Recurrent miscarriage: worth investigating or jump to IVF?

[Presently83]

Hi all,

I'm 39, have had two MMCs (10 & 11wks) and one chemical pregnancy in the past 10 months.

I've been advised to do IVF with PGT testing of embryos, but others have advised me to wait and do all the Dr Shehata tests first. But that requires not getting pregnant for a few months, and I'm 40 in January so really don't feel I can wait.

I've had lots of testing (including NK cells, MTFHR and thyroid) and everything has come back normal, and in my heart of hearts I think it's just a combination of age and bad luck, and that testing embryos might help. But I don't want to spend all this money on IVF only to fail and then do the RPL testing later and find something weirder was wrong all along.

I'm so confused about it all! Any suggestions??

@Presently83 hi lovely, I have a similar issue, almost 37 and had 1 CP, 1 MC and 2 MMC's, I was just wondering how your journey is going since Sept?
I too have debated the IVF/NKCell testing decision and am still a little unsure what to do. xx

Sorry to hear about your losses - I’m in similar position. Second miscarriage - first CP, second MMC. I’m nearly 37 and panicking like crazy. No living children.
@FfayeN im really sorry to hear I saw your story on the TTC after miscarriage thread and was so gutted when you posted your update. I’ve just found out my 2nd pregnancy is MMC and i’m devastated. Did you have D&C? Xxx

@LAURAPAX I'm so sorry to hear that 😔. Yes, they call it an RPOC now, but very similar to D&C they just don't dilate as much xx

@Presently83 i know this was a while ago but did you decide testing or IVF?

I am in a similar boat with no idea what to do xx

What are the RPL tests/ Dr Shehata tests?

I'm nearly 42, have had 2 miscarriages in 6 months and would love to explore options that would allow me to conceive naturally before having to hage IVF. It's intrusive and expensive.

I had ivf with genetic testing and I'm now 9 weeks pregnant. It worked first time for me and I'm nearly 43 having my first baby. If you can afford it I would defo recommend it. It reduces the chance of miscarriage massively.

@Willow1980 congratulations ❤️
@Whataretheodds I have an appointment with dr Shehata tomorrow so will update you. He is a specialist in reproductive immunology and a huge believe that recurrent miscarriage is not genetic so I am going to see what he says before I go down the ivf route xx

I’m sure you’ve seen that statistics of trying to get pregnant after 35 😬 I would jump straight to IVF if I were you.

Yes very good point hard if time is not on your side. My worry for me is that ivf would do nothing if it’s not genetic my issue and I would miscarry anyway. But I shall update after tomorrow xx

Great thank you!

How did you get on @MeganBistram ? Xx

NC as I don't want this linked to my other posts.

TLDR: My experience with Dr shehata's clinic was appalling. Dr Rai's clinic at St Mary's was great. Get diagnostics to check your blood clot factors.

I was referred to Dr Shehata's nhs clinic back in 2017/18 after our 3rd miscarriage. Not once did we see him, only his team. Never once saw the same team member twice and none of them were knowledgeable about where we went from there.

No diagnostics were ordered. I was told to take baby aspirin and keep trying - despite the fact I'm anaphylactic allergic to aspirin. Appointments and guidance were impossible to get.

We had another miscarriage whilst trying to go with NHS ivf and aged out of assistance at that point.

We went privately with Raj Rai at St Mary's. He was brilliant. Sent for comprehensive diagnostics.

Discovered that I have:

• Factor V Leiden issues - my blood clots don't break down like they should
• one fibroid I knew about and two others that I didn't
• Adenomyosis - mixed with FVL, makes my uterus lining resemble a concrete wall rather than a squishy sponge when it comes to implantation
• Shortened luteal phase.

We went through one round of ivf with him.

Out of 15 or so mature follicles and a few immature ones there was only 1 mature egg to be found on one ovary and 1 immature one on the other.

The one embryo was high quality. We didn't genetic test it as that can damage it. I had multiple injections daily including blood thinners.

I did get pregnant but unfortunately the embryo stopped growing at about 5 weeks.

We decided after that (miscarriage #5) to stop trying and I'm now on the waiting list for a hysterectomy due to the andenomyosis and bad reactions to hormone based remedies for bad periods.

@NewName9876 thank you so much for sharing your experiences. Sorry to hear what you've been through.

I had a bad experience with admin before getting to see Raj Rai and was wondering whether it was worth persisting (I'm not feeling totally reassured that they'd be on top of test results etc).

