Seeking an ObGyn for Miscarriages

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  • Recurrent miscarriage specialists

    (3 replies)

    I am 33 years old and have been through two miscarriages (one at around 10w and one at 5w) which were 4 months apart in 2021. Post that I was diagnosed with hyperthyroidism (the levels started to change right around miscarriage #2 so no way to know what caused #1) due to thyroiditis which the endocrinologist says will take care of itself in the course of a few months. So far, there has been no reason attributed to any of the miscarriages. I have been referred to a recurrent pregnancy loss specialist at Stanford. However, I was just informed that my insurance does not cover this clinic. Therefore, I am looking for other specialists who may be experienced in recurrent pregnancy loss cases to do workups if needed in the future. Thank you in advance for any suggestions! 

    I am so sorry to hear of your losses. I would highly recommend Dr. Mary Davenport. She used to have a clinic in El Sobrante but now only works through "My Catholic Doctor". However, you don't have to be Catholic to see her. After my miscarriage she worked with me to figure out what had happened and then about a year later saved my pregnancy with my twins by carefully monitoring my blood work up/hormone levels and through administering progrestrone shots etc. She is very knowledgable and helped me with resolving other health issues as well that I had had for years and seen many other doctors for who weren't able to help. You can contact her through https://mycatholicdoctor.com/resources/doctors/mary-l-davenport-m-d-f-a-... 

    or call at 314-888-5233 ext. 1005

    I would check about insurance. If she doesn't take yours ask about a sliding scale or if there is a set fee per appointment. She tends to be willing to work with you when it comes to billing. 

    Take care!

    Hi,

    I don't have a specialist and my miscarriages were years ago.  But, I had two miscarriages and then for the next pregnancy I did a progesterone insert.  Something about how the oxygen changes at three months. (The doctor who did my cvc did not think that that does anything but anecdotally several women I know have had success with that insert.).  Well, that pregnancy went the full term and I had a wonderful baby girl.  I was 42.

    All the best to you.

    I am really sorry about your miscarriages.  I also went through two miscarriages this year and was diagnosed Hashimoto's / hypothyroid in March.  

    I'm at Kaiser and just started the process for addressing my losses with a reproductive endocrinologist Dr. Hirata.  But, in general, I've been frustrated with Kaiser who only seem to say that if my TSH is in range, then everything should be okay (it was in range for both losses - but age is also a factor for me).  

    This book about thyroid disorders and pregnancy might be helpful while you find a specialist.  It generally agrees with many other sources that it is probably good to check into a number of nutritional deficiencies that are common with both thyroid fertility issues:  Vitamin D, iron, selenium, Bs, etc.  As well as possibly removing gluten or other foods from your diet.  https://www.amazon.com/gp/product/B01882N8ZU/ref=ppx_yo_dt_b_search_asin...

    I also posted recently about my experience and found some great advice in case it's helpful.  

    https://www.berkeleyparentsnetwork.org/questions/functional-med-dr-pregn...

    All the best to you.  

  • Unfortunately, I've had two miscarriages back-to-back this year. In 2019, I had my first child (a boy) with no complications -- super easy pregnancy. I'm 30 years old, and seem to be having some trouble staying pregnant. With Kaiser, there have been extremely long waits to move forward with any testing. My rheumatologist has indicated that I may have very quiet, very early lupus (no symptoms), but that's the only clue so far as to the consecutive losses. Before we try for a third time, I'm wondering if anyone has been through something similar and had success with a particular OBor reproductive endocrinologist, line of testing, or treatment plan. My gut is telling me that the losses are autoimmune-related. I've looked up Dr. Zouves, who seems to focus on immunology and fertility, but don't think it makes sense for us to pursue IVF since conception doesn't seem to be the problem. Thank you in advance for any and all advice! This is such a lonely and frustrating experience :(

    Hi highly recommend Spring Fertility, Dr. Minjarez in Oakland. They are a fertility clinic and specialize in everything- not just IVF. She is kind, compassionate, and extremely knowledgeable. It’s possible that your insurance doesn’t cover it. But my only regret is not switching my fertility care from Kaiser to Spring sooner. It would have saved time and heartache. 

