Brief Answer:
MORE THAN 95 % CHANCE OF NORMAL PREGNANCY

Detailed Answer:
Dear XXXXXXX
Thank you for trusting us with your health concern.
I will be glad to assist you with this matter.
However I need a few more details.
1. THe first time round , you conceived within 2 months of trying to do so, am I right ?
2. At how many weeks of pregnancy did you have a miscarriage ?
3. Was a medical abortion done or a surgical one ?
4. Have you been trying to conceive since then ? If not, what method of contraception are you using ?
5. WHat is your height and weight ?
6. Do you have any other significant medical or personal issues ?
7. Can you upload all the test reports rather than typing me out ? This is because different labs have different ranges of what is normal and abnormal, and just typewritten values make little sense, as opposed to scanning and uploading the reports.
That said, most miscarriages occur due to random freaks of nature ( unfortunate, but reassuring ) and not due to parental disease.
They occur due to problems in the genes of the embryo as the embryo grows and divides.
Hence chances of such a mishap occuring again are pretty low actually.
About 10 to 20 percent of pregnancies end in miscarriage. The actual number is probably higher because many miscarriages occur so early in pregnancy that a woman doesn't even know yet that she's pregnant.
Miscarriage is usually a one-time occurrence. Most women who miscarry go on to have a healthy pregnancy after miscarriage. Less than 5 percent of women have two consecutive miscarriages, and only 1 percent have three or more consecutive miscarriages.
SO please take heart, I can understand what a first - time pregnancy loss must have meant to you, particularly in terms of your mental and emotional well being, but you must really and truly believe that I am not uttering mere cliches, but scientifically telling you that you would have a healthy pregnancy the next time round ( more than 95 % chance of that ).
Please upload all reports that have been done so far to investigate the cause of the miscarriage, so that I can suggest if something is amiss or something else needs to be tested for.
You are young and healthy, and it has already been 6 months since that unfortunate event.
It is time now for you to begin trying afresh with a positive attitude .
Looking forward to hearing from you.
Take care.

---

Brief Answer:
ECOSPRIN IS RECOMMENDED, NEED TO LOOK AT REPORTS FOR REST.

Detailed Answer:
Thank you for the update dear XXXXXXX
As such, I cannot comment further without having a look at the reports.
Please upload the lab tests done so far, even the thyroid ones, PCOD ones, all of them - including the ones you mention as normal.
I would want to assess the situation in depth.
Regarding the ANA too, I will let you know if it needs to be repeated once I have the reports in hand.
Ecosprin is recommended for women with a previous pregnancy loss, yes it aids in conserving the pregnancy and preventing a miscarriage.
It should be continued right through the pregnancy.
Folic acid too is vital.
As I said there should be no apprehensions in trying once more, but I will reserve my definitive opinion until I go through your reports.
Looking forward to going through them.
Take care.

---

Brief Answer:
Yes, LMWH and aspirin should be taken throughout pregnancy.

Detailed Answer:
Hello again dear .
I have gone through the ANA report.
IT is positive, but , since you have absolutely no symptoms of auto immune disease, you can actually disregard the report.
I would not see a need to repeat it , however, if your doctor wishes, you may do so.
Since all other tests were normal, you have nothing to worry about.
I would have liked to go through all test reports, even if normal, so that I would have known what all tests were done , and if there were any more I could suggest further.
One important thing is that the abortus ( aborted fetus ) should have been sent for karyotyping ( chromosomal analysis ).
That is a must - was that done ?
Regarding aspirin and low molecular weight heparin, yes, once you conceive, right from the beginning, you should take these , until atleast the third trimester.
It is a proven and scientifically recommended technique to prevent pregnancy loss.
As I said earlier, more than 90 % of women go on to have a successful pregnancy if these proper treatment steps are taken.
There is no need for any anxiety or stress, it will negatively impact your hormones and your body.
Relax, try some yoga / meditation and yes - I can clearly say - please start trying again for a child.
I am sure you would have a wonderful outcome this time.
Take care.

---

Brief Answer:
Answered in numerical order.

Detailed Answer:
Hi again XXXXXXX

Yes, please continue the Ecosprin and Folvite, LMWH will be started with your doctor alongwith progesterone supplementation once pregnancy is confirmed. I am answering your questions in the order in which you have asked them.

1. With irregular cycles, it is very difficult to chart fertile days. As a safe bet, you should remain sexually active from day 10 - 12 of your cycle. If the first day of bleeding is day 1, you should remain sexually active daily or every alternate day starting from day 10 - day 11 of your cycle, and continue till the next 15 days or so.
That way, you would not miss your ovulation days.
The other method is to rely on follicular monitoring ( serial ultrasound scans that track the growth of the egg follicle and can accurately target the days of ovulation ) .
However, you had no trouble conceiving the first time around , even with delayed cycles, without medications, so I anticipate no difficulty this time too.
You can try the same way you were doing the first time.
Ovulation is the release of the egg from the ovary, it remains viable for 2 - 3 days, and the sperm too is viable for upto 2 days in the genital tract of the female, so the fertile days are actually from 2 days prior to ovulation, then including the day of ovulation, and 2 days after ovulation - a period of 5 days.
And since this window is difficult to predict with delayed periods, I am suggesting sexual activity regularly from day 10 onwards.

2. Daily or alternate day during the fertile window.

3. After ovulation, the egg and sperm unite within hours, and the embryo starts developing. It implants in the uterus a week after intercourse ( fertilization ) and the earliest time to detect a pregnancy is when you miss your period.

4. Please take a pregnancy test when the longest time of your period delay has been exceeded. For example, if your cycle length is maximum 38 days, then you should take a test on cycle day 39.
Hope this has helped you.
Would be always welcoming more queries.
Wish you luck .

---

Brief Answer:
Bicornuate uterus is fine, some pointers detailed.

Detailed Answer:
Hi again.
Well you just need to be reasonably healthy, which I assume you are !
Still some pointers for you -
1. Get all the tests done for reasons for a miscarriage. You say they are all normal, however, as stressed earlier, I would have liked to review them to know if any further tests are required. Particularly, karyotype of the aborted fetus.
2. Continue taking Ecosprin and Folic acid.
3. Start LMWH and progesterone in addition to ecosprin and folic acid as soon as a pregnancy is diagnosed.
4. Maintain an ideal BMI ( ideal weight for your height ).
5. Exercise regularly and have a nutritious diet.
5. Avoid drinking/ smoking / drugs / radiation / late nights / irregular hours / stress in personal or professional life )
6. Get in touch with a reputed Gynecologist, and get a checkup done as soon as you miss your period.
7. Remain sexually active during your fertile window.
8. Do not take any medications while you are planning to conceive, before consulting your doctor.
9. Try some yoga / mediation. Surround yourself with soothing music, refreshing photos and memories.
Regarding a bicornuate uterus, that does not lead to missed miscarriage.
It can be associated with preterm labour or less than optimum growth of the baby due to space issues, but more than 90 % of women with bicornuate uterus have a successful pregancy outcome.
Take care, XXXXXXX
Wish you lucK.

---

Brief Answer:
LMWH will only improve symptoms either ways

Detailed Answer:
Hello again.
A positive ANA in absence of any symptoms means nothing as I said.
Even if you had a positive ANA and symptoms of an auto immune disease, the treatment for the condition involves LMWH.
It will only benefit the pregnancy either ways, and improve success rate of a positive pregnancy.
Take care.

---