Webchat with Professor Siobhan Quenby on recurrent miscarriage on Friday 29 January from 1 - 2pm

[SallyRoseMumsnet]

Hello

We’re pleased to announce a webchat with Professor Siobhan Quenby, Obstetric Consultant at University Hospitals Coventry and Warwickshire NHS Trust and a Professor at the University of Warwick. She’ll be joining us for a live webchat on Friday 29 January from 1 - 2pm.

She runs recurrent miscarriage, implantation and preterm prevention clinics dedicated to the management of and research into recurrent pregnancy loss prevention. She has over twenty years of experience in research into implantation and recurrent miscarriage and has published over 120 original articles and 22 chapters for academic books.

Of course Professor Quenby won’t be able to give detailed clinical advice to individuals on this thread, but she has a wealth of clinical and research experience in recurrent miscarriage and is keen to offer help and advice to MNers with questions about this area, as well as talking with you about the ongoing work of her Coventry clinic.

So please do join us on the day at 1pm or if you can’t make it, please post your questions in advance here. As ever please do also remember our webchat guidelines.

Thanks
MNHQ

@patienceisvirtuous

After the uNK test performed by Prof Brosens, my recommended protocol is progesterone only. We're currently on 3rd cycle of ttc.

I feel anxious only relying on the progesterone - especially after the results of the promise trial. Would it do any harm to have heparin and pred too, as well as the progesterone? I feel I want to throw everything at the next pregnancy if I am lucky enough to have one.

Would Coventry be supportive of prescribing the 'full protocol' despite my results not indicating I need it?

The Promise trial found that the progestrone given after the pregnancy started does not prevent miscarriage. Professor Brosens work shows that a likely cause of miscarriage is failure of the lining of the womb to develop and support the pregnancy in the last week of your cycle. This means, that starting the progestrone in the last week of your cycle would theorically prevent miscarriage according to experiments carried out in Professor Brosen lab.

Hi Prof Q, I just wanted to say a massive thank you to you and the team at Coventry. I had my daughter in May 2014 after 4 first trimester losses, on my first pregnancy on the Coventry protocol. You are giving hope to women who have been told nothing can be done. Thank you!

@Frecklefire

I am hoping to visit the Coventry clinic soon as I know so many women who have overcome rmc and had successful pregnancies due to the protocol used there. Please could you explain the theory you have regarding why so many women have successfully carried a first child (more commonly, it seems, a boy) and then seem to experience rmc when trying for another? How does the environment of the uterus change due to pregnancy that makes nk cells to rise, and is there any way this could be reversed? Thankyou.

There is study from Denmark that suggests that if the first child is a boy you are more likely to miscarry further male pregnancies however, this work has never been repeated in any other country. At University Hospital, Coventry we feel that the key to successful pregnancy is the way the lining of the womb prepares for pregnancy. It is important to realise that the lining of the womb is shed and regrown every month hence it does change over time. In some women, it seems to get better and their pregnancies get further on each time and in others have a normal pregnancy then it seems to get worse. If you come and see us, we will be able to study the lining of the womb and get better answers to these questions with our world class research.

@Miloarmadillo1

Hi Prof Q, I just wanted to say a massive thank you to you and the team at Coventry. I had my daughter in May 2014 after 4 first trimester losses, on my first pregnancy on the Coventry protocol. You are giving hope to women who have been told nothing can be done. Thank you!

Thank you for your kind words, I am delighted you have a daughter.

This would be relevant to me as I only started progesterone at 6weeks for mc5 due to the pregnancy being unplanned (we were waiting to come to Coventry following mc4!) So this could still be a possible treatment for me???

@Kazz2112

Hi Prof Quenby.

I am 32 and have had 5mcs since may 2014. I am yet to have a successful pregnancy. 3 of my mcs have been mmc where foetal development stopped at around 6 weeks. The other 2 were full natural mcs at 5weeks. For one of these (mc4) I was on the Response trial. For mc5 I was on progesterone and clexane.

Is it likely that the mmc and the natural mcs were a result of 2 different problems?

My paternal grandmother had at least 7 miscarriages in the 1930/40s before conceiving and carrying my father. What are your thoughts on a possible genetic /inherited link here?

Following discussions with other ladies who have experienced recurrent miscarriage we noticed that a disproportionate number of us are 1.teachers 2.cat owners 3. Suffer quite severe reactions to mosquito bites! Do you have any thoughts on whether these things can potentially heighten the immune system therefore possibly impacting in pregnancies?

I am planning on coming to Coventry in a few weeks time for the unk cell tests and am really hoping you can help us find some answers.