    I don't have any dr recommendations really but I do know I made a lot of assumptions about what fertility drs do and there is a whole range of things other than IVF. You're having a fertility issue, so I think a fertility dr is a great person to see. It took us several months to get into a dr early this year, so I'd def recommend reaching and scheduling something. We went to UCSF Mission Bay Center for Reproductive Health and saw Dr Noel. Everyone there is amazing. Good luck and I'm so sorry for your losses. 

    I’m so sorry for your losses. I had 3 early miscarriages (at 9 and 11 weeks), no previous live births- I went to UCLA high risk OB chief who prescribed natural progesterone suppositories until 11th week as soon as I became pregnant. I went on to have 4 normal pregnancies, each with the supplement to be on safe side and had no additional miscarriages. I suggest consulting a high risk OB at UCSF. Good luck! 

    I'm so sorry to hear about your losses. I am 38 and went through 3 recurrent losses in late 2017 and 2018 before having my son last year and am also with Kaiser. My experience does not sound totally similar to yours (no indication of auto-immune issues for me), but will share a few things in case they are helpful. There is bloodwork specific to recurrent miscarriages that my OB was able to order for me (you should be able to ask for it, and if you want me to look up exactly what all they tested, DM me and i can look it up). Then, i got referred to Kaiser's fertility services. While i live in E bay, i was working in SF so was using SF's Kaiser services at that time, and my OB said that she heard E bay ones were much more backed up, so if you don't mind traveling to SF, that might be worth pursuing? I ended up being diagnosed with a borderline case of PCOS and took a supplement called myoinositol specific to that. Also unrelated to PCOS, from positive pregnancy test i took baby aspirin and progesterone daily, which are pretty standard recurrent miscarriage treatments. I have no idea if any of these things helped or we just got lucky. One other thing: not sure how far along you have gotten before miscarrying, i had 2 very early and 1 at 9.5 weeks, and the one at 9.5 weeks i was able to request they test to determine whether it had chromosomal abnormalities (which is the most common reason for miscarriages) - because mine had normal chromosomes, it was an indicator that something else was likely going on. 

    I definitely know it can be a frustrating and lonely experience, but I've also been surprised to become acquainted with so many people who have been through stuff like this, it just is that people don't typically talk about it. Good luck to you, and best wishes for a sticky pregnancy soon!

    I don’t have any advice , just wanted to say that I’m so sorry that you’re experiencing this. I’m sending positive energy and love your way.

    Hi there

    Sorry to hear about your loss and struggles. I moved here recently from Ireland. I imagine most likely you’ll be advised to go on clexane injections in combo with daily baby aspirin. I had 6 miscarriages and ten rounds of ivf. I’ve seen and been through it all. I’ve mild lupus with severe endometriosis. Once I was put on that protocol for recurrent loss, we had our baby girl 

    good luck! 
    Sarah 

    No doctor recommendations, but maybe check to see if you’re a carrier of the homozygous MTHFR gene mutation. It’s a relatively common gene variant and is linked to recurrent miscarriages. Dr. Google can tell you more, including the potential treatment of taking a baby aspirin a day while pregnant. 

    I’m so sorry for your losses. It is heartbreaking and I’m sending you good thoughts.

    I had back to back miscarriages in 2019 (had my first child in 2017). My doctor (Sutter Health) said up to 3 miscarriages is considered “normal”, though it felt anything but normal. I’m a bit older than you, mid-30s, and mentioned my concerns about getting older and having enough time to have another baby. She agreed after the second miscarriage that we should pursue testing, starting with a test I can’t think of and a hysterosalpingogram. I got the feeling that normally she wouldn’t pursue this route until after the third miscarriage. It is a PPO, and Kaiser may be different-I had Kaiser for years and found that they seemed to have “rules” about when treatment was allowed. I had a baby this summer (after 2 miscarriages, got pregnant before pursuing the testing) and have friends who had three miscarriages before having kids. I have no idea if it is “normal” or not. That said, trust your body and if something feels off, pursue it. Wishing you all the best.

