Which option would you choose for a missed miscarriage?

I've had 2 previous early losses, both naturally conceived pregnancies and both treated conservatively. My first loss was at 6+5, and it took 4 weeks for my hCG to return to normal (I had bleeding for around a week, then it stopped and restarted again). I remember the pain being quite intense for a couple of days. My second loss was at 5+5, but I knew at around 5wks that the pregnancy wasn't viable as my tests didn't progress, so it took a few days for my body to realise this. My hCG was only 46 and the loss was like a heavy period. My current loss is from an IVF pregnancy where I've been taking progesterone pessaries. I've had weeks of bloods and scans. Initially, my hCG rose slowly but then doubled to 903, and after that, the scans showed progression, but I was measuring 2 weeks behind. We saw a heartbeat twice. Went back yesterday at 10+2, and there was no heartbeat. Baby stopped growing shortly after my last scan - measuring 6+5. We want to send the baby off for genetic testing. The hospital has said we can do that with whichever option we choose. I feel like the surgical option would be best for this, but I'm so scared of complications such as scarring that may cause issues with future pregnancies. I know this is rare, but I've experienced lots of rare things already, so this doesn't mean much to me. I'm also a little nervous about being under general anaesthetic, as the last time I was under, I had a cardiac arrest (albeit due to the gas needed for keyhole surgery). I really don't want to wait for the miscarriage to occur naturally, as this whole thing has already been so drawn out. We started medication for this cycle on boxing day, and I've been bracing myself for a miscarriage for the past 6 weeks. Given that my first loss took 4 weeks to resolve, I want things to happen a bit quicker this time. That leaves medical management. But I'm so scared because I've heard this can be super painful. Also, realistically, how easy would it be to collect the baby to send for testing with this method? If you've experienced a missed miscarriage before, which option would you choose if it happened again? x
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Hi I am so sorry for your loss. I had a miscarriage on the 16th of December. I waited three weeks but nothing happens other than slight bleeding then I was given the medication had a pretty horrific bleed and was in bed for most of the week following I had a scan four weeks later to find I had still retained the pregnancy sack so ended up having to undergo surgical management. Now obviously I’m not saying any of this would happen to you however from someone who has done all three options and it took a long period of time to get through the process. It was about eight weeks all in all from start to finish. The surgery is not an easy route, but personally I found it far more preferable as I went to sleep and when I woke up it was done and I could process it for easier. I found the bleeding quite horrific with the medication . But I also know people who have done it and have been okay depending on how far along they were. I was nearly 10 weeks

If I found myself in that unfortunate situation again, I would only ever choose the surgery as I was back on my feet within a couple of days x

Hi my lovely, firstly I’m really sorry for your loss. I had a surgical procedure yesterday, unfortunately on Tuesday I found out I’d had a missed miscarriage also. Devastating to say the least. I was extremely anxious myself and likewise concerned of any complications. Today in myself I’m feeling well physically, emotionally that’s a little different… The care you receive in the hospital, I couldn’t fault one bit. Everyone was very comforting and discreet regarding the sensitive procedure. If you’d like to pop me a message please do, I’d be happy to talk x

So sorry for your losses. I had a missed miscarriage in September and went through the same stress about what option to take and ended up opting for the surgery. I know everyone is different but I was so glad afterwards, I had very minimal pain apart from a few cramps and only light spotting. I had a period 4 weeks later and no known after effects from the surgery. Good luck with your choice x

Hi! Sorry for your loss, I’ve had a missed miscarriages at 8 and a half weeks and medical miscarriage was the best option for me it was not painful and it got it out the way quick. I had a natural one last time (few months after) and it was the most painful! X

I'm super paranoid about complications so went with medical and it was a really positive experience and a close to a horrific chapter.

I went with medical management because the baby stopped at 6w4d and I was 10w1d so almost 4 weeks and I didn't want to do surgery. It was super painful, not gonna lie. But you can sit on the toilet for passing the tissue and use a collider to catch. I did not but I read that is what some women do. I would recommend taking a laxative or enema before if you plan to catch tissue because I had severe diarrhea with my experience. I'm so sorry you are dealing with this and I hope you recover quickly. Feel free to message me if you want some support.

