Dr Shehata advice

[Wolfemum]

Hello, I am currently experiencing my 3rd consecutive miscarriage and my 2nd MMC. I have been told I will now be referred to the RMC unit but due to my age (42) i think I need to go privately and I was wondering what your opinions are on Dr Shehata? I've heard he has a brilliant reputation but is quite focused on NK cells and less on other things. Can anyone share their thoughts, opinions experiences?
My first pregnancy was healthy and resulted in my 6 year old boy but the last 2 MMC we saw a heartbeat at 6 weeks but then no growth or heartbeat at 7/8 weeks.
Many thanks for reading

[seven201]

I'm with Prof Shehata. I have a naturally conceived 6 1/2 year old and 5 years of ttc #2 including lots of ivf and 4 early losses. I have immune issues so that's what I get treated for at CRP, along with superovulation treatment. I like it there.

[seven201]

Sorry for your losses

[MeganBistram]

@Wolfemum I am in a similar boat, have a happy heathy 3 year old but 3 subsequent MMC at 9,12,9 weeks, I have gone to him as had all the basic tests which all came back fine.
I toyed with this or IVF with PGTA testing but wanted to do the tests first. No results yet. What did you decide? xx

[Wolfemum]

Hi Megan, like you I decided to visit Dr Shehata and only had my first appt yesterday and they taken bloods and recommended I start taking Folic Acid, Vitamin D, Q10, asprin and pregnancy vitamins.

I had a lot of bloods taken by my GP such as Thyroid, blood clotting, liver etc and they've all come back normal as well so will be interesting to see what my bloods show from CRP.
I'm going back in 2 weeks to review so can keep you posted.

I'm so sorry for your losses x

[MeganBistram]

@Wolfemum looks like we are a week apart then :)

I am going back on Monday for results. Same recommendations with vitamins. Although interestingly he also diagnosed me with PCOS due to my gestational diabetes. ( I am small and no history so he found it odd ) and I did a thyroid deeper test on the recommendation of my fertility acupuncture lady and and I have very high anitbodies ( GP tests didn't pick this up as my thyroid TSH is within range.) However I have very regular cycles and ovulate every month so no clear signs. Also have had multiple scans of my ovaries and no-one picked it up.

I also have MTHFR which they recommend higher does folic with. All of the above Dr. S doesn't think will make me lose 3 babies. So I think more of a side discovery rather than the cause

I will update post monday results :) xx

[Infinitebows]

Hi! Just marking my place really as I'd really like to see your update once you've been. Im in a similar position with two recent losses - currently, desperately ttc but worried it'll end around 7-8 weeks again if I'm lucky enough to get caught (AF due this weekend) it's so hard to think positive when you've been through recent MC's isn't jt? I'm 43 so time is what I'm worried about the most as I don't want to keep trying for more than say the next 6 months. Hope everything goes okay - do you know why they suggest aspirin? Never heard of this one before xx

[Greenvelvetdress]

Also watching this thread with interest. Currently going through my third missed miscarriage, no children. Getting referred to a consultant we know in our home town but will be interesting to see what tests others have. So sorry we are all in this crappy group together.

[MeganBistram]

@Greenvelvetdress @Infinitebows welcome to the group we all don’t want to be in :(
I will keep you updated. What I would be prepared for is the cost. The testing is not cheap. Some tests can be done via the NHS though so it can bring it down. I also have a fertility acupuncturist and she is fab ( midlands ) if anyone is near there. She has a list of professionals you can get certain prescriptions from if you don’t want to do the tests but want to try certain protocols xx

[seven201]

Just a warning that I found my results appt pretty overwhelming. There were three 'things' found on my results that I didn't already know about. It's just a lot to take in when some of it you've never heard of so don't understand. I'm just saying it takes a week or so to get your head around it (if the results show something). From what I remember he told me about phase 1 treatment (for me adimulumab/humira) and I had to do that before going back to be told what my phase 2 treatment was (lots of drugs while ttc, different plans for natural and ivf (not hugely different)).

After my results appt I Googled all of my problems and thought it meant I'd have all sorts of illnesses when older, but apparently not. I decided to just not overthink it and go with the plan.

[Greenvelvetdress]

@MeganBistram yeah unfortunately the cost is a massive thing. We've already been seeing a private consultant after 2 MMC and he then diagnosed me with Ashermans (luckily that was operated on the NHS) but even a scan with him now is £200 which is eye watering and our genetic bloods came to £750

[MeganBistram]

@seven201 i can imagine. I asked him max Length of tests vs trying again and he and stage 1 can be 1 month. I only had my last MC at end of jan and just had period so happy to wait but I am sure you know how it feels that in between trying stage where all you want to do is try and get pregnant again 🙈

google can be our best friend and worst enemies :) xx

[Infinitebows]

Thank you for the heads up on cost and on what it entails. It's good to know. I am East Midlands (northern) @MeganBistram, is your fertility acupuncturist far from this area? I am that desperate now I have tracked ovulation on the clear blue sticks almost since the end of my MC end of Jan/early Feb and have DTD on smiley days - the fun has gone out of that for the time being, it's more like a military operation these days! I know you should wait but every single day seems like a decade when TTC. Was Dr Shehata recommended to you and local?