@NewName9876 thankyou for sharing, its so good to get a rounded view as every expereince is different. So sorry to here what you have been through must be horrific. xx

@LAURAPAX @Whataretheodds

I went to see Dr. Shehata yesterday ( privately ) and the meeting/ Expeirience was good, he is quite a typical professional.. quite straight forward and to the point but the ladies and receoptionist were lovely.

We went over my history and he made a connection between my previous gestational diabetes and thyroid anit body levels that I was likely to have PCOS ( I have 0 other symptom's, regular and no pains etc. and none of my miscarriage's have been empty sacs. ) but they did a scan there and then and diagnosed PCOS, I asked why it was missed before and they said in milder cases it can easily be missed. So they gave me a diet and supplement to start taking now.

Anyway more improtantly the tests... as expected as extremely expensive for interest to others listed below :

7/02/23 Initial Consultation - £100 deposit
Consultant - Professor Shehata
£ 250.00
27/02/23 Ultrasound Scan (Initial Assessment) £ 235.00
27/02/23 TDL HS5 - TH1/TH2 HS5 £ 450.00
27/02/23 TDL HS10 - full immune profile HS10 £ 455.00
27/02/23 TDL HS11 - cytotoxicity assay TDL11 £ 680.00
27/02/23 TDL TB Gold Quantiferon test TBQ4 £ 145.00
27/02/23 TDL HS8 - ovarian ageing profile HS8 £ 205.00
27/02/23 TDL Prolactin PROL £ 85.00
27/02/23 TDL Fasting Insulin FINS £ 80.00
27/02/23 TDL HbA1c GHB £ 75.00
27/02/23 TDL HS2 - Wellbeing Screen HS2 £ 290.00
27/02/23 TDL Vitamin D VITD £ 65.00
27/02/23 Handling Fees £ 28.00
27/02/23 Courier £ 35.00
27/02/23 1 x HS Inofolic INOF1234 £ 110.00

Some might not be needed for everyone but this gives a good overview of costs.

We have decided to go ahead as still a third of the cost of IVF. I have a follow up in 2 weeks and we decide a treatment plan ( will update you )

The costs post this drop dramactically as its then just the drugs and scans if you are pregnant ( scans are £290 each with consulation ) and drugs are 3 months worth for about £100 a pot depending on what it is.

Anyway not sure if this helps anyone or not, But I will know more when I go back on the 13th

txx

Thank you for the update

@MeganBistram that's really useful to know thank you. How did they discover your PCOS, was it a normal ultrasound internal scan? xx

@FfoxRedN yes they did an internal and checked if my egg formation was around the outside of my ovary's which it was, worst on the right than the left :)

@MeganBistram Ah ok thank you 😊 just wondering if I had it it would have been spotted when I had mine 7dpo, I'm guessing they would have seen something to indicate. I don't have symptoms just wondered if I could be affected (thyroid antibodies same as you 🙂) x

@FfoxRedN I have had at least 6 internal scans and checks of my Ovaries and no-one picked it up before, So worth asking ( although I think it was my sugars that concerned them as I am low BMI and have no history of Diabetes so this was a flag)

x

I was in this boat at 37 -38 (double digit early losses and CPs) and did 4 rounds of IVF at 39 and every round is quite similar. we have chromosomal issues - most of our embryos are abnormal. The embryos behave the same in the lab as they do in my body so IVF has confirmed that for us.

@MeganBistram That's really helpful thank you ☺️. xx

@MeganBistram to update: we did two rounds of IVF with ARGC in London, got plenty of eggs and 7 embryos, and only one came back normal from genetic testing, all others had chromosomal problems. My second miscarriage also came back from testing as chromosomally abnormal. We were preparing to do another IVF round this month to try and find another normal but I fell naturally pregnant again in Feb. I'm now 5+1 but am convinced I'm going to have another MMC as I've suddenly lost all symptoms and feel completely devastated.

Saying that, the information we received through the genetic testing of the embryos was pretty invaluable as it sort of explained the miscarriages and has hopefully saved me lots of expensive recurrent miscarriage testing, even though the IVF was horribly expensive too.

Thanks for the update, I am keeping everything crossed for you that this time is your time ❤️

I am still waiting my the results of the testing on my last miscarriage but my miscarriage when the baby was almost 10 weeks was genetically fine and which has pushed me slightly more towards the immunology testing xx

Ah yes, if you had one tested normal I think immunes was probably the right way to go for you. Best of luck with everything. This is such a hard damn journey xxxx

@Presently83 its horrible isn’t it. I am trying to talk about this one and the testing a lot because I have learnt so much on here and feel like it has massively helped me make choices and feel part of a community xx