5 miscarriages in a row and no explanation

[PineappleDilemma]

Hi, I wanted to get some information, a reason for all the hurt and hope for the future. Today it was confirmed on our 8 week us by the fertility clinic the baby has not grown any more since last week (7 week)which measured 6 w 1d no heartbeat, we had iui this time so our date were spot on. They told me to stop my meds, (progesterone pessary 2 a day 400mg, innohep, baby aspin) and said that the hospital will connect me and scan me in a week and I need to decided to go for a d and c, (which I have done twice) nature way, or a tablet for( which I have done once before). I wonder does so many d and c do damage? We also got the fetus tested before, but the tested failed. I have got so many tested done . Bloods, genetic, scan. I do not Suffer with pco . Everything has come back clear . Even my husband swimmer are top Quality. I am Exhausted with trying to find answers. Its being 5 years of trying 5 pregnancies (which 4 off them ended as missed miscarriage all stopped growing between 6 to 8 and half weeks but body continued the pregnancy), one we just got a faint line and then it was gone. I need answers at this stage, please help. Our next step is ivf and we need to make this happen. I am also on 5mg of folic acid and high dose of coq10 and vitamin d. And what do you think is the best option d and c or tablet? Any advice please and thank you

Hi @PineappleDilemma I'm so sorry for your loss. It is heartbreaking to lose a pregnancy and I'm so sorry you are going through this.

Are you in the Uk? If so have you been referred to a recurrent miscarriage service? After three miscarriages you can be referred and they will do further investigations. This can include checking your immune system but also other things.

I've not been myself but there are lots of other women on here who have and might be able to give you more advice.

Again I am so sorry for your losses 💐💐💐

@Janefx40 thank you for the kind words, we live in ireland which is the same after 3 miscarriages they do futher investigations, but never heard about checking your immune system. Also I read things about natural killer cells , which I never being tested . Do they do that in uk ?

@PineappleDilemma I’m really sorry to hear your news just to add in addition to the tests the miscarriage clinic will do… If you’ve had d&c then you’re at risk of developing Ashermans syndrome, adhesions form in the uterus, lining is usually thin, periods light m and if implantation does occur then there is a high risk of miscarriage.

I have had a lot of investigations for recurrent implantation failure recently, many of the tests overlap with those done in recurrent miscarriages. I pushed for a endometrial biopsy to assess my microflora, it is pretty much the only thing that’s been found to be wrong in me, anyone with less than 90% lactobacillus (good bacteria) has just a 5% chance of a live birth, my level came back at 0.00%.

I'm sorry for your losses @PineappleDilemma I've had 4 and all my standard recurrent tests for lupus anticoagulant, thyroid and antiphospholipid syndrome were normal.
I had an nk uterine biopsy after my 3rd and that was also normal, so was prescribed progesterone but had my 4th loss on that (was my 3rd MMC where the baby stopped in week 6, so we knew something else was happening).
So I then had peripheral bloods and I have an overactive immune system (aggressive nk cells which active in pregnancy) which my specialist thinks is the cause of my recurrent losses. So I've been following an immune protocol with hydroxychloroquine, intralipids, prednisolone and cyclogest but I also struggle to conceive and we haven't had a pregnancy in 6 months, so we've started ivf (in the middle of my first round). They've added in clexane to my protocol.

I'd definitely recommend looking into immune factors. Best wishes x

@Gardenlady543 I am quite angry at the moment the doctor never about these tests. Is the UK you are?did you get the endometrial biopsy test done in a specialist or can you get it done in your gp office. Is there anything you can do to improve your good bacteria?

@VenusStarr I am so sorry to hear off your losses , Its Cruelty! Is it the UK you are? I live in ireland and I have never got nk uterine biopsy. Is it like a smear? What are they testing for?
I am the same as you, our baby stopped growing at 6 weeks and I was taking progesterone. I just asked the doctor about peripheral bloods for overative immune system , nk cells attacking the pregnancy. And he didn't know what I was talking about. Could you tell the name of the test? Or is nature killer the medical term they use . Thank you so much ye ladies are really helping with information. I feel like I have to advocate for myself. Doctors are telling me that they done all the standard tests. But that is not good enough. 5 miscarriage is cruel! I need to Exhaust all options

Hi @PineappleDilemma

I'm in the midlands at Care, after my second unsuccessful transfer I said I wanted to pause and have investigations. I had my embryos PGT-a tested and 83% were euploid (normal). Since I had never had a BFP it was clear that I have recurrent implantation failure.

I had a thrombophilia screen and autoantibodies and that didn't flag anything up that would have caused my situation.