[rainbowssky]

Hi all, im watching for your updates- I can't afford any private help and have been waiting on the nhs for a gyne appointment for 18 months now (backlog due to covid).

I've had 2 mmc and not sure why and no help until there's been 3 which might be too late by then as I'm 43.

A Doctor did tell me to take high dose folic acid and vitamin D but not what high was.
What have you ladies been told?
I've never seen that Doctor since.

Good luck to everyone.

[MeganBistram]

@Infinitebows she is Sutton Coldfield. Website is verve acupuncture. She is amazing and highly recommend especially if you’re trying to regulate your cycle. Been seeing her for 3 weeks and my period came back when predicted.

@rainbowssky sorry to hear of your losses. If at all possible I would try and get a private appointment. dr S will see woman after 2 MC but he is in London xx

[Infinitebows]

@MeganBistram only an hour south for me. If I'm unsuccessful again this month Ill try her for sure. That's great that you have had good results already with her.

@rainbowssky I think with MC it's hard for them to tell you what the issue is unless your a good way along with the pregnancy. My consultant told me that it's usually either genetic or implantation isn't in the correct place. Don't give up hope, I'm 43 too, have a bicornuate (heart shaped) and tilted womb but the blessing is in the fact we can get pregnant, it's just the waiting to get one that sticks. Good luck to you too.

[Wolfemum]

I've been told to take low dose of asprin 75mg at night after food
Vitamin D3 50mcgs/2000 units
Pregnancy multivitamin plus omega 3
Coenzyme Q10 200mg 1 tablet 3 times a day
Folic acid
Like Megan I've not had any results back but I'm sure they think it's an immunity issue so you could just start taking more of those vitamins in preparation for being seen.

I'm sure Dr S sees patients on the NHS even out of area but I've read on other forums there is a 4 month wait but speak to your GP.

X

[Infinitebows]

@Wolfemum that's great thank you x

[lookingforaholiday]

Hi all, sorry to hear of your losses. I went to see Dr S after 3 MC. I had undertaken lots of testing with my IVF clinic and only thing that came up was the MTHFR snip. I had testing for NK cells but was told results were normal. Went to see Dr S and he did lots of testing (17 vials of blood)! He didn't agree that my NK cell results were normal and put me on immunosuppressants for my next IVF cycle which was successful. I will be eternally grateful to him and his team and can't recommend him highly enough although his bedside manner isn't always brilliant.

I would however suggest speaking to a nutritionist about supplements as in my opinion, that is not where the clinic's skill set lies. For example, whilst I was there, a lady asked why the omega oils said not to take with blood thinners, they didn't know but it's because omega oils also thin your blood. Additionally if you have the MTHFR snip then it's recommended you take the active form of folate, not folic acid. It's called 5-methyltetrahydrofolate or methyl folate. This is because the body needs to convert folic acid to the active form which is harder to do if you have this snip.

Wishing you all the best of luck in your journeys x

[MeganBistram]

@lookingforaholiday Amazing news and big congratulations on your baby:)

Yes I have to agree his bedside manor is definitely that of a Male highly trained professional ;) however the nurses and receptionist were lovely. We went to Harley street as its nearer to us than Espom.

I ignored his just take normal folic acid and continue to take the methyl one.

@rainbowssky yes I think they are just the standard vitamin's to prepare as best possible.

I should also say that my husband has had the sperm fragmentation test, was this recommended to anyone else? the more I read up on it the more I believe the male side should be considered more outside the standard testing xx

[lookingforaholiday]

Thank you @MeganBistram. My experience of the clinic was the same, all staff were lovely and made me feel at ease.

I certainly agree that male testing is very important. My husband had 0% normal forms due to a varicocele at one point but a relatively simple operation helped with that.

I had meant to add before that we did find genetic testing in conjunction with our IVF very helpful. I did two rounds of egg collection - we got 10 embryos that made it to day 5 from the first but only one was normal when tested (sadly lost by MC). This was at age 34 and and the proportion with abnormalities was a massive shock to us but so glad we did the testing as I'm sure it saved us from even more heart ache. The second time we had 6 normal from 11 so fortunately much better.

[MeganBistram]

@Wolfemum @lookingforaholiday @rainbowssky @Infinitebows

Update :
Yesterday I went for the results. Just a heads up @Wolfemum 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 :)

[Wolfemum]

Thanks @MeganBistram for the update. I'm getting my results on the 22nd next week so we can compare notes.

How are you feeling about it all and trying again?
X

[MeganBistram]

@Wolfemum I was quite apprehensive as the way Dr S delivered the message I wasn’t sure if this was actually the issue. But since then seen my fertility acupuncturist and she was very comforting and said that 100% could cause recurrent miscarriages.

I am so glad I’m not just doing the same thing again and hoping. Just having a plan makes things seem much more positive. Who knows haha

let me know how yours goes :) xx

[MeganBistram]

@Wolfemum how did it go? :)

[Wolfemum]

Hi Megan, sorry for the delay in replying. My NK cells are high, over the 20% needed for a healthy pregnancy.
I've been away the last few days but will reply tomorrow night with the full breakdown xx