Secondary infertility, IVF and recurrent miscarriage!

[Ticktock40]

This is a long one but I would really appreciate some advice.

I started TTC in 2019 and fell pregnant really quickly. After a tough first trimester with severe sickness and bleeding, at 17 weeks I found out my son had died. I was devastated.

Throughout the following year we continued TTC but had no luck. I visited the GP who did the standard tests and everything was ‘fine’. I was then referred to a fertility clinic where I was advised to start ivf asap due to my age. (I was 38 at this point).

I started my first round in Summer 2021 and we made 6 day 5 hatching blasts. I had a fresh transfer and the rest were frozen. Sadly, my first transfer ended in a mmc at 7 weeks. I then proceeded to have the other blastocysts transferred throughout the year which either failed or ended in chemical pregnancies. In this time I was seen by the recurrent miscarriage unit who found no reason for my losses. (Although they only did bloods and a scan of my uterus). After my last transfer of this round I had my progesterone tested and as it was low, I was prescribed Lubion as well as progesterone pessaries. I also take clexane as after my son died I tested positive for lupus anticoagulant (although I have tested negative ever since).

I started my second round just before turning 40 and although the egg collection seemed to go similarly well to last time, we only got 2 day 5 blasts. I had one transferred and one frozen. I was shocked to learn I was pregnant again but after some one sided pain, I had a scan and they found an empty sac at 6.5 weeks. I have to go back next week to be rescanned but at this point, it all feels pretty hopeless.

I’m just wondering what to do now, I feel so close to giving up but equally, can the last almost 3 years be in vain? I had planned to do PGT-a testing this time but after only getting 2 blasts, I was advised not to. I am planning on asking my GP to refer me to Tommys in Birmingham in the hope they might do more thorough testing than my local recurrent miscarriage clinic did.

If you read all that, thank you. If you can offer me any words of advice or recommendations for what to do next etc, I would really appreciate it.

Thanks in advance.

Shameless bump!
Anyone…?

Really sorry to hear everything you've been through. You're doing all the right things. Fingers crossed for you.

Can't be easy, and so sorry to hear the difficulties you have faced.

You say secondary infertility does this mean you have a child already, if so how long ago was this? Or were you referring to the unfortunate MC.

Thank you for your replies.

@BabyOnBoard90 I have a teenage son who I had with a previous partner. I was obviously significantly younger then too.

I'm very sorry for your losses @Ticktock40 ❤️ ask to have this pregnancy tested, even though it is an empty sac they might be able to get some genetic information which could be helpful.

I've had recurrent losses and was seen by a Tommy's. Ask your GP to refer you but I'll be honest, they have done very little for me - wouldn't even prescribe progesterone until I'd had 4 losses abd because everything was normal they just told me to come back wgen im next pregnant. I 2 more losses under their care (saw them after my 2nd).

If you can, look into Reproductive Immunology/ nk cells. I have been found to have an overactive immune system in pregnancy so need additional medication. Sadly I have continued to have losses so its not a complete guarantee but I do take some comfort that we're no longer unexplained recurrent losses. Our last embryo transfer failed so I didn't get a chance to try a different protocol yet.

I would suggest genetic test your embryos and any future ones and consider prednisolone for transfer and ask for recurrent miscarriage bloods from your clinic. It’s soul destroying. I know only too well how hard all this is. Don’t be afraid to pay for another consultation elsewhere to see if they would do or suggest anything different.

@Ticktock40 I am so sorry for your losses, it’s just heartbreaking isn’t it. I would second what @Everhopeful41 said which is to get a second opinion. I am currently with the evewell and they said there is no lower limit on them doing genetic testing I.e they could send just the one for testing. Of course there is the cost involved. We got 4 blasts in our last round (so much more successful than all our previous rounds at our other clinic) and they tested them all and turns out only one was genetically normal, however we haven’t transferred yet so can’t say yet as to whether this will have an impact, but either way a second opinion can often be helpful. Best of luck xx

Thanks so much for your replies and I’m so sorry to the people who have been through this too. Its really shit!

I was rescanned yesterday at the clinic and there is now a small fetal pole and slow heart rate. I’m measuring much too far behind for it to be ok so it’s just a case of waiting now. I’m back to the EPU tomorrow.

@Everhopeful41 I think you’re right about getting a second opinion. I feel like I’m shooting in the dark. My consultant kept saying it’s a numbers game but after 7 embryos not working out, something is wrong!

@VenusStarr Who tests for NK cells, the recurrent miscarriage unit or the ivf clinic? I definitely think I need more tests. I’ve also read about having a hysteroscopy, hycosy and hysterosalpingogram. I’ve only ever had a 3D scan and bloods.

@HopeSpringsEternal123 Do you mind me asking if you changed your protocol the last time when your round was more successful?

Yes they did - the main change was that they put me on growth hormone for a month before my IVF cycle, and they also had me on DHEA which is a kind of medical grade supplement for a couple of months before the cycle. They also suggested a couple more supplements e.g Co Q10 which I was taking before but they upped the dose. It does seem to have made quite a difference. Our first two rounds we only got one ok embryo (both failed) and the third we got 2 (one MMC at 9 weeks and 1 chemical), although during this time my husband’s scores improved dramatically due to lifestyle changes as well. It’s hard to know if it is a coincidence or not but given the change I think it had something to do with it. Best of luck with whatever you decide to do xx

@Ticktock40 just wanted to post as I’m in a similar situation. I’ve had 5 losses in the last two years (2, chemicals, 2 at 5 weeks and 1at 6 weeks) also have one living child from 2019. these were natural conceptions not IVF. I’m also stuck as to what to do next. My most recent loss was a chemical (had progesterone from positive test but only took it for 4 days as test were so faint).
Hope your next scan goes ok, good news there was progress but I know how all the bad news gets you bogged down.
Ive heard lots about Dr Shehata but he’s so expensive not sure it will be an option for us

Like Venusstarr I had numerous mmcs. I went to Gorgy who you can see lists of posts about on here. Dr Shehata also specialises in immunes.
I’m sorry, it’s so awful isn’t it. I was totally bereft and in a dark place with all the losses. I had a baby through the immunes protocol and I’m pretty certain it made the difference

@Ticktock40 I've been trying for over a year with 3 early losses, miscarrying at the same time for each. Like @VenusStarr I've had the tests done under Dr Shehata's NHS clinic and have been diagnosed with high NK cells. My guess is this could be the case for you too. You can either ask the GP to be referred to his nhs clinic (this takes a loooong time - I live in his borough so got this anyway and it took 8 months in total) or go private but it's expensive to test.