    I'm so sorry to hear about your losses. I went through something similar and recall that the worst part, for me, was the agony of not understanding what was happening.

    After having my first child at age 35, I had three miscarriages back to back in the span of about one year when I was 36-37. I have an autoimmune disorder (hashimoto's thyroiditis) and was very concerned that there might be an undiagnosed health condition causing the miscarriages. Like you, I had zero trouble conceiving; just did not manage to stay pregnant past 12 weeks. After my third miscarriage, I saw Heather Huddleston, a reproductive endocrinologist at UCSF. I sought her out because she specializes in recurrent miscarriages and because there's still so much we don't understand about miscarriage, but I reasoned that someone working in academia would have the latest research at her fingertips. And I was not disappointed in that regard. She was so much more informative than my "normal" OB's office was.

    The first thing she did during our appointment was show me the data that pertained to women with my age and health history. The data showed two things: 1) how common it is to suffer multiple miscarriages, for women of all ages and 2) that even at my "advanced" age, I still had a very high likelihood of conceiving and carrying a baby to full term with medical intervention of any kind. One of my takeaways was that the conventional wisdom around miscarriage - that it is super rare among young women but very common among women over 35 - is not quite that straightforward and that there's a much broader range of experiences that can still be called "normal." She encouraged me to try again and also expressed a willingness to continue to work with me. I did as she suggested and my next pregnancy was the one that led to the birth of my second child, so I never did work with her on a more detailed treatment plan. But I really, really liked her and remember her as a bright spot during what was otherwise an anxious and painful time.

    I wish you the best!

    Just a note on not pursuing IVF because conception doesn't seem to be the problem.  I managed to conceive three times (with some minimal fertility treatment such as Clomid) but each pregnancy ended in either miscarriage, or in one case, a partial molar pregnancy that had to be terminated.  After these experiences, my reproductive endocrinologist suggested IVF, because she felt that with IVF, the most promising embryos can be selected, and the chances of miscarriage of a faulty embryo were thus lowered.  Obviously just anecdotal, but on our first IVF attempt we ended up with two embryos implanting, and healthy twins eight months later.

    I can recommend Susan Willman as an excellent RE.  I don't know if she has any particular expertise in immunology.  Best of luck to you--I sympathize, it is indeed a difficult experience.

    Hi, I would definitely recommend seeing a reproductive endocrinologist as your next step since you are already under the care of rheumatologist.  While I saw an RE for a different issue, they will be the most knowledgeable in what tests to perform for RPL.  For example, they could help figure out whether it's a uterine, blood or possibly a genetic issue with the embryos. I was very happy with my treatment at Spring Fertility.  I saw Dr. Klatsky at the San Francisco office, but they have east bay and south bay offices as well. I would also recommend joining reddit (if you don't have it already), and joining the r/infertility group.  I learned so much from these daily conversations between women going through the same thing and it made me feel less alone.   

    I'm so sorry you're going through this. 

    I had a similar experience about 5 years ago when my husband and I were trying to get pregnant. I also have Kaiser, and my experience was that it required some significant pushing on my part to have them recommend treatment. (They either told me it wasn't a problem, keep trying, or tried to steer me straight to IVF, which doesn't really make sense if conception is happening relatively easily.) As hard as it was in the midst of grieving, I ended up getting a recommendation to see a reproductive endocrinologist, Dr Orkun Tan, who I REALLY appreciated. He does some appointments in Oakland, but is mostly out of Kaiser San Ramon. He did blood test, a uterine saline test to check any physical issues, and an ultrasound (I think that was it, it's been a while). I ended up getting prescribed a thyroid hormone, and got pregnant pretty soon after, so assuming it helped. He also monitored the early pregnancy directly, and I had a lot more early pregnancy exams than a standard pregnancy, which really helped mitigate fear/worry.

