Recurrent miscarriages/Is Shehata the right choice? Desperate...

[annaif]

Hi everyone

I have been trying to follow one of the existing threads on Dr Shehata's patients but it seems that none are accepting new messages.
I have an appointment with him on the 22nd of February and I am still unsure as to whether he's the right person to see. I have read people's experiences with Dr Quenby, Dr Gorgy, Dr Taranissi and Dr Yau Thum and I am still in two minds about who to see.

The issue with us is slightly complicated which is why I don't think that a fertility/IVF specialist will be the right choice.

We have a healthy 4 year old boy who was conceived spontaneously and I had no problems whatsoever with my pregnancy with him (being 35 at the time)
However it took us 15 months to conceive baby #2, which we lost at 20 weeks for yet unexplained reasons. I have since lost 2 more pregnancies around the 9 week mark, both of whom gave us good early scans with heart beats, both of whom were conceived relatively quickly.
I have been seen at St Mary's already and have tested negative for all their autoimmune, blood clotting testing; did a hysteroscopy (all clear), a 3D SIS scan (again clear) and a ovary reserve/follicle count which appears to be quite high so no problems there. My husband's semen analysis appears to be normal too.

Only recently and by my own insistence to see an endocrinologist, I discovered that my thyroid function is abnormal and was diagnosed to have an auto immune compensated hypothyroidism, so I have been put on 50mcg of thyroxine daily, selenium and folate. Having said that, my TSH levels were pretty normal during the last pregnancy and before then so I am not entirely sure that an endocrinology related problem may have caused the miscarriages, or whether the consecutive pregnancies messed up my thyroid.

Having said that, I am turning 40 in a couple of months and the last consultant that saw us in UCLH basically said that "we'd better get on with it and fast" as time is not in our favor- if we want to have another child. Incidentally, there are no more tests offered by any NHS hospital/clinic in London that I haven't done and that they can refer me to do....So looking into Natural Killer Cells is the only thing left to do- privately.

We are totally depleted with the 3 year vicious cycle of ttc, miscarriages, investigations, more ttc, more miscarriages and zero confidence that any future attempts are going to be successful- given my medical history and age.

Someone who has been treated successfully by Taranissi said to me that since conception is not my problem, I shouldn't be looking in any of the "top guns" of the IVF private clinics and that I should really be focusing on miscarriage specialists, such as Shehata or Quenby.
But on the other hand, everyone seems to be looking into the NKCs theory and to be doing different sort of testing on it....

Apologies in advance for the very long post by I am slightly at my wit's end and very lost as to who to see privately- as neither time nor money is of unlimited supply! My husband has pretty much given up on the idea of another attempt so I would need to have pretty good arguments to convince him to give it another go....

Really looking forward to hearing from somebody on this.

Thanks ladies

Anna

[annaif]

Hi Lulu
I am sorry you've had a difficult month hon, is there anything you'd like to talk about? You can PM if you'd like....
I should really start temping too, I have been telling myself that and my acupuncturist also strongly advised to do so, in order to keep track of how the therapies affect the cycle (if at all)
Remind me, are you with the Coventry team or Dr S? Have you tried any steroids or planning to?
We have decided to start ttc again this month, after a loooong break since last Nov'.
Mixed emotions:

[333LuLu333]

Hi anna, thanks will pm in future.

I'm with coventry. I've had two cycles of accupunture and has reduced my ovulation date (which is typically 28 days, now 19 ish), wondering if luteul phase will be affected but won't know for a while as I took progesterone from ovulation last cycle. I temp as I can't rely just on pee tests. However I pee tested this month ovulated on bbt but not on pee sticks so interesting. I'll give it till the end on the year and then will chill for a bit, and may think about adoption.

Not trying steroids currently as nk cells are normal... so think I'll do chromosome and auto immune next. Will check with coventry in a couple of weeks as Hubbie is getting anxious x

[CarryOn2016]

Hello annaif
I was wondering how you got on with the appointment with Dr Shehata and are you still seeing him?
I got an appointment on mon week and would be grateful to hear your views.
Thanks a lot,
E

[333LuLu333]

Good thanks (I'm hoping), after finding March so hard lol, I seem to be 8.5 weeks pregnant. Its the furthest dpo I've got... so pretty nerve wracking time and my new docs aren't as supportive as my old ones (moved house) although I things may improve as I'm seeing the midwife this week, if not ill change gp as its too much strest fighting them constantly. 6th confirmed pregnancy and had a scan this time... so I have everything crossed. How are you?

