Hello doctor, I have a history of miscarriage at 18 weeks, and hysteroscopy and laparoscopy confirmed cervical incompetence and my polypoidal endometrium was removed. Recently I conceived again with follicle test procedure during which CG 10000 was injected into my blood, but unfortunately, I had to undergo D and C at eight weeks because of no sign of fetal pole (no yolk sac and heartbeat). My TSH value is 7.44. Please let me know the cause of my first miscarriage and lack of proper development and absence of fetal pole in a second pregnancy. Which is the exact specialty which would be best placed for resolving my problem?
Hello. It is evident by the history that you have cervical incompetence, and that is what the possible cause of your mid-second-trimester spontaneous abortion. Nextly your TSH (stimulating thyroid hormone) levels are high, qualifying you to be hypothyroid, which is the probable cause of anembryonic gestation, the second time. It is essential that your TSH levels should be rough between 2.8 to 3.2 by taking thyroxine supplementation to attain safe levels for conception and avoid future mishaps. Also, it has to be kept in mind that at 16 to 18 weeks of your next gestation, cervical McDonalds or shirodkar stitch has to be applied to the cervix to avoid spontaneous mid-second-trimester abortion. I hope I have answered your query.