    Sending you and your family good thoughts. It's a hard situation. Happy to answer any questions directly, too.

    I don't have any advice or recommendations, but what you are experiencing is really hard and sad and I'm sorry you are having to go through this. I commend you for seeking the answers and not giving up. 

    About 25% of pregnancies end in miscarriage. So, given that probability. women have about a 6% chance of having one right after the other. That's significant. It may just be a fluke. I know someone who had back-to-back miscarriages and then went on to have healthy pregnancies and healthy children with no more miscarriages. Wishing you future success. 

  • I'm 40 seeking to conceive child #2 and just had an early miscarriage. In the process, I came to feel that my OB's office was not a good fit for me. Because of the impersonal approach of the practice group, I hardly ever talked to the same person twice, and efforts to get help during the miscarriage were met with slow replies or non-responsiveness. Unfortunately, as my insurance doesn't cover fertility, I can't go directly to an RE. Can you recommend an OB who is great on fertility issues? And / or can you recommend an OB who is available when you need them (my OB at this practice group was booked up for the next three months solid!) and in a well-run practice that allows you to build human connections? (I hope my desires don't sound unrealistic. I actually had a good experience at Kaiser because I always saw the same OB, and when I got pregnant last time they efficiently ordered a small suite of labs to make sure everything was going well. But now we're with Blue Cross Blue Shield.) Thank you!

    Sorry to hear about your miscarriage. She’s not an ob but CNM Lindy Johnson may fit your needs. She delivers at Alta bates. I had the same issues with my ob office, which is why I switched. Her care is definitely different-more midwife style-than an on but imo is better and she is always availabe by phone. She doesn’t see you until you are already pregnant so you’d need to find a separate doc for fertility.

    I had a great OB/Fertility doctor, however it is in San Francisco, UCSF, Heather Huddleston (https://www.ucsfhealth.org/heather.huddleston).

Archived Q&A and Reviews


 

April 2004

Hi, I have experienced a miscarraige 8 months ago. I know first time m/c is fairly common, but why can't you take an active role in prevention as to having to wait for the third one? I was upset by the casual way my current OB/G just shrugged it off saying it was probably chromosomal difficulties (which might be the case, but I felt like I was hanged out to dry) Does anyone have information on, or experience with a caring and understainding OB/G that is more supportive and involved after a first time miscarraige. And which shows an interest in prevention, natural and non interventional aproach to pregnancy. Someone that does perhaps strike me as such a person is Dr. Albertine Omani and the East Bay Perinatal Medical Associates. Any recent recommendations and/or experiences with Dr. Omani and the group? Many thanks Anon


Hi, I had an experience with Dr Albertine Omani (which I think relates somewhat to your situation) I'd like to share with you. If you'd like to email me about it please feel free. Linda


I offer you support and sorry to hear of your loss. After two miscarriages, I had to push myself to finally talk about it with other women. I learned so much and wished I hadn't kept silent for so long. I learned there are tests that can be done to make sure everything is working as it should to support subsequent pregnancies (HCG & progesterone levels for example).

I, too, was frustrated with the rule of three most doctors follow before investigating more aggressively into the cause for miscarriage. After my second m/c, I told my doctor I didn't have time to wait for a third (I am 41). As he reached for his pad to write out a Rx for Clomid, I told him I obviously didn't have trouble conceiving and didn't think that was the answer. With his fingers laced on top of his desk, he asked, ''Then what do you want from me?'' I asked about progesterone which he didn't seem to support. After I left this consultation, I knew I would not be returning.

I switched to a doctor who immediately ran lab work to check my hormone levels (results all were normal). I also made an appointment with Dr. Katz in SF. His office seemed in favor of uncovering causes (auto immune factors, uterine factors, bacteria factors). As fate would have it, I took a home pregnancy test three days before my appointment with Dr. Katz and cancelled my appointment. My new OB put me on progesterone as a ''can't hurt might help'' measure.

