COGNITIVE BEHAVIOR THERAPY

The utility of psychological intervention for coping with spontaneous abortion

By Natalène Séjourné, Stacey Callahan, and Henri Chabrolb

QUOTES:

(I have bolded certain passages.)

  • Between 12 and 24% of confirmed pregnancies [end in miscarriage].
  •  The feelings of isolation and blame felt by women who have experienced miscarriage are often poorly confronted by not only their immediate support system, but by health professionals as well (Regan, 2001).
  •  20–40% suffer symptoms of anxiety.
  • After a miscarriage that 51% of women fulfilled DSM- III criteria for depression (Garel et al., 1992). Miscarriage is an unexpected event that can imply sudden and intense pain, bleeding, hospitalisation, and surgical intervention; it thus constitutes a physically traumatising event. In one study, the prevalence of PTSD was observed to be 25% one month after the loss.
  • CBT-based prevention interventions on post-traumatic stress…Many authors underline the interest in using CBT techniques in situations necessitating emotional adaptation, such as grief and loss.
  • CBT for helping women deal with miscarriages emphasising that these methods were particularly suitable for dealing with the feelings of guilt, incapacity, fear, and depression often noted in miscarriage experiences.
  •  Simply discussing the experience does not seem to have any notable positive impact on well- being, and it seems logical to provide more effective support and supplement therapy with a more active therapeutic approach.
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  • About Me

    Me: 41
    DH: 38

    Fertility issue:
    Recurrent Pregnancy Loss
    6 pregnancy losses
    All early
    5 with my own eggs
    1 with donor egg

    DOR
    Abnormal embryos

    Blood:
    Factor V Leiden heterozygous
    MTHFR heterozygous

    AFC: 2 - 12
    AMH: 0.2
    FSH: 6.8
    E2: 40
    LH: 2.8

    History:

    April 2011 -
    Natural conception, first try. Blighted ovum (gestational sac only). D&C to remove products of conception at 9 weeks.

    Oct 2011 -
    Natural conception, first try. Blighted ovum (gestational sac & yolk sac). Took Cytotec to induce miscarriage at 9 weeks. PTSD, depression, anxiety, insomnia, night terrors followed.

    Winter 2012 -
    Two rounds of Femara/Clomid + IUIs at Columbia and RS of NY. The idea: to produce more eggs and increase chances of catching a good one. BFNs.

    April 2012 -
    Natural conception, first try. Ultrasound showed activity in the uterus, but no complete sac. Diagnosed with "missed abortion." Natural miscarriage at 5 weeks.

    June 2012 -
    Conception after 7 mg Femara for 5 days + IUI. Diagnosed with chemical pregnancy. Natural miscarriage at 4.5 weeks.

    August 2012 -
    Natural conception, without trying. Chemical pregnancy and natural miscarriage at 5 weeks.

    October 2012 -
    ODWU at Colorado Center for Reproductive Medicine (CCRM).

    January 2013 -
    IVF with Dr. Schoolcraft.
    Straight Antagonist protocol

    What he predicted:
    I will produce 11 eggs
    Good chance 1 will be normal
    30% chance 2 will be normal
    Transfer 1, then a 45% chance of success
    Transfer 2, then a 65% chance of success

    What happened:
    7 follicles stimulated
    6 mature eggs retrieved
    2 died during ICSI
    4 fertilized
    3 out of 4 embryos CCS-tested
    All abnormal

    ***
    Aug/Sept 2013-
    Frozen Donor Egg IVF at Reproductive Biology Associates (RBA)
    What Dr. Shapiro predicted:
    6 or 7 will fertilize
    1 we will transfer
    1 - 3 we will freeze

    Protocol: Lupron, Vivelle patches, Crinone

    8 frozen eggs from donor thawed
    6 fertilized
    1 Day-5 Grade A XBbb blastocyst transferred
    1 Day-5 Grade A EBbb blastocyst frozen
    1 Day-6 Grade A XBbb blastocyst frozen

    September 13, 2013: Pregnant

    Protocol:
    Prenatal vitamins & baby aspirin,
    Vivelle patches & Crinone

    Beta #1: 171
    Beta #2: 706
    Beta #3: 7,437

    6 w 3 d: measured 6 w 1 d
    FHR: 80 bpm
    Fetus did not grow
    7 w: FHR 121 bpm
    8 w: heart stopped
    9 w: D and C

    Test results: We lost a normal karyotype male for unexplained reasons

    Quit stressful job
    Anti-inflammation diet
    Gluten-free diet
    Vit D, DHA/EPA
    Zoloft
    Therapy/energy work
    Creative Visualization
    Art Therapy

    March 14, 2014:
    Double FET at RBA
    1 Day-5 Grade A EBbb blastocyst
    1 Day-6 Grade A XBbb blastocyst

    March 24, 2014:
    Pregnant

    Protocol:
    Prenatals, baby aspirin, Folgard, Vivelle, Crinone, Lovenox

    Beta #1: 295
    Beta #2: 942
    Beta #3: 12,153

    1 fetus implanted

    Measured on track

    Fetal heart rate:
    7 wk: 127 bpm, 8wk:159 bpm, 9wk: 172 bpm

    Due date: Dec, 4 2014!

    NatureMade (USP Seal) Prenatals and 4000 Vit D3
    Baby aspirin
    40 mg Lovenox
    DHA and EPA
    Folgard 2.2

    Born: One perfect baby boy 12.4.14

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