Am I mad to consider IVF for recurrent miscarriage?

[Groundhoghcg]

So I'm currently recovering from miscarriage #6. I'm fortunate to have one living DS (3) but he was born between 7 lost pregnancies between weeks 4-8 (6 miscarriages + 1 ectopic)

I saw Prof Brosens in the implantation clinic and was told I had low uterine NK cells and low stem cells, I was put on sitagliptin for this but on finishing the course of this I immediately fell pregnant with the baby I miscarried at 8wks.

I've been on progesterone and heparin, and I've had the usual recurrent miscarriage tests. I think the only two remaining causes are high NK cells and potentially sperm fragmentation on DP's side.

I can't quite bring myself to approach Dr Shehata at the CRP, it sounds like folk end up spending £££££ there and I'm not really convinced by his results. Happy to be told I'm wrong!!

I was wondering about doing IVF with PGD and ICSI, I've found a few clinics that offer the pred + intralipids alongside treatment so I could feel like I'm giving DS one last roll of the dice in having a sibling. This obv wont be cheap but I don't think from reading online that this in total will be more expensive than CRP?! I seem to weirdly get pregnant so easily, I feel like if I can put an embryo in I know is good I'll be in with a chance?

Hi!!
I've also had 4 miscarriages in 12 months.
Various tests and investigations show nothing major wrong but will be on heparin injections and steriods for the next pregnancy.
Me and my partner have just had karyotyping done to see if there's a chromosome reason we're miscarrying.
Have you had this ?
If that comes back we've got a problem we'll go straight to ivf with pgt.
If all 'normal' we will try again if we have another miscarriage then it will be ivf for us too.
Sorry to hear about your losses! Here's hoping we both have happy outcomes.

Hello,

I’ve only had the 2 CPs (one with a pretty full on miscarriage) and it’s given me the push to have PGT testing in the hope of a chromosominally normal embryo sticking.

good luck!

I went down the IVF route after a similar number of losses as well as ectopics. It felt like the only test we hadn't done - looking at what was happening to those embryos from moment of conception to point of transfer. It did give us some insights - my egg quality was poor for My age - fertilisation rates were really low. Plus quality of embryos on day 3 weren't good. I did do PGTA but to be honest I had such low blastocyst numbers that I sort of wish I hadn't bothered as I didn't get any genetic normal embryos (age 32) - I did lots of research on mosaic embryos etc and did get my clinic to agree to transfer one but it really defeated the point of PGTA in the first place. But if you drop over £10k on a single round of IVF only to get no normal embryos trust me you don't want to walk away without having even attempted a transfer. For me I knew I could mentally go through another miscarriage if it meant giving an embryo a chance. By rounds 3-5 of IVF the doctors and I had a clearer idea of what was going on and this did enable us to change strategy and I did have healthy twins. So for me it was worth it. I spent nearly £40k though.....

I have recurrent miscarriages and I am seeing Dr Shehata. We need ivf now as can no longer conceive naturally (my first 4 were natural, but it took us 18 months to conceive initially).

I've also see Prof Brosens and took sitagliptin but it caused major lining issues for me and I've not conceived since taking it.

Have you tested any of your losses? Our 4th was a natural pregnancy with progesterone (prescribed by Prof B as my first biopsy was normal, second after this loss was very low, am sceptical of the biopsy now as its just numbers). That baby was healthy and was my 3rd MMC where the baby stops growing in week 6, so a definite pattern. So we went to Dr S. Diagnosed with very overactive nk cells in pregnancy.

Unfortunately I have had 2 more losses, first was a progesterone issue, so have to have 2 types of progesterone now. Second was a MMC again at 6 weeks after seeing a heartbeat. My immune issues are so aggressive that the meds didn't work. We tested the baby and she was healthy too.

We're doing a 3 cycle ivf package soon. But not doing pgta - Dr Shehata doesn't think that's our issue. Although we now have male factor issues now, my dh was very sick earlier this year and its had a bad impact on his sperm. I'm not confident we'll even get blastocysts this time. Similar to @thelonemommabear I want to get a transfer out of this and give them a chance. This is our last go at trying for a baby (we have no living children). After this, we'll stop and live childfree.

You've got to choose what you feel most comfortable with x

Thanks for the replies, my head is in a spin with this

@Amyb87 We haven't done karotyping, I believe its only responsible for a minority of recurrent miscarriages and as we have one living child I haven't thought this would be helpful? Perhaps I'm wrong though

@thelonemommabear what an ordeal, so pleased it ended well for you. We definitely don't have 40k to gamble on this but I can understand why you made those choices. Did you do any immune as part if your ivf?

@VenusStarr I'm so sorry for what you've been through. I can relate to the 'last go'

Can I ask about what immune protocols CRP usually use? It looks like for testing alone we'd be down at least 3K and I could get IVF with ICSI and pred + intralipids in Greece for that.

I agree about karyotyping - I asked my clinic and they said no point unless you have a suspicion that there is a genetic issue in the family. Karyotyping is very individual - it doesn't tell you about the genetics of a baby you make with your partner just your own genetics.

I did do basic immunes - course of prednisolone leading up to and post transfer. But I did that on every transfer so I wouldn't say it was the key to what helped the twins stick. In fact the twins transfer was in lockdown and the clinic policy didn't allow you take it due to risk if you caught covid with a lowered immune system and I was warned this policy would be in place for at least another year.

Intralipids my clinic didn't agree in and thought wasn't worth the money - it can cost hundreds of pounds per transfer and isn't rated that highly by the HFEAA

I would recommend reading up about PGTA before embarking on it. Again it isn't rated that high by the HFEA. I joined a lot of groups where it's common to transfer mosaics and abnormals (mainly in the USA) and women were having healthy babies. UK clinic aren't allowed to transfer full abnormals - you may get them to agree to a low mosaic as I did but most clinics won't. I decided not to test the embryos that ultimately became my twins - odds are that since I didn't have any normals in the previous rounds that at least one may not have been classed as normal....

❤️ @Groundhoghcg

My immune protocol is very complex. I'm on hydroxychloroquine daily. But I also have clexane, aspirin, intralipids 6 days before transfer, then, 4,8,12,16 and possibly 20 weeks. Gcsf injections every 3 days, starting before transfer to 10 weeks, prednisolone 25mg before transfer 12 weeks, then wean up til 16 weeks. Will also be on cyclogest and lubion. Am also on 75mcg levothyroxine.

I don't have this, but Sr S tests for tnf alpha / cytokines and the meds are humia injections before trying to bring the levels down.

It is a lot of meds and expensive for the initial tests. My situation is very complex though, so intralipids and pred can and does work well in many women.

I would push for karyotyping just to rule it out. I had one living child and then 8 MC and a TFMR and that’s when we found out I carry a balanced translocation. In America this is routinely tested for but not in the U.K…I just knew something was wrong, so trust your gut. We went on to do IVF with PG testing and had one normal who is now nearly 1…
wishing you all the luck.

How are you getting on @Groundhoghcg i have just recently found out i have low NK Cells before heading into my first FET and following x2 miscarriages from natural conception trying for my first. I feel really stressed and upset about the result and cant find much online on ladies being successful with low nk cells. My clinic support with a protocol but concerned its not going to be enough and i'm so fearful of miscarrying again : ( xx

Hi just a quick question when did you take predisolone and omprezole before frozen transfer?