Please contact me if you have any specific questions. I wish you all the best. mg


August 2001

I've checked the website several times, and all the advice is very old. I formerly used Dr. Heather Irwin, and really loved her, but she retired last fall. I've heard really mixed feedback about Dr. Chin, who is taking Dr. Irwin's patients: many have said he's very arrogant and they really didn't like him, but that he was good at what he did. I know that I don't do well with arrogance, so I've been looking around. All the women ob/gyn's that I've called are not accepting new patients, and I think I'd prefer a woman, though I also realize my husband is probably more comfortable with men (and his comfort is also important). I've seen Dr. Streitfeld, and sometimes I like him (obviously very smart, and he does seem to care, and I can usually get him on the phone if needed, and his nurse is great), but sometimes I feel like he's just too disorganized for my comfort (always late for appointments, sometimes forgetting what we've already looked into). I've lost two pregnancies in the last four months, and I'd just like to talk to some other Drs. to find out how they'd approach the problem. I lost them both at 6 weeks, and I don't want to go through this several more times without more information or trying to find out what the problem is (other than just bad luck, which I realize is a possibility). Does anybody know of other ob/gyn Dr. that they love? I'm pretty analytical, and do best w/ a Dr. who's willing to tell me exactly what they are doing and why, and what my other options are. I'm also happy to do more research if pointed in the right direction (e.g., reading books to figure out what other factors can be going in to the problem). Or are my frustrations just kind of the way it is with any dr.? I'm also considered an older mom, so waiting around for the next 5 years is not an option. Also, do others out there have experience w/ multiple miscarriage, and do they have advice or recommendations about that? Books? Experience? Thanks.


Please consider giving Dr. Streitfeld another chance. It's in the nature of OB/Gyn's to be late... (see Hank Streitfeld recommendations ). Fran


From everything you wrote, it sounds like you'd love Dr. Susan Willman ....


Just wanted to let you know that I am currently seeing Dr. Heather Irwin , she is back in practice ....


I highly recommend Dr. Amy Huibonhua at Omni OBGYN ... One other thing.....since you have had a few miscarriages right at 6 weeks, maybe a visit to a fertility specialist is appropriate (even before seeing an OBGYN)...it could be that there is something going on that a fertility specialist could diagnose and as you said that you are older why not go directly to a specialist??? Just a thought!! Ruth


I'm so sorry to hear of your losses. We have personal experience with infertility and wanted to recommend the website www.inciid.org especially the section on miscarriages which describes the immune issues which might be involved in multiple losses. There is a doctor on the bulletin board who answers questions as well. This page has the bulletin board/forum for miscarriage and immune issues: http://www.inciid.org/forums/immune/index.html This has helpful fact sheets which describe the basic issues pertaining to miscarriage http://www.inciid.org/fact.html I am new to the area so do not have any doctor recommendations, but my own experience has been that Reproductive Endocrinoligists (as opposed to regular OB/GYN's) were very knowledgeable and compassionate about reproductive concerns. Jen


I'd like to recommend Dr. Mickie Adams at Alta Bates Perinatal Group... Heidi


I was sorry to read about your miscarriages...that's so hard. It happened to me too. I found it very helpful to go to a compassionate fertility doctor to discuss possible causes and strategies for getting pregnant again and having it actually work. The doctor I chose was Louis Weckstein of San Ramon. I recommend him without reserve. Also I found it very helpful to join Resolve, an infertility support group. (They're probably online and I think that they're also in the phone book.) Marina Resolve of Northern California: http://www.resolvenc.org/


I am currently in my last month of pregnancy at the practice where Dr. Heather Irwin and Dr. Chin are ... Linda


I just gave birth to a beautiful baby girl last month after three early miscarriages in a row, and I am sure I have Dr. Streitfeld to thank for it! ... Marguerite


If you can switch insurance to be able to use the high-risk ob team at Alta Bates, I highly recommend them. Dr. Marinoff was my doctor who I went to in parallel with my excellent ob. I did not suffer from pre-term labor, but was a high-risk patient. Kathy


I have the perfect OB/GYN for you. Her name is Kimberley Fillmore ...

