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

@MeganBistram 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

@Wolfemum dont be silly.. I hope you have enjoyed some well deserved time away :)
Give me an update when you can… interestingly I have been questioning things so much more since the results yet all I wanted was answers.. the joy of trying again after loss eh? :( xx

Hi @MeganBistram
Dr S said I have very high thyroid antibodies and my NK cell count is high at 23%, he said normal is under 20%. He did say my blood reacted well to the medication therefore has recommended me to follow the complex natural killer treatment programme which includes
Intralipid infusions, in addition to Hydroxychloroquine 400mg, Prednisolone 25mg and Progesterone.

I am going to start trying again at the end of the summer and digest everything I was told first.

What have you been questioning?? Xx

Soo glad I found this thread! I had my first appointment today. Were the thyroid antibodies detected from the nk cell tests? Do you go for the infusions at Epsom? Did they give an idea or cost? The blood tests alone are eye watering. I’m getting a lot done by my GP. To you have to have the treatment before you start trying or in combination? X

@Wolfemum pretty similar then accept I had the high th1/2 ones. Interestingly my NK were 22% and my bloods also reacted well but he has only suggested intralipids not the prednisone.. although it’s one of my questions when I go back in 2 weeks time. I would feel better to do both.. feels like I am doing more.

I don’t know.. probably just worrying if this really is the answer or there is something else.

also at the advice of my acupuncturist I did a micro biome and got the results today and she said I had the hugest reading of group B strep they have seen. I did know I had it from my first child I tested but I wonder if it has played a part given it’s so high?

@JandL2020 welcome :) not 💯 sure which test it was for the antibodies but I am confident it would have been covered in some of the ones you had today. I think it’s Epsom for the intralipids but not started them yet. I think it’s £380 an infusion which is needed 3/4 times in a pregnancy.. far form cheap

my treatment started from appointment 2 and it’s his belief that this is where he differs to most professionals as he starts before conception.

we will be trying again in May when we have all answers :) x

That’s not actually as bad as I thought it would be. Yes he’s very keen on pre conception which is good. Wish I had done all these tests before. Would have saved a lot of heartache! I was really pleased to hear we can try naturally after my ectopic. I was told not too and to go straight to ivf ( I have 4 frozen embryos) so my case is a bit unusual…not sure how it works with ivf timings. Will ask on my next appointment. Best of luck to you xx

Had my 2 healthy babies thanks to Mr S after 4 early mcs (at ages 29-30). NHS told me it was just bad luck. Was 100% worth it.

You will be given a treatment plan that works alongside your ivf. From memory it's something like intralipids 5 days before transfer, same ish for prednisolone. I'm on the 'super complex' plan (oh joys!) and currently 8 ish weeks pregnant (but measuring a week behind, which is a concern) with a letrazole ovulation induction round and go for scans every 2 weeks and intralipids every 4 for a while. As I've been ttc for so long my gp has been kind and prescribed quite a lot of the drugs for me on a repeat, although not all gps will. Intralipids and the scans are expensive though (£670 for a scan and intralipids combined last week).

Can I be nosy and ask what your Gp is prescribing? Mine told me they aren’t commissioned to prescribe progesterone which is a load of rubbish!
I hope your little bean is just a bit small and will catch up xx

@JandL2020 some of them are from my ivf protocol (different clinic), some for CRP.

I have prescribed through my GP:
Estrogen tablets
Estrogen patches
Viagra (for thin lining)
Prednisolone
Omeprazole
Cyclogest
Sukkarto
Levothyroxine
Clexane
I've probably forgotten some!

All is for ttc or recurrent miscarriage treatment. It took a few years to get to the point where they'd prescribe all the above.

The only ones the GP couldn't do was lentogest (progesterone in oil injections for ivf) and obviously intralipids.

Thanks so much xx

@seven201 wow that does sound complex, I have everything crossed that this is your time :)

Yes forgot about the cost of the scans which is £280 for scan and consult I think from the price list

@JandL2020 if you look on the CRP website there is a price list deep in there somewhere :)

Also question ladies, has anyone had any tests for endrimetriosis? I have no signs of it but read that at the age I miscarry that it can be down to that? xx

@seven201 how is everything going?

I go back to Dr S on the 17th for my results after the treatment for the high TH1/2 cells, I am going to ask him to prescribe me Prednisolone alongside the intralipids and see what he says, my NK were raised but he seemed happy with just intralipids

xx

@MeganBistram there's no harm in asking. He may try and talk you out of it, so be prepared. Or maybe he'll just say 'no problem'.

I'm ok. Had brown spotting last night and this morning but happen to have my 10
Week scan tomorrow at CRP, so at least I should know tomorrow.

@seven201 Yes definitely strikes me as a try to talk me out of it kind of man :)

Oh gosh ok that must be scary but fingers and toes crossed, I know the 10 week mark is the magic milestone with him. Please let me know how it goes if you feel comfortable to share xxx

I had my 9+6 scan today and it's measuring 9+0 (past two scans have been 7 days behind each, so this is good). Strong heartbeat. I'm still spotting brown though, which is a worry. I think it's approx when my period would have been so hoping it doesn't last much longer. Going back in 2 weeks!

