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??

@MeganBistram
What diet and supplement did they give you for your PCOS?

Was the supplement Ovasitol?

@IlonaRN Inofolic Alpha you have to take 2 sachets a day. You can get it on Amazon xx

Interesting, quite similar to us - we got 7 embryos from 4 rounds and only 1 was tested as normal plus a mosaic. Three were abnormal and two untested (I'd had enough by that point!). None have gone back in yet.

Hoping you have a keeper - it’s not over until it’s over - but I understand how you expect the worst.

I myself fully expect to be childless at the end of our ttc journey but then I do use expecting the worst as a coping mechanism.

Sorry for all of your losses.

I would recommend doing egg collection/genetic testing then keep those embryos frozen whilst you do the testing with Dr Shehata prior to any further transfer.

I was in a similar situation, 2 losses from natural conception and a loss following IVF with a genetically normal embryo. I had lots of testing including NK cells but all apparently normal. However when Dr Shehata looked at my NK cell result he disagreed it was normal and long story short, immunosuppressants combined with IVF (genetically tested) worked for us under his protocol first time.

If you struggle with quality of eggs/embryos I strongly recommend seeing a good nutritionist or at least read 'It starts with the egg'. We only got 1 normal embryo first time round (from 10) then we got 6 normal (from 11) after taking various supplements etc. The IVF clinic even asked if we had done anything differently and I'm convinced it made a big difference.

All the best x

@lookingforaholiday yes, we’ve done all that - Melanie Hall who confirmed our diets are great, red light therapy, every supplement possible, cut all toxins, no plastics or receipts, even filter our air and water! My eggs are still apparently poor quality… sometimes it’s just not in the cards no matter how hard you try.

I'm sorry @Wednesdaysotherchild, I have no doubt you've tried everything under the sun. I just mentioned it since my IVF clinic didn't give any suggestions of that nature. Has your partner had a sperm analysis done too? My partner had 0% normal forms, turned out he had a varicocile which he had a procedure for and luckily helped.

I really do hope all of you get your happy endings xx

@lookingforaholiday yes, saw saw Jonathan Ramsey and had all
the works, including sperm frag. Nothing found. I am starting to think that DP and I are just not compatible genetically!

@Wednesdaysotherchild have you thought about having immune testing to see if its impacting your egg quality / production? xx

@MeganBistram yup, my clinic tested me and I do have slightly raised NK cells so all my rounds have included steroids during stims (and I have had pred/progesterone for my natural pregnancies too). They’ll
do intralipids for my transfers as well. No dramatic changes unfortunately. I haven’t been to Shehata or Gorgy but not sure what extra they could do beyond that and whether it’s worthwhile.

@Wednesdaysotherchild honestly no idea, Its £350 for a consultation where he will review all notes and results, might be worth it but of course it is another extra cost xx

Update
Yesterday I got my results back .... if you're looking for an all singing all dancing OMG we have found what's wrong, look again as our dear DR S is a consultant who is very used to seeing these results so it was a bit of an anti climax - I even had to confirm that this was what the issue was ;)
So results showed, normal everything except :
High Thyroid Peroxidase Anti bodies - 103 IU/ML (normal is up to 34)
High TH1/TH2 cytokines - TNF Alpha - 42.5 ( normal up to 31) IFN Gamma - 19.2 ( normal 14.8)
Borderline high NK-Cell Cytotoxcity assay - 22% - (anything over 20%)
So my protocol is in 2 phases :
Phase one bring down the TH1/TH2 cytokines - take 2 injections of Adalimumab 2 weeks apart and then go back for bloods and a further consultation ( FYI you have to pay for the bloods again which is daylight robbery at £480) . Also started Hydroxychloroquine which I think is for the Thyroid & cytokines but I am not 1005 sure, this is advised to be started 6 weeks before trying.
Phase 2 - carry on with the Hydroxy but then add intrlipids pre conception and then every 2 weeks after confirmed pregnancy. Also Progesterone from conception and continued to 20 weeks if pregnant. Carry on throughout the other vitamins / aspirin as taking now. I believe the Intralipids are for the slightly raised NK cells as they reacted to reduce it fine and are less invasive than steroids.
So I will keep you updated as we won't be trying for another 2 months :)

