Is IVF the right next step?

[ccxo]

We have our consultation tomorrow to discuss our options and whether IVF is an appropriate next step.
So far we have had:
Hormonal blood panel - good results
3D ultrasound scan - no abnormalities
Semen analysis - great results
APS & repeat APS - unequivocal results
Karyotyping - normal (46,XX)
AMH - 9.9pmol/L
MRI: awaiting results
I take COQ10, vitamin D, vitamin E, omega 3, methylated folate, multivitamin, magnesium, B6 and a probiotic. I also use from 3DPO cyclogest 400mg x twice daily and 75mg aspirin. My partner takes COQ10 and a men's fertility support vitamin.
I am 31 and my partner is 35 and we have been trying since April 2024 and we have had 6 early losses.
Is there anything else we should be doing/testing?
Is IVF the next step or is there something else before this?
I am spiralling about tomorrow, I don't know if we are doing the right thing, but I also don't want to wait any longer and ‘waste' anymore time? 😔

After two years and six losses yes, you should move to IVF. You could in parallel consider checking for endometritis and insulin resistance. If you continue to have losses, also consider PGTA despite your age.

It sounds like you don't have trouble getting pregnant, it is sadly just staying pregnant. So I think the question is, what is causing the losses and will IVF address it (e.g. bad luck with chromosomal issues then you can do PGTA with IVF but something else might be able to be addressed outside of IVF). Have you looked into the EMMA/ALICE/ERA tests? And the NK testing (which is apparently better if done via a womb biopsy rather than blood test? I would be inclined to try and get answers for what might be causing the miscarriages if possible (but appreciate they might have already tested everything and there is no obvious answer but I would want to talk to somw clinics that specialise in multiple losses to know this had been fully explored. Bluntly, IVF alone won't help you to stay pregnant - just get pregnant. But of course there are things that can be added on to IVF to overcome potential issues). Really sorry for your losses xx

Honestly, thank you!!! This is something I am petrified about, because we’re going to be spending all of this month and then ultimately it still won’t stop any losses. We have no idea why we’re loosing the babies, nobody can pin point a real cause so it’s something I’m absolutely going to push for and really highlight to the clinic tomorrow!! I have heard about NK cell testing but haven’t really looked into it so that’s what I’m going to do right now!! Thank you so much x

Aw I am glad you found it helpful. And in case at all helpful, Tommy's has quite a lot of info on the NK cells test and why a blood test isn't very useful (flagging as I know that's what a lot of clinics offer). Some info here, including info on a testTommys run: https://www.tommys.org/baby-loss-support/miscarriage-information-and-support/tests-and-treatments-after-miscarriage/natural-killer-cells

The only clinic I found that did uterine biopsy for NK cells was CRGH although there probably are others out there. I didn't end up having the test in the end and not saying it's a silver bullet at all but just conscious that a lot of clinics offer blood tests which doesn't seem to actually tell you much, according to Tommy's so wanted to share in case it is at all helpful.

Best of luck 🤗