As far as advice about multiple miscarriage, all I can say is they suck and do what you can to avoid them. I've had three miscarriages and one pregnancy that ended in disaster, so that is one area where I'm very experienced. I am constantly anemic because I lost so much blood during the miscarriages that it's taking forever to get my iron reserves back to normal, not to mention I think I had/have some form of post-traumatic stress disorder. The emotional demands are enormous. Good luck, Julie


I am so sorry to hear of your losses. The book Motherhood After Miscarriage, was very helpful to me. I believe I found it at Amazon. We love or OB/GYN practice, OB/GYN Partners for Health in Oakland ...


You might want to skip the OB/GYN route and go straight to an infertility specialist about miscarriages just to be safe. I saw Dr. Robert Taylor at UCSF ....

The INCIID website contains a wealth of information (but try not to let it scare you) on infertility, miscarriage, conceiving. Contacting RESOLVE is also a good place to start. The book 'Take Charge of Your Fertility' can help get you started observing your cycle to see if everything is OK there.

As far as OB/GYNs are concerned I've found Katarina Lanner-Cusin to be compassionate, careful and conservative in dealing with miscarriage....


With several recommendations, I began seeing Dr. Amy Huibonhoa ...


You need to see a reproductive endocrinologist, not just an Ob-Gyn, although many of them won't tell you that. Most will give you a referral, however. If not, switch to one that will refer you right away. You could have an immunological problem such as anti-phospholipid antibodies or natural killer cells. Check Dr. Beer's work on the web. Even if the tests (which only a few labs, including one called something like Reproductive Immunology Associates, can do) come up negative, it never hurts to take one baby aspirin a day. Also check for celiac disease -- test for antiendomysial, antigliadin and antireticulin antibodies. A search on the internet, including medline, for recurrent miscarriage, will turn up a wealth of information. Good luck.


I really like Dr. Betsy Matlock at OBGYN medical group. (She may well be one of the many women OBGYNs who is not taking new patients.) I saw every doctor in that practice at one point or another when I spent 3 months in the hospital with preterm labor (which FINALLY resulted in a healthy child). Some didn't seem to take the issues seriously, but others were knowledgable and sympathetic. When my own doctor retired from the group, I switched to Matlock. Also, there used to be a support group at Alta Bates Hospital called SAND, standing for Support After Neonatal Death. I found this group EXTREMELY helpful after losing one child through premature birth and then experiencing subsequent infertility and a miscarriage. It was a great place to get info on different doctors and their approaches.


I agree with all the people who suggested you see a Reproductive Endocrinologist (RE) and investigate possible immunological problems. In the short term, you might want to talk with your OB-GYN about taking one baby aspirin a day and continuing it through week 13 of your pregnancy (it's available from your pharmacist without a prescription). Infertility-related newsgroups provide a place to share information with other patients about the latest treatments and the best REs. I'm not sure how you subscribe to newsgroups-- though on AOL it was as easy as clicking a button. In any case, a key word search for the name of my favorite newsgroup, alt.inferility, led me to this source: http://www.fertilityplus.org/faq/infertility.html. It lists all the infertility newsgroups and provides a lot of useful information. Another avenue you may want to try is acupuncture. My RE actually used acupuncture as part of his protocol, and you'll find many great acupuncturists in the Bay Area. My final piece of advice is to keep trying to find a doctor who helps you. If your gut feeling is that it's time to move on, then do it. My total time in treatment was 5 years, but it wasn't until I found RE#3 (through the recommendation of other patients on alt.infertility) that we got results. My beautiful miracle baby is now 2 years old. Maria


In the previous newsletter, two people recommended Dr. Katerina Lanner-Cusin ...


I want to add my voice to the accolades for Hank Streitfeld . ...