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Secondary Infertility…what test should I have done?

Hi Dr. Ramirez!

I have a beautiful two year old daughter, but I can’t seem to carry another baby. I had a chemical pregnancy earlier this year followed by a blighted ovum. Since then, I have had a recurrent loss panel run. Everything came back normal but a positive ANA result. My doctor told me to start on 81 mg of aspirin a day, but even with the baby aspirin, I’ve had two more chemical pregnancies and am scared that I’m having another. How could my tests come back normal and I’m still having such a hard time? I had no complications with my daughter and I’m only 25 years old. Please help. I’m desperate and losing hope.

A. from Arkansas


Hello A. from the U.S. (Arkansas),

Recurrent pregnancy loss is a difficult problem, and it is possible that the cause has not yet been found, rather than everything being normal.  Have you had the following tests:

  1. Chromosomal testing in you and your husband
  2. Lupus anticoagulant
  3. Antiphospholipid panel
  4. MTHFR
  5. Hysteroscopy

In my patients, often everything will turn up negative, so I then treat empirically with low dose aspirin, mini dose heparin, estrogen, progesterone, and medrol.  This is a standard RPL (recurring pregnancy loss) protocol used by many docs.  You might want to discuss this with your doctor.

Good Luck!

Edward J. Ramirez, M.D., FACOG

Monterey Bay IVF

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