Advice on private rmc tests with Shehata/Quenby at age 41

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Hi everyone. I'm new to mumsnet. I'm looking for some honest advice. I'm 41 and have no children. We started ttc two years ago when I was 39. I have had 4 pregnancies in that time all conceived relatively easily within 2 - 7 cycles. The first one was a mmc at 12 weeks due to a chromosome abnormality, second pregnancy we had a tfmr at 14 weeks after a horrible diagnosis at the 12 week scan (holoprosencephaly/pataus syndrome). I then had a cp followed a few months later by a mc at 6w4d which I am currently going through.

I had the NHS rmc tests after the cp as my very nice GP had pushed for it. They came back clear.

Technically my history isn't quite recurrent miscarriage. The consultant was very clear in explaining why its not rmc until its 'three in a row' as mc is common and statistically two in a row is likely and they don't count the tfmr. I'm feeling hopeless just now and at a bit of loss what to do. Given my age we think it might be worthwhile going private for more thorough testing anyway. I don't want to keep going through this and really need answers now. I will definitely try for one more pregnancy but would like a plan of action before doing so. Chances are that nothing would come up in testing and it may just be age and bad luck. I think one more will be my limit, if I lose a fifth we will probably start looking at other options to complete/start our family.

Prof Quenby and Shehata seem to be the leaders in miscarriage treatment. Can anyone tell me what the difference in their approaches is? They both appear to do immune testing. Shehata seems slightly more thorough? Or is this all a pointless waste of time given my age and poor egg quality?

All advice and opinions welcome!

Hello, I'm sorry for everything you've had to go through :-( I have recently seen Professor Quenby at Coventry and was in a similar situation to you in that I didn't fall into the 'recurrent' category. I have had four miscarriages but (thankfully) a healthy little boy after two. My doctor asked if Professor Quenby would see me anyway. The implantation clinic and RCM clinic are seperate. In the RMC they will do lots of bloods (probably what you've already had plus some more). If you look on the Tommy's website it lists the bloods that they do at each of their clinics. The implantation clinic is a private clinic - it's around £540 I think for two biopsies (two for accuracy) where they test the level of natural killer cells in your endometrium. If the levels are high they prescribe steroids for when you next conceive plus progesterone to take from day 21 of your cycle when you are ttc. I suppose it's impossible to say if it's worthwhile until you get your results. I just felt I wanted to rule out there being anything wrong before I tried again... I didn't want to go through another miscarriage and then find there was something I could have done to prevent it. There is a good article on the Tommy's website explaining recent a breakthrough made by Professor Brosens at Coventry who works with Prof Quenby on the implantation clinic. It may help you to decide if you feel it's a worthwhile test for you. Good luck with your next pregnancy xx

I’m a two time patient of Shehata. Diagnosed with high natural killer cells and successfully treated to have two beautiful girls.

The tests were around £1200 iirc. But given that you have had some NHS testing you may save some money.

I didn’t retest for DD2. I just followed the same protocol.

In terms of the difference between quenby and Shehata I don’t think there is much in terms of the treatment protocol. It’s actually a very straightforward treatment for NKC, but sure about other conditions.

I love Shehata. He installs a ton of confidence but he’s to the point and doesn’t waste too much time on the niceties.

Really best of luck and sorry for your losses

Sorry I meant to add that it is definitely worth asking your doctor to email dr Quenbys secretary (details on Tommy's website) to see if they will see you on the NHS. They would almost certainly do more blood tests than you will have had locally. They will also advise on whether or not they think NKC test is something that you should consider. I know from experience that they absolutely don't push it on people who they don't feel it's potentially relevant for. If they won't see you then try emailing Kerri Geraghty
Biomedical Research Unit Secretary
024 7696 7528
[email protected]

Explain your history and ask if they think you should consider the testing. Here is a link to their website if you haven't already seen it

www.uhcw.nhs.uk/miscarriage/nk-cells-testing-clinic

Hope that helps x

Thanks for all the great advice. We have made an appointment to see Mr Shehata next month. I couldn't really decide who to go to but as we need to travel it was easier to get to London. Really hope we get some answers.

Good luck with it... hope you get some answers x