You are a very interesting case and I am delighted you are coming to see us. At present, we think that all your miscarriages could have been a problem with the lining of the womb. I can assure you that women from all professions and walks from life suffer miscarriages, there is no link with teachers. It is possible, that there is a link with shift workers as Professor Brosens work has shown that the lining of the womb body clock. I can assure you that are similar proportions attending our miscarriage clinic, having antibodies to toxoplasmosis that can be caught from cats prevents it being caught in pregnancy which can have serious outcomes for the baby.

Hi,
I've had 7, 5 of which were blighted ovums.
I was eventually referred to Liverpool.

After travelling to & fro, trying different things, they told me that actually, they do not know the cause of up to 80% of miscarriages and that funding for research had come to an end.
I so wish I had been told this sooner.
It would have given my the informatio to see things on a more realistic light. I thought that I would go & they would have all the answers & the magic cure.

This was 4 years ago, is this still the case and how open are you with couples 're the probability of diagnosis and causes of the issue?

I am very excited that Tommy's is funding research into women who have had two or more miscarriages rather than the standard three miscarriages. This means that if you have had two miscarriages we would be delighted to see you because you could help us to find new treatments to prevent miscarriage and new tests to help understand why they occured. If you want to be part of this, please get your GP to refer you to me at University Hospitals Coventry and Warwickshire NHS Trust.

Thank you for this reply. I am very interested in your comment that progesterone is onlyneffecruve if taken before pregnancy as I started it around 6 weeks with my 5th pregnancy.

I look forward to meeting yourself / prof brosens hopefully in a few weeks. I should maybe warn you that my lovely rmc friends gained through mumsnet have challenged me to get a selfie with yourself or prof brosens! I don't like to back down to a challenge. Just like I will not let my miscarriages beat me! 😊

Kazz if there was a like button i'd press it

@jimijack

Hi, I've had 7, 5 of which were blighted ovums. I was eventually referred to Liverpool.

After travelling to & fro, trying different things, they told me that actually, they do not know the cause of up to 80% of miscarriages and that funding for research had come to an end.
I so wish I had been told this sooner.
It would have given my the informatio to see things on a more realistic light. I thought that I would go & they would have all the answers & the magic cure.

This was 4 years ago, is this still the case and how open are you with couples 're the probability of diagnosis and causes of the issue?

Stories like this are the motivation for our research programmes. Each year we gain new knowledge into how the lining of the womb can contribute to miscarry such as yours. Gradually, we are improving the tests of the lining of the womb and with Tommy's funding we expect to speed up this process and have new treatments. Whilst we do not have all of the answers the moment everyone who comes is part of, world class research which will one day mean that everyone with stories like yours will have satisfactory answers.

Sorry, kindle has a mind of its own...

Haha Kazz, look forward to the selfie 😉

@Kazz2112

Thank you for this reply. I am very interested in your comment that progesterone is onlyneffecruve if taken before pregnancy as I started it around 6 weeks with my 5th pregnancy.

I look forward to meeting yourself / prof brosens hopefully in a few weeks. I should maybe warn you that my lovely rmc friends gained through mumsnet have challenged me to get a selfie with yourself or prof brosens! I don't like to back down to a challenge. Just like I will not let my miscarriages beat me! 😊

I am looking forward to meeting you

Care varies from hospital to hospital, can you see standardization in the future?ie, NICE guidance.

That is care of the woman suffering miscarriage.

I would very much like to help by contributing to research following my experiences, how can I do this?

Well... you issued the challenge ladies... those of you who have met me know that I don't like to fail 😁

@jimijack

Care varies from hospital to hospital, can you see standardization in the future?ie, NICE guidance.

One of the reasons I am so pleased to be part of a National Miscarriage Centre funded by Tommy's is that it is a real opportunity to standardise care and this process does take some time and lots of meetings. However, I am very confident we will gradually improve things in our new partnership.

@jimijack

That is care of the woman suffering miscarriage.

I would very much like to help by contributing to research following my experiences, how can I do this?

Please get your GP to refer you to me at University Hospitals Coventry and Warwickshire NHS TRust, the more people I see, the quicker I will get an answer to my research questions.

Sorry, just seen your answer 're research involvement. Will go to my gp
Thank you.

Thank you for your questions today, sorry I didn't get to answer you all but I hope I have helped.

Thank you for taking the time to do this.

Thank you Professor. If you ever have time to do another webchat we'd love to do another

Please could you publicise the fact that the PROMIS results haven't shut the door on progesterone as a treatment? We're worried gps may be even more reluctant to prescribe progesterone now.

@ProfSiobhanQuenby

Thank you for your questions today, sorry I didn't get to answer you all but I hope I have helped.

Thanks so much for taking the time to join us and thanks to everyone who posted questions.