Recurrent miscarriage and low AMH - IVF clinic recommendation

[LovesFood1987]

I have had 3 miscarriages, investigations for this has shown that I have low AMH/high FSH on day 2. (AMH was 8, FSH was 13)

We're considering IVF with pgt-a and are looking for clinic recommendations for anyone who has been in this situation

I was 27 when we started trying (31 now) and I'm devastated tbh 😞

I used Create in my 30s after 5 miscarriages and had twins after 5 rounds of IVF

I wouldn't bother doing PGS at your age though - I did one one cycle with PGS and didn't get any normals - in the U.K. you aren't allowed to transfer them (unless it's a low level mosaic and even then lots of clinic refuse) and they have to be destroyed. There is lots of evidence that these embryos can still make healthy babies

I stopped testing and had twins on the next transfer

Thanks so much for your reply. Congratulations on your twins 😊 I will look into the Create clinic 🙂

I have definitely seen that pgt-a hasn't got a huge amount of evidence to suggest it works... Only reason for doing it at my age is because my ovaries are effectively in the 45-50 age category because of my premature ovarian insufficiency. That's the most likely cause for my recurrent miscarriages... My remaining eggs have low viability so theory being that pgt-a will mean no non-viable eggs transferred 🤔

We're at the very start of our journey so appreciate your advice 😊 we've got a lot to learn!

I also went to Create. I have low amh and had 4 miscarriages. We decided not to test the embryos as one of my babies was tested chromosomally normal and the clinic weren't sure how I'd respond to meds / stims. They were preparing me for a day 3 transfer if I didn't get many. In the end I got 7 eggs but only 3 fertilised. I ended up with 3 top quality blastocysts. I had a chemical pregnancy in my fresh cycle and amended my protocol to add more progesterone and got a bfp with my frozen transfer (but still early days). I did mild ivf.

Have you had any answers from recurrent miscarriage testing like clotting issues? I'm on an immune protocol to stop my body rejecting the pregnancy.

Great to hear your experience from create too, they're obviously a popular clinic and we'll definitely look into them🙂

We have had a full (private) recurrent miscarriage investigation including all the clotting factors, ultrasound, thyroid etc. Everything apart from my fsh and Amh are normal 🙂

Hi there, you don’t mention immunes testing. Venusstarr has had that done as have I. Sometimes your body attacks the embryo. Don’t assume it’s low amh! I have very low amh and had 4 mcs , then I tested and had sky high immune reaction. I’ve taken meds to suppress immunity this pregnancy and currently a few weeks from birth 🙏🤞
I also tried pgs route as thought the same as you ( bad eggs) but this was iui pregnancy and untested.
Even with low amh your egg quality is likely to be far better than mine was at nearly 40
there are a few places that do immunes - argc, Gorgy , Shehata. You will find threads on them and can read up. Worth a test to at least rule out before you go the ivf and pgs route . Good luck

Thanks very much for your advice 😊

Just to check (sorry if I'm being dim!) By immune testing do you mean uterine NK cells?

Thanks again 😊

There are two schools of thought. Some (I think prof Quenby) believes in testing uterine cells for NK. Others like the ones I listed above test the blood instead. Don’t think there’s any definitive research on which is right or better. I just had the blood test ( expensive £500 quid ish)

There’s some good info here

www.fertility-academy.co.uk/reproductive-immunology/

I also had LAD testing which shows if you produce antibodies to protect the embryo ( mine was bad result!)

My friend on this forum had many many mcs and multiple euploid fet fails and is now second trimester with immunes at 42.

There’s got to be something in it

That's so interesting. Thank you for the info.

Again sorry if this is a stupid question but is the treatment prednisolone?

Thanks again!

Yes, prednisone 25mg, progesterone (6 pessaries a day) and intralips every couple of months. I also had ivig twice but that’s £££! Also LIT
In addition, I took 75mg baby aspirin, clexane 40mg. I don’t have any clotting issues but they can help blood flow where there are immune issues.
It’s about getting tested and then being prescribed specifically for any issues you have as an individual . You can get ( depending on your gp) an nhs referral to Quenby or Shehata but it does take time. I went private with Gorgy

I'm with Dr Shehata. I did the uterine nk cells test but that came back normal and I miscarried my 4th baby who was chromosomally normal. So I went to Dr Shehata and he tested my peripheral bloods and found that in pregnancy my nk cells go into overdrive. My protocol is hydroxychloroquine, aspirin, prednisolone and intralipids. As I did ivf I've had 2 different types of progesterone support too x

Did you get a bfp @VenusStarr?

I did @Smiler79 but in limbo at the moment. Had a scan with the ivf clinic on Friday at 6+2 but they said the sac was empty, so went to the epu who rescanned me and found a 5mm crl foetal pole and cardiac activity but couldn't see the yolk sac and put me at 6+0. So back on Monday for a rescan.
I do think the fact we got a heartbeat means the immune protocol has worked at it measured the same as my mmc last year but we had no heartbeat then at 5mm.
Just got the worry of what's happening now, feel very uncertain.

Oh no @VenusStarr I actually had something similar with this pregnancy. The sonographer never told me but at 6 weeks there was no heartbeat or fetal pole and said likely mc.
I had to wait a week ( absolute torture isn’t it, especially when you’ve been through this before like we have) well went back and fetal pole , yolk sac , heartbeat etc. The sonographer then said the embryo was tucked in a corner and hard to measure etc so that’s why everything was unclear. Never even mentioned that the first time. Been two days ahead in growth ever since.
I’m sorry it is so hard though , being told one thing then going to epu and them seeing something positive. The crushing low to the hope is the the hardest bit sometimes. Fingers crossed for Monday xx

I'm sorry you had a similar experience @Smiler79 but good news all progressed. That's given me a little bit of hope that we might have similar next week.

I just don't think I'm processing it at all. I'm stuck in the bad news scan. In hindsight I should have asked for the scan to be this week instead but I trusted the clinic to know best. I also have a retroverted uterus so the epu said it makes things more tricky and it did seem like they were tucked right into the sac too. But we had 4 nurses in with us at one point all confirming the heartbeat, so trying to remind myself of that. Thanks for sharing xx

I found it better to exist with no hope in between those scans. I wrote this embryo off as another mc and was shocked it was fine.
A retroverted uterus is notorious for not being able to see things properly especially at this stage. Could you have a private scan this week to see if any progress? Just feel for you waiting til Monday

Dr Shehata's clinic said I can go down this Friday but my husband has to work and it's a 3 hour drive, so just don't want to travel all that way on my own if its bad news. I just don't really want another scan, I can't face getting bad news again @Smiler79 x

I really hate scans , even now. I feel like I can’t breathe for a few seconds. It’s really traumatic. I’m sure it’s some form of ptsd. That’s what my counsellor reckoned anyway. The way I got through the early ones was not to look at the screen. It actually really helped to do that.
Could you go private locally ? It’s just all the waiting until Monday , that’s so difficult 💐

I've started disassociating during scans and procedures. It happened during my transfer this time, it's horrible. I think I'm just going to wait. I'll still have to go on Monday either way as if it's bad news I'll need the epu to test the baby. Totally avoidant. X

It’s the hardest wait , crossing everything for you and will keep you in my prayers

Good luck today @VenusStarr

Thank you @Wakeuptocake it's not good news sadly. The baby died a couple of days after my last scan 💔 so I'm booked in for surgery on Wednesday 😢 we can't seem to get passed week 6, even with the immunes.

@Smiler79 thank you for your support too x

I’m really sorry to hear this news, I’ve sent you a pm x