Amazing news.. I’m so pleased for you :)

is this a good milestone vs. Your previous losses? ( don’t worry if you don’t want to answer that ) xxx

@MeganBistram thank you. Yes, it's a good milestone for us. The last loss was heartbeat at 7 weeks then none at 8 weeks, along with slowing down growth. All of my previous losses were earlier than that. I did have a bit of red bleeding with my dd, so logically I know brown spotting doesn't have to be bad news. Trying to enjoy knowing I'm currently pregnant.

@seven201 amazing 🤩

With my son I had spotting and of course he was my first with no issues so I didn’t even give it a second thought. But I know how hard it must be now to stay positive.

We start trying again next month and I have a mixture of excitement and pure dread.. but I will keep you updated :) xx

@MeganBistram please do keep us posted! Good luck

Hi everyone hope you don't mind me joining in, i'm on another dr s thread and just came across this one.

I started on a superovulation cycle last month with CRP after being diagnosed with normal nk cell count but high activity of the ones I do have. (I also tested positive for ANA). My treatment consists of hydroxychloroquine, aspirin, intralipids, letrozole, cyclogest, prednisolone.

I have already had 4 ivf transfers last year, 1 of which was a chemical which has now led me to dr s to help me understand why they're just not implanting. Happy to answer any queries if anyone has any regarding protocols/costs etc.

@seven201 congratulations to you, it's always nice to read positive news! Can I ask if you had a superovulation cycle and if so how many months did it take?

Unfortunately, they found a polyp in my uterus last month, so my protocol is on hold until I can get a hysteroscopy done this month. I also had dh do a dna sperm frag test with them, which came back borderline so he is currently on Impryl.

Good luck to everyone on this journey x

@star2022 that's the same protocol as me, except I also had adimulumab at the start. I had lots of started letrazole rounds that were abandoned, 2 or 3 as I had 'something' in my uterus and they thought it might just go. Eventually a hysteroscopy found it was actually retained products turned to scar tissue from my last miscarriage (I'd had medical management). After that was cleared it was the 4th cycle of letrazole that worked. I was on 75 (I'm 40, it's not always that high) and each cycle had 3 follicles looking like they might ovulate. I did have another delay due to there often being fluid on my c-section niche, so went to see the doctor who had operated on that years ago (to improve the shape of the niche) so I understand how the delays for things like hysterocopies can be so very frustrating. Good luck with yours.

@seven201 thank you so much for your response! That gives me so much hope! I definitely need a hysteroscopy as I even did the saline hysterosalinogram at crp where they pump fluid to expand the uterus and it definitely looked like a polyp just hanging on. We waited to see if it went away on its own, but this week we went back for a scan after taking letrozole and it was still there so we have had to abandon this cycle. Yes its so frustrating, and even more so as we will have to pay £2500 for the hysteroscopy too but its good to know that you had success after yours so i'm keeping my fingers crossed.

I'm currently on 5mg letrozole and both cycles we've had 2 dominant follicles which they've been happy with. Thank you so much for responding, keep us updated with your journey! x

Hi, realise I’m late to the party, but wanted to jump in nonetheless. Apologies for the long read!
im so sorry for your losses. It’s such a difficult thing to go through, and I wish I could go back to being naively innocent about it all.
I know that there have been successes with Dr Shehata, and that some people think he’s incredible. My experience is very different and so, for a balanced view, I wanted to share.
by the time my husband and I saw him, we’d had 2 MMC. We did all the testing (just over £2000 worth) and the results came back positive for increased and overactive NK cells. I was skeptical, but we proceeded with the treatment plan, which was very similar to the ones described here. I was also offered an ultrasound to make sure my uterus was healthy
over the next 18 months, I had 2 Chemical pregnancies.
We we’re about to give up, but were traveling to South Africa and so decided to see a specialist there. He was shocked by the treatment protocol I had been placed on, stating the monthly Intralipid infusions were unnecessary. He was also shocked that I’d been offered an ultrasound rather than an HSG scan. This scan involves a harmless dye being injected into the uterus to properly understand the shape of the uterus. It’s also used to flush fallopian tubes.
The results of this test showed I had a misshapen uterus, which was fixed with a minor surgery.
I’m now 16 weeks pregnant and didn’t need any of the medication prescribed by Dr Shehata to get to this point. I know that this might be a rare condition and a unique case, but no one, in the 2 and a half years we were going through this mentioned an HSG scan and so I just want to create awareness.

@michileo absolutely worth pointing out the other things they are not so strong at e.g. the scans

I have had an aqua scan which was fine so they took that as gospel, However for my own comfort I had another one not with them after my last Miscarriage.

Massive congratulations on the pregnancy :) xx