[333LuLu333]

Sorry I've lost the plot... think link took me to link for anna asking how I am and I've not clicked next page to see carry on has messaged anna.... sorry... hope all are enjoying the bank hol

[annaif]

Wow 333Lulu, you're pregnant!?? Amazing, congratulations my dear, things do change within a few weeks, don't they!?
I can appreciate it must be nerve racking but hopefully you've found ways to stay calm and focused due the difficult first few weeks of uncertainty.
So you are with Coventry, does this mean you are taking progesterone as per their plan? Or nothing at all? Good luck with your next appointment, have you had a scan yet? Let me know how you get on....

Hi there CarryOn2016, welcome to the mini thread! There's a bigger ongoing thread of Shehata's patients called "the pred thread" and we're currently on the 19th thread of the general group- it will come up if you search for it.

I have seen him twice already at his London clinic, had all the NK cells' tests done and I've also been to Coventry- to cover all bases!
I've been diagnosed with normal NK's but high NK's when pregnant- also have slightly high uterine NK's found by the Coventry team.
So I have been taking pred from ovulation for 10 days, I am now on my second cycle of this. Also take aspirin, VitD and Pregnacare daily alongside numerous other supplements etc.....And taking progesterone 7 days post ovu, for 7 days in a row, as per the Coventry plan.

Once (if) I get the next BFP I will continue with the pred and progesterone and start taking heparin too- as all consultants agreed that it's probably safest if I took heparin until week 24 (again, IF I ever get to that point again)

Are you visiting him in the Epsom clinic? And are you going private or through NHS referral? I know that he doesn't do the full NK testing through the NHS. Good luck with it, he can appear quite arrogant and smug but at the end of the day, you're not there to make friends with him (that's what I keep reminding myself!)
xx

[333LuLu333]

Hey, they are talking about shehata on this website (good article) www.stylist.co.uk/life/miscarriage. If this doesn't work I'm gonna see shehata. Although I'm obviously hoping I don't need too... yeah i was beside myself when i last posted... so weird. I'm on progesterone, and clexane. I'm not as regimented as I was with other cycles. So I do prog most mornings, clexane and prog when I goto bed (instead of recommended 7pm). I do it when it suits me rather than fitting my life in around them. I'm also taking inofolic, as well as folic acid and vitamin d. week 6/7 was tough as had cramps so went for early scan and saw flashing heartbeat (which is something I thought I'd never see). After then I've relaxed a bit more, and looking forward to week 13 when I think placenta will take over... and then will work out next hurdle. Keep me updated on your progress. Interesting how much is becoming known about nk cells x

[CarryOn2016]

Thank you Anna and 333Lulu333
I am new to this so trying to find my way 😃
I am going private as went to local NHS and had basic tests.
I am quite nervous as already had 4 miscarriages last one in April.
333lulu333 I hope it all goes well with your pregnancy!! Keep us updated
Will let you know how it goes
X

[CarryOn2016]

It's me again. Just back from seeing dr Shehata. Had a barrage of tests, started aspirin, vit d and cont folic. Will see in a month. Hope you are both well

[333LuLu333]

Ooh that's good. Have you tried any of those meds previously? Hopefully they will help are you mc's early or late out of interest? Are they thinking nk cell and steroids perhaps? PM me if you ever need me by the way.

All ok over here strange but good x

[CarryOn2016]

Hello 333lulu333 and thanks.
Hope you are feeling well.
I started aspirin previously but stopped it as thrombophlia tests were normal. Had previously taken vit d but this is a higher dose
Mc early - last one in April at 12 weeks. Awaiting thyroid and nk cells and some other blood clotting tests. Got to wait 1 month.....and cannot ttc. Seems long but will see.
Take care

[annaif]

Nice to hear from both of you Lulu and CarryOn

I am also on aspiring, vitD, pregnacare and a whole lot of additional supplements I've decided to take to boost egg quality.
I have decided to make a move to the Lister as the Shehata London clinic is closed for an indefinite amount of time. Have heard very good things about Dr Thum and he's supposed to be following similar protocols with Dr, uses same labs etc so will be able to work from the results I already have.

Let's see how it goes....Hopefully a fresh pair of eyes may give us a different insight on what's wrong.