So sorry for your loss. I had a natural loss and actually collected the baby then. It was quite easy to differentiate between that and a clot. My baby was about 6 wks. My experience of medical management has left me with PTSD that I’m just about to start therapy for. This loss, baby was about 9 weeks. Personally I’d never recommend it. It wasn’t a nice experience, it was painful and I bled for 10 weeks and ended up back and forth to the hospital having pregnancy tissue manually removed from my cervix. I felt the grieving process couldn’t really start whilst I was still actively having the miscarriage - so felt it was very drawn out. Although surgical management seems scary… if I was ever in that position again I’d 100% opt for it. It means you can get the physical loss over with much quicker and work on the emotional rollercoaster afterwards. Although scary, I feel it would potentially be less traumatic. Wishing you all the best with what ever you decide to do. Be kind to yourself x

@Charlotte sadly this was exactly my experience. Xx

@Danielle so sorry you’ve been through it too. Absolutely awful and so painful both physically and emotionally. Here if you ever need someone to talk to. X

@Charlotte thank you and you too. I lost 2 pints of blood within 90mins when I took the medication and they didn’t believe me when I kept saying in the three weeks after that something was wrong. Turned out I had retained the whole pregnancy sac and ended up needing surgery x

@Danielle it really is horrible. Mine took 10 weeks to completely pass. I didn’t have surgery but did have 2 occasions where they manually removed tissue whilst I was fully awake and had to have several scans etc too. Just not a nice experience at all. I went in at one point because I was sitting on the toilet and it was like I had a tap on and it wasn’t urine. That was some tissue that was stuck. Personally I’d never touch medical management again x

@Charlotte sounds like you’ve had the same experience as me it’s dreadful. I wouldn’t recommend it to anyone.. The surgery was a much better option because it was over with one go and you don’t see it which for me is far better x

@Danielle I also think you just need to be able to process your loss and begin therapy journey of grieving and recovery - you can’t do that whilst actively miscarrying so it just feels so drawn out. I’m so glad you got what you needed eventually and hope you are doing ok xx

@Charlotte I’m mentally better now it’s over. I was destroyed throughout the whole eight weeks. After the tablets I could barely get out of bed for a week. X

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@Danielle I went through mine in 2023. My rainbow baby was born 10 months ago. My pregnancy with him was awful, full of anxiety and PTSD. If there is one piece of advice I can give you is please seek support to help you get through it properly if you need it. I wish I had. Now that I’m not pregnant and I’m In a good place with my little boy, I’m finally ready to start high intensity trauma therapy. I just wish I’d done jt before falling pregnant again xx

@Vicky - I have been in similar situations as yourself. 2014 - 1st natural conception and missed miscarriage at 9 weeks. I took medication but it ended up in surgical management. This was the worst thing ever. My body took 5 years to recover. My periods went out of sync, I would get reoccurring UTIs, I was constantly on antibiotics. In addition, I have a self diagnosed mildly prolapsed uterus, which is all as a result of the surgical management. I would never opt for this again. 2019 - natural conception and missed miscarriage at 7 weeks. I took medication and had recovered in a week, my period came as normal 5 weeks later. I also drank golden milk (boiled milk, w/turmeric, tsp coconut oil, cinnamon, cardamom and black pepper). This contracts the uterus and helps induce periods and worked for this situation too.

Currently - around 5 weeks pregnant via ivf but only a sac has been seen, no embryo. A follow up scan is in place for next Thursday, but the consultant has already warned me that it's unlikely the pregnancy will go ahead. I'll opt for medical management again and drink my golden milk daily until I'm cleared. I hope this helps. I also have unique situations in pregnancy and my biggest regret is having surgical management 11 years ago. My body wasn't strong enough for it. And I believe there was scar tissues as a result, affecting implantation over the last 10 years

One thing to be aware of is that, I was further ahead at 9 weeks when I needed the surgical management, vs the 7 weeks MMC. So that will impact how difficult it is to pass everything and the amount of blood you lose. Either way, your body will be going through trauma and blood loss. In our culture, there is a saying that you lose more blood during a miscarriage vs a normal birth. I hope you are able to decide and pick what the best option is for you. Xx

After having medical management twice & having 2 very different experiences (one much more painful than the other but less bleeding & one barely any pain but too much bleeding & ended up needing a MVA & a blood transfusion) I’d now opt for surgical in future.

@Vicky - which option did you go with? I hope you are feeling OK x

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