How is everyone getting on in this thread? I am still on the IVF train did embryo batching with PTGA - going into my first FET but also tested for EMMA / ALICE and NK Cells due to history of previous miscarriage. I am very concerned that my NK Cells has come back low. Everything i hear says high and treated with steroids but I've not really come across anyone who has a low result and what that means. Feeling terrified. I hate this journey. Its so awful. Hope everyone is doing ok xx

@LAURAPAX
Hi lovely. I never proceeded with IVF as managed to conceive and have one stick at last! I did have NK testing too and mine were borderline low. They were going to treat with sitagliptin which is to raise the stem cells in utero, may be worth looking into. (This was with Prof Brosens at Coventry). Very best of luck to you 🙏🏼 xx

Hey @FfoxRedN thanks so much for getting back to me! I remember your story from one of the other threads that I used to follow but was too early in my journey to get involved in. So happy you got your happy ending you must have your baby now? I’ve had two miscarriages both from natural conception trying for baby no1 - then got ill and had surgery to have my gallbladder removed then couldn’t conceive again so went down ivf. I started ttc at 36 and now nearly 38 arghhh! Wish I could have been a natural success story but not yet sadly. I spoke to my consultant again today as I was so freaked out about the results and I didn’t really understand when she first went through them as it was rushed. Basically bloods have come back high / out of range and uterine back as low. Don’t know if this is a worse combo or what but I hope science and medicine can help! I asked about Sitaglipton but my consultant wasn’t aligned and my clinic don’t provide this. Will probably see how this transfer goes and if not consider a review. Did you rate Coventry? Thanks again for getting back to me it helps so much xxx

@LAURAPAX oh I've never heard of a mixed result but I didn't have bloods, just the uterine test. I do think there's something in it if the results are extreme, but after my MCs and tests it seemed it was all chromosomal issues. I was lucky on my 5th pregnancy 😊 so if I ever did IVF it's likely I'd have needed PGTa to help us pick a good one.
He's 3 months now! It's awful but I would go through it all again to get him.
I do hope this works for you, sitagliptin is a new treatment that I don't know where else even offers it! Prof Brosens was great, really realistic but hopefully you won't need him at all!!!

Hi @Presently83 I was just wondering how you got on? I am in a similar position and looking at everything I can now. Would be so interested to hear how it all went for you, I do hope you got the outcome you hoped for 🩷

Hi all, so sorry for lack of updates, I haven’t been on here for quite a while as the natural pregnancy i told you about here was successful and we had our perfectly healthy baby girl in October 2023! Hooray!

We decided to try naturally when I got my period back (9 months pp) before going back for our one and only embryo but no luck until one year in this August (we were planning a transfer for September) when I fell pregnant. But all symptoms tapered off at 8wks and an early NHS scan showed no growth from 6wks, so a third MMC. I’m currently 9wks, no sign of miscarriage, and just hoping it doesn’t happen over my daughter’s second birthday next weekend 🙁

I’m hoping it will happen naturally though as I don’t want a second d&c to thin my lining before a transfer in (hopefully) January.

i really believe our issue was chromosomal all along. So I’m just hoping our one normal embryo makes it as I don’t think I have many (any?) normal eggs left now, aged 42.

Hope you have all found luck or peace or both xxxx

We got our miracle baby too - a little boy- thanks to the Evewell (IVF) and Professor Shehata’s clinic (miscarriage prevention). He’s 10 months old now, adorably cheeky, and we are so grateful for him! Mine was an overactive immune system and suppressing it retained the pregnancy, phew. Hope you all either got your baby or found a way forwards despite it, it’s a tough old journey.