It's great to hear that you're coping well with the pregnancy Lulu, I am stressing out even at the thought of getting another BFP (which is obviously something that we really want and are trying for but are terrified of in equal measures)
So I am wondering whether my fear and slight reluctance at the thought of another pregnancy may actually set me up for another failure....

Does this make sense??

[CarryOn2016]

Hello annif
good luck. When are you going? It is nerve wrecking and I can completely understand what you are saying of the fear and reluctance!

I am Trying to figure out how to send you a pm but failing miserably!!
Was curious about what dr Shehata had to say to you when you went back for results
I guess we got to remain positive somehow.....
Glad for this support 😊

[333LuLu333]

Ah anna I know how you feel, and so many mixed feelings and for so long. I don't think fear or negativity can change an outcome, the same as positivity (for me anyway) so try not to beat yourself up. I now try to keep level (yet at times neurotic) head (not too negative not too positive just real), and looked what happened. It is hard at least we have each other.

[annaif]

Thank you ladies, it means a lot to be understood and not dismissed with the usual "oh you just have to relax and it will happen" or the worst "what are you worried about, you already have one child"....

I am trying to not freak out by the idea of pregnancy too much, before it even starts! I was speaking to my acupuncturist the other week who basically said to me that I need to make some quiet time for reflection in my hectic lifestyle, just for myself, so that I can start feeling safe that my body could do this.
And it rang so true, it's this feeling of loss and fear that takes over the normal maternal instinct that kicks in once a pregnancy is detected....but I have to find a way to not get carried away by the panic, otherwise what's the point really....

CarryOn, if you're on a computer you can click on "message poster" for a PM- if you're on a phone it's a different process (used to be able to do it but clearly not any more!)

I am seeing Dr Thum on Friday at 12- I had to go through the depressing task of filling in all the forms with all of our medical history on our losses and secondary infertility, collate all the different test results from all the clinics we've been the other night with DH.... It's taken so much time and resources from our life, I really hope that this will lead us somewhere as I feel robbed of my innocence and joy over having another child. And this will never ever come back....

Courage!

[333LuLu333]

Try and get outside for your me time enjoy the flowers and greenery. I also signed up for lovely spa for one month as my time out... If something like that suits you? Maybe write a diary to offload your thoughts... and shred them... and in the meantime vent away to us x

[CarryOn2016]

Thanks Anna
I am using iPad and phone that's why then i can't pm.
What made you decide to go and see someone else? I find it so tricky with different Drs having different ideas! And it looks like then end up with aspirin, vit d, foclic, likely heparin +- pred and progesterone.
I have not yet tried acupuncture but might give it a go in a few weeks.

The spa lulu sounds a good ideA together with the walks.
I honestly am finding this therapeutic too 🙂 Never tried it before.
Good to hear your updates lulu, gives me hope!

[CarryOn2016]

Hi Anna. How r u doing? How was your appointment yday? Take care

[annaif]

Hey there, thanks for checking up on me
I always find the day after an important medical appointment to be a bit of an overwhelming info overload and end up wanting to drink a bottle of wine as a result (I didn't!)
I suppose it went well in the sense that he spent lots of time with us discussing my history and looking at all the results.
We liked him and his general approach much more than Shehata's arrogance and haste.
He did outline the possible causes of my rmc's in a very neat diagram which leads us to a whole load of tests and investigations on the probable reasons. We have already done quite a few of them so we have ruled out many of the probable causes.
He also agrees that there must be an underlying immune issue causing havoc with my reproductive and thyroid system and that the two are linked.
He sent us for blood karyotyping testing which should give us results in 5 weeks. He also suggested to proceed with a monitored cycle and timed intercourse after caused ovulation via Ovitrelle injection.

But... He did make the valid known point that my age is not on our side, in terms of trying naturally and the inherent quality of my eggs. He also pointed out that he's a fertility specialist as opposed to a reproductive immunology specialist (like Shehata) but he uses similar protocols and labs as S does so I can continue on the same basis as with S without needing to do the trek to Epsom every time.

