IVF for recurrent miscarriages?

[recurrentmis]

Hello,

I've been trying for two years and in that time I've had four chemical losses and one natural loss at about 7 weeks.
I've had a million tests and no problem can be identified. I've even seen a reproductive immunologist.
I'm wondering if IVF could solve these issues if I'm led to believe all these losses are a result of non-viable embryos implanting and "bad luck". It's been two years and no baby, and I'm now approaching 36.
My AMH I have had tested twice in 6 months - first time 18.4 pmol/L, the second time bizarrely went up to 23.2 pmol/L.

My question is does anyone know if I can get funded treatment on the NHS? Would I qualify? My hospital consultant thinks not! That I'll just end up transferring the same embryo that basically could have implanted anyway and won't stop me having a loss. But won't you be able to choose an embryo that looks good quality?

Spoke to my consultant - not eligible for IVF on the NHS - would have to wait 2 years from last miscarriage

Hi, so sorry to hear about your struggle, it's heartbreaking to have so many losses. Have you been tested/treated for recurrent miscarriages eg thrombophilia, immune, microbiome etc? I think that is the route you should be looking at. Your amh level is high and getting pregnant is not an issue, so not sure IVF is the answer. What you need is diagnosis and treatment to stay pregnant.

I have had repeated implantation failure of good embryos (created with donor eggs) and one miscarriage. I am seeing Dr Sami at Plan Your Baby, he gave me some tests to do. If you have funding for private treatment then I would recommend seeing Dr Sami or someone like him specialising in RIF/RM, they can help to diagnose the problem and help you stay pregnant. Good luck 🍀

Thank you @Serendipity24 - all my clotting tests run by the recurrent miscarriage clinic came back normal. I think I will go private to see Prof Brosens to see about the womb tests / uterine biopsy.
The issue is the consultant leans towards bad luck and I keep implanting non-viable embryos so IVF would surely solve that.

Speaking from experience, I would be careful about any doctor blaming luck while your problem remains undiagnosed. At your age it's unlikely that so many of your embryos are non-viable. IVF with PGTA could shed some light on that aspect I suppose. But I would recommend you don't go for IVF before having a thorough investigation done by Prof Brosens. My doctor also blamed luck and inefficiency of the IVF to "explain" why I had implantation failure with donor eggs. He wasted our precious embryos, time and money by insisting that. I really regret trusting and listening to him.

It's not necessarily the answer, as I'm in the same boat. Had my son naturally, then 3 miscarriages trying no 2. After 3rd couldn't get pregnant at all and we went through IVF. First go was a success and I miscarried at 8 weeks in oct so still whatever the underlying issue is it's not resolved.
Maybe IVF with PGT testing might be the way to go?

Sorry for your losses. Did you see a recognised Reproductive Immunologist? Did you get a chance to genetically test the loss at 7 weeks?

You could try at least one round of IVF, seeing how many eggs/PGT embryos you get could be a good gauge if the issue could be egg quality or immune.

Hello, unfortunately I was not eligible to get the second loss tested as the hospital said I needed to have 3+ losses. Since then all my losses have been chemical pregnancies so nothing to test.

I've seen Dr Shehata and my blood NK cells were low 😕

@recurrentmis with regards to IVF, yes, once you have your embryos they start transferring the ones with the highest quality first.

I would recommend you to do IVF one cycle In a cheaper place just so you get an idea about your egg quality. Once you know you can decide if you can keep trying natural or IVF.

I did immune protocols to stay pregnant and they always told me "you need a healthy embryo for the protocol to work". So technically, you still don't know if the protocol works or not because the embryos haven't been tested.

Good luck.

Hi, I am really sorry to read your story, and totally agree with Serendipity24* *

Hi @recurrentmis sorry for what you're going through. My situation is similar (5 chemicals, I'm now under Dr Shehata's care, with 1 chemical under his protocol). It's incredibly unlikely for that number of miscarriages to all be caused by chromosomal issues - I believe the chance is 0.4% (assuming you have 25% chance of miscarriage each pregnancy, and you've had 4 pregnancies). He also told me that IVF is unlikely to help in these kind of cases as the issue is with staying pregnant rather than conception. Did you decide whether to start treatment with him?

Hello, thanks so much for your message - it's good to know the stat! I'm worried about taking prednisolone since my NK cells were low if anything I'm wondering if I could be over-immune suppressed! But then I think he obviously knows much better than I do! I will try his protocol and if I have another miscarriage I will go to the clinic in Coventry with Dr Brosens. He does a test to see if your womb lining is more prone to breaking down early and treats this with a short course of medication for diabetes. Since our pregnancies end so quickly it seems like a good theory.

@recurrentmis my results from Dr Shehata came back all normal, but he said that you can still have an immune issue with normal results. I'm a bit sceptical about the treatment too though. I'm trying to tell myself that he is world-renowned and has treated many people like us, but it can be a hard to keep the faith! I'm having an appointment with him next week, presumably to change my treatment after the last chemical. Did you ask Dr Shehata about other treatments you've read about eg this diabetes one? I'm not sure how focused he is on natural killer cells, and therefore if I should be getting tested for things which I've not had...

I've also read about a study from Dr Quenby about Doxycycline, which i thought I might mention to him next week! I just want to get treated for everything, in case!

My recurrent losses have been down to chromosome abnormalities that I have (diagnosed after 3 MMCs between 8-11 weeks). Genetic testing of the third loss showed trisomy 15, so me and my partner were tested and turns out I have a quite rare combination of issues on chromosome 9 and 13 (the trisomy 15 was just double unlucky apparently!). Since then I had a 4th MMC again at 10 weeks, I found out I was pregnant about 2 weeks before getting my genetic blood test results back.

I'm being seen under the care of genetic counselors at St George's and am eligible for 3 rounds of IVF with PGD should I wish to go down that route. This eligibility is totally separate from the usual fertility pathway now I've got a genetic diagnosis.

Wanted to share in case this ever becomes your reality so you can have some knowledge of what happens if you do fall into the small bucket where there's a known abnormality in your order your partner's chromosomes that is causing the losses xx

@Moosey898 thank you so much for sharing your journey! Can I please ask how you found out about these genetic issues? Was it blood karyotyping? If so I've had karyotyping done via I think it was Guys & St Thomas hospital. We have not had the results back yet (test was done 29th November). I've been told it's rare for anything to show up on the karyotyping test.

@recurrentmis yep so I had surgical management (actually for all 4) - they took tissue samples from no3 and sent those off for karotyping. When they came back showing trisomy 15, that meant the EPU called me and me and my partner had blood tests done, and mine came back with 2 separate issues. At that point I was referred to the genetic counselors to discuss the results in detail as the consultant at the recurrent miscarriage clinic only knew the basics. Was the test you had done bloods for you and your partner?

Edited to add: my EPU also told me it's rare to get anything back from karotyping. I'm now describing myself as a broken unicorn.