I then insisted on a ERA EMMA ALICE (ERA looks at if my endometrium is receptive and EMMA and ALICE look at microflora), my specialist said the ERA is normally done much later down the line and the clinic had never done the EMMA ALICE before. Anyway it came back that my microflora is horrendous. It's extremely easy to fix, 1 week of antibiotics and then probiotics.

I have been having my IVF and investigations privately, it has cost me £16k to date and that's with a access fertility finance package.

The endometrial biopsy will need to be done by a private clinic. You could try taking probiotics to see if it helps if you can't access the test. I am taking femdophilus orally and canesflor vaginally. The microflora is really important and is so often overlooked.

Wow @Gardenlady543. Hopefully now you will get your BFP and naturally. All that time and money, for something that could be cleared up so easily. I am in shock 😲. It must be a relief for you.
I mentioned to my clinic today and said the era is more less testing for progesterone Deficiency and would supplement instead of testing to rule it out .. they also said that the emma Alice is such a rare test and only recommended if there was no implantation. But said it could be done. Was it a high dose off antibiotics you were put on ? Or just a normal dose. I can't remember the last time I took antibiotics, over 10 years anyway. Maybe it could be a solution. The probiotics ill definitely add them to my list of supplements.

The fertility clinic consultant don't believe in over active immune system. And will not do the tests for nk cells . Its mad , cos my husband cousin was failing on trying to conceive and she found out her body was attacking the pregnancy. She had to go to Germany and now she has to set of twins. I know the hse (which is your nhs) don't believe in it aswell, but I am going to stress to them that I want the test done .
Happy trying conceive to you, and lots of baby dust 💙♥️💕

Sorry @VenusStarr i have consumed with my own concerns today and I never mentioned to tell you best off luck with ivf hun. I say your up to your eye balls in it. May you be blessed , Piles of baby dust flying your way x

@PineappleDilemma yeah the ERA is done so that they can determine if more or less progesterone is needed in a frozen transfer cycle, if people have a low ovarian reserve and have limited embryos then it's useful to do it before a transfer but otherwise they don't usually consider it until after a few transfers, I was able to get it after 2 as my embryos were so good, so there was no point in doing trial and error.

The EMMA and ALICE is done on the same sample of the ERA, it's a shame that there isn't an easier way to do this, but unfortunately the most accurate way of determining the bacteria in the uterus is a biopsy of the endometrium. I really wish there was an easy way to test for this, because I had to spend the £16k to get to this point, it's not something that can be considered right off the bat.

The antibiotics recommended dependent on the bacteria that's found, I was put on, co-amoxiclav, my friend was put on metronidazole. We both took treatment for 7 days. And then 10 days of vagina probiotics after. Moving forward I will be continuing vagina probiotics every few weeks and oral probiotics daily. Nobody has told me to do this, but I do not want to get myself into this situation again.

I agree with you about the antibiotics, these days antibodies are very rarely prescribed. I also haven't been on any for many years. In my case I think that the bad bacteria got into my uterus when I had a coil inserted, which was in for six years, the bacteria must've taken over my uterus. With no antibiotics, there was nothing to clear them out and get good bacteria in the region. It makes you think whether antibiotics should be given as a one off dose when the coil is inserted.

The immune stuff can get very complicated, the evidence base for it isn't huge, so that treatment is usually only carried out by specialist clinics.

Dear @PineappleDilemma:
I’m sorry for your loss.
I would like to share this information so you can see if that might be helpful. Pls, make your own research

www.justdani.co.uk/post/dieting
www.rejuv.co.uk/seven-pillars-of-wellness/fertility-nutrition-brian-mcfadden-danielle-parkinson/

Whishing you good luck and may you have good news

@PineappleDilemma sorry to hear of your looses. I had 6mc before having my son. I succeeded with pgs embryo (I need ivf due to male factor) and full Immunes similar to what @VenusStarr as none of the usual tests done by the Nhs clinic found any issues (except for male factor which they don’t think causes mc though I’m sure it played some role).

If u go privately most of the miscarriage experts go down the immune route, mr shehata in London has excellent results with his protocols. I had seen a various consultants and ivf clinics over the years and they all have similar approaches but slightly different ways of testing your immune issues. These specialists don’t suggest Emma and Alice currently for miscarriage either but more for implantation failure.

It might be worth having a saline scan / hysteroscopy to check for ashermans. I did get that from multiple d and c sadly. But it was fixed and I had my son (I’ve now got it again).

You said ur husbands sperm is good - has he had sperm aneuploidy and fragmentation done as they can cause miscarriage. We couldn’t ever test for them as our count was too low but it’s def worth doing them.

Wish u all the best x