are having treatment for Ashermans or thin lining treatment. Emilie had three unsuccessful rounds of funded IVF and then they moved onto having further private rounds with PGS testing. After her fourth round, Emilie had the summer off and talks about the importance of having a break during treatment. They then attempted frozen embryo transfers but Emile was still struggling with lining issues.

‘Decent Lining’

We're talking thickness and appearance as the ladies discuss that 'Triple' means -  three layers, so it looks white and the thickest part should be measured and ideally, for IVF it should preferably be 8 mm or above. Normal is 13 or 14mm. Both Katy and Emilie talk about feeling like they couldn’t get off the starting line due to their lining issues and how difficult that is. Feeling like your body isn’t working and the feelings of anger towards your body.

Deciding to use a surrogate

After 10 failed IVF rounds, Emilie and her husband decided to go down the surrogacy route with a Ukrainian Surrogacy and hope to bring their baby girl home in August.

Dr. Adrian Lower  - Asherman’s expert explains

Adrian explains how Ashermans is caused and how it impacts the endometrium. We discuss the number of women who are diagnosed and undiagnosed and Adrian explains how and why Asherman's is largely unrecognized. It could be up to 5% or more of people who have surgical procedures and then have scarring. The problem is that people

We need to talk about miscarriage.

Welcome to the very first episode of The Miscarriage Series where we will spend the coming weeks bringing you real stories and expert interviews about the difficult topic of miscarriage.  This week’s episode is with Dr. Jessica Farren who Kate and I met in London, in her kitchen before we went into lockdown.

Jessica is an Obstetrician and Gynaecologist at Imperial College Health Care Trust and we spoke about her involvement in research that was published earlier this year. Jessica looked at the psychological impact of early pregnancy events and in particular miscarriage.

The Trauma of Miscarriage

The study looked at symptoms relating to anxiety, depression, and post-traumatic stress disorder (PTSD) and how high these levels are shortly after experiencing a miscarriage and then months later. The study found that at 9 months 1:6 women are still experiencing symptoms suggestive of PTSD.

How to improve support

Frequently women are discharged from the hospital very quickly following a miscarriage and often without a follow-up. Jessica suggests that this poses a lost opportunity for support and the ability to ask questions after a miscarriage which can help to reduce self-blame.

Jessica talks about the importance of healthcare staff managing expectations at the first scan, particularly if the scan does not have a positive outcome.

How can we talk more freely about miscarriage?

Jessica talks about the concept of not talking about a pregnancy until after the 12-week point and how it would be much better if women did feel that they can open up and talk before this time, and in particular if they miscarry.

Miscarriage and the Workplace

A miscarriage occurs in a woman’s life span during their peak contribution to society both at work and in the workplace, the impact of PTSD in both environments is huge. The work we are doing as part of our Fertility Matters at Work initiative will be providing support and guidance for anyone dealing with this. 

The First Scan

Jessica tells us that it is very common to have an inconclusive scan at 5-6 weeks but by 8 weeks you would expect to see a pregnancy developing normally. She also mentions that for IVF pregnancies it would be preferable to be able to be more conclusive with scans for this group.

Why it’s not possible to investigate a miscarriage until after 3

70% of miscarriages are genetically abnormal and therefore investigating for this after one or even two miscarriages doesn’t change how anything would be managed going forward. Jessica does think there is a move to investigate after two miscarriages in the future.

The impact of miscarriage on men

The research also considered men and this will be published soon. Jessica did say that whilst men had lower levels of the psychological disorders assessed, they did still suffer.

Dr. Jessica Farren – Research paper

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Meet Katy Leeson, Managing Director of Social Chain who also hosts a podcast called 'I Shouldn't Say This But' and at the time of us chatting had just been nominated for an award for 'Leading the Charge and Pushing the Boundaries' with Campaign Magazine ( a big industry title ) I spoke with Katy in real life at Social Chain's very cool office in central Manchester, in the days where you could do that, which is why Kate isn't in this episode.

Self Protection

Katy spoke about her struggle with the responsibility of being a young female Managing Director. She had imposter syndrome and took herself into therapy sessions to get support on how best to deal with it. In the context of this chat, Katy explained how she made sure she was mentally prepared to talk about her miscarriage in the public sphere because she had no idea what the reaction would be and she was nervous that people would tell her it wasn't the right place or platform  - something so many people fear when talking about infertility.

Baby Loss Awareness Week

Katy shared her story in October 2019, a year on from her miscarriage which happened in December 2018. She spoke about the challenges of that time of year with everybody being together and how it forced her into telling people that I was pregnant, as she wasn't drinking in the Chrimbo celebrations - this was before the '12 week' point. Her family and friends knew and so she also had to share her that she had miscarried on Christmas Eve because she didn't want to get messages wishing her the best Christmas and New Year because I was going to have a baby in the next year. Katy talked about feeling that she was also ruining other people's Christmas because I'd tell them such sad news.

Miscarrying Naturally

Katy spoke about how she miscarried naturally the day before she was due to be put under for the operation. The first the scan she had, she said felt a good connection to someone who really cared and she said 'You look healthy, everything there on the scan looks healthy, you've just started an unfortunate experience, there was just a problem with that egg or that sperm, and you should be fine and I can't wait to see you again' which Katy said gave her such hope as every other interaction she had, felt like she was just being told to get on with things.

Breakdown in Communication.

Katy explained how she was still getting letters about having scans for her pregnancy after she had miscarried due to being registered with two different hospitals and how they were ringing her partner but wouldn't speak to him so he couldn't even act as her  gatekeeper for. This meant in the end, she had to have numerous conversations reliving her experience over and over/

Telling Work

Katy talked about how she had spoken to others about how much of a lift it is, to be told it's not your fault, which is such a straightforward piece of information to give to somebody. We talked about how she had no follow up conversations after going through it and wasn't given any guidance on where to find support. She had stopped her therapy and hadn't told her work as she didn't want to tell them she was going through 'something so horrific'  because she was worried they would think she would then be trying again and be off on Maternity. So she didn't tell anyone and struggled with it from Christmas until Easter - which is when she said the broke down. When she did tell them, they were amazing

Talking it through in Therapy

Katy discussed the grieving process with her therapist and how she had been putting so much pressure on herself with her work and doing the right thing by others. She talked about giving...