He also reduced my pred dose from what S suggests in his complex NK plan as we don't know how long it will take me to conceive again and it's not great to be on this dose for prolonged periods of time.
So there is a form of plan in place but the more I think about it, the less confident I am that 1. My eggs are not totally rubbish and 2. My body can actually sustain a viable pregnancy

I guess I need some time to digest it all. Just feel a bit deflated at the moment

[333LuLu333]

Ahh babe If your eggs were rubbish the consultant would tell you that it's time to call it a day. They haven't... Also when I saw Prof. Brosen's he said as heart breaking as it is rmc is a numbers game. You have the same chances of a viable pregnancy with every rmc pregnancy they never reduce. Yes age may not be on your side... but you're also not over the hill... very hard but try and see some positive. Thinking of you... x

[CarryOn2016]

Hello Anna, I guess it does seem all overwhelming but there is still hope even though at times all you want is a whole bottle of wine 😜
It is good you are trying ovitrelle, had you done that before? Fingers crossed for u.
Take good care and hope u manage to have a relaxing Sunday X

[annaif]

Thank you for your kind words ladies.

I don't think it would be politically correct for any of the consultants to tell me that my eggs are rubbish lol- but they all seem to agree that the last 2 miscarriages looks like they were chromosomal. The 20 week one is anyone's guess really, this is what bothers me the most, that it was a viable baby and that whichever the reason it couldn't grow further (whether blood clotting or thyroid/hormonal issues) it could have been picked up had I been more regularly screened....

I feel like I've missed my last chance for a pregnancy that will make it and that from this point on, I'm reliant of my reduced fertility and my slightly worse for wear eggs (at the age of 40, as it's all a "numbers game", a Russian roulette where each time there's a 50% chance to lose the pregnancy- on the basis of age alone)

I am trying to focus very hard on a daily basis on all the good things in my life and see what I am fortunate enough to have, as opposed to what I've not been managing to achieve. It's such a tough exercise, isn't it?

I have never taken the time in my life to do proper introspection or to exercise "mindfulness"- both of which are necessary if I am to come out of this with a sane mind.
Joke's on me now as I am trying to clutch at straws, anything to help me find some meaning in this whole painful never ending ugly mess we've found ourselves in....
I am taking strength from all the ladies in these threads who have gone through similar ordeals and yet manage to find the strength to keep going...

[Ash77]

Hi Anna,

I am In very much same boat as you. So you are not alone.

My first preg was cheese cake no problem and had a boy who is 6 years old. Past 3.5 years we have been trying for our second child and have ended up in 6 miscarriage. Recent one is in Feb this year. I have seen shehata after my 5th miscarriage and I was diagnosed with high NK cells.. I was on usual medication which is vitamin and progesterone , pred etc... After 3 months which is in Dec 2015 tried again and in Jan I was pregnant but.. It was all messed. Until 8 weeks my hcg didn't go up so ended up waiting then it shoot up to 1000 then to only miscarry again.

Apart from 1st MC at 11weeks all others have ended up by 8-9weeks.

Finally after Feb we decided to give up and focus on my work which i haven't in last 3 years.. And me and my husband have taken this 2nd child thought from our mind.. But surely when I feel confident and emotionally strong we will try again.

But today I just googled and found your blog..

Age is not an factor completely.. I had my first one when I was 24 and now I am 31years.

We spent at least 3-4K with shehata .. Please let me know your journey with dr thum.. So whenever we are ready again we can thk.

For now I am just go using on my health and not thinking about anything else.

Thanks for reading

[annaif]

Hi Ash good to hear from you and thank you for the words of support.
I can imagine how much of a toll all the mc's have taken on you- and it's true that sometimes age is irrelevant with the outcome.

My worry about mine stems from the fact that all the consultants I have seen (Dr Rai in St Mary's, Dr Shehata, Dr Thum at The Lister and Dr Webber at UCLH) make consistent reference that my mc risks have increased and are on average 50% purely on age alone.
Combining this with what appears to be an underlying auto immune response to pregnancy, it's not good news at all. We have some tough decisions to make as to whether to keep going or pack our boots on this one....

I hope you feel better emotionally, physically and psychologically :)

[trinabosein]

Dr Shehata any day..i posted the following in another thread but reposting it here

I have had direct experience with Dr Shehata and can say one thing..absolutely brilliant..i had 3 miscarriages all within 10 weeks from 2011 to 2014.I finally decided to go to Dr Shehata and the first thing you will notice about him is his confidence and his straight talk. He just told me leave it with me I ll handle it..you go and enjoy and don't stress about your past miscarriages..and yes he handled it well..i was diagnosed with elevated NK Cells..started his medicine routine and now I am a proud mom of a 14 month old son jumping around like a monkey and not even letting me cook read eat..but all thanks to Dr Shehata and his team..