Recurrent chemical pregnancies - Fertility Network UK

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Recurrent chemical pregnancies

RS43
RS43

Sorry for the long post.

Just had my 5th transfer and ended up having yet another chemical. Feeling really helpless at the moment. Have my follow up on Thursday and just wanted see if anybody can suggest anything else to try to help. I’ve tried the following:

Fresh cycle: utragestan= chemical

FET: prednisone, clexane , utragestan = BFN

Fresh cycle: Utragestan, heparin = chemical

Fresh cycle: cyclogest and prontogest = chemical

FET: cyclogest, prontogest, baby aspirin = chemical

I have 6 more embryos in the freezer but I don’t want to keep having transfers for the same thing to happen. It’s just emotionally draining. I haven’t tried any genetic testing on any of the embryos so am thinking maybe it would be the way to go? The doctors keep saying that the embryos are good quality (I cannot remember the exact grades) and are quite happy to let me carry on with transfers but they haven’t been able to give me a reason as to why I keep having chemicals. I have also had 2 hysteroscopies and a laparoscopy which has not shown up anything but blocked Fallopian tubes which is why I have to have ivf in the first place.

Any help or ideas of what I can try would be really appreciated.

32 Replies
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Sorry to hear about your multiple chemicals, in a way they’re worse than a bfn because you feel like you’re almost there and it gets snatched away from you.

Can you do ERA test? Look it up, it’ll show whether you’re receptive at the time of transfer.

Some people have had success after adding intralipids, clexane and prednisone + hcg wash to the transfer (even without immune or blood clotting issues).

It could be the embryos but then it’s kind of unlikely that all 5 would be aneuploid so I’m kind of thinking that it’s something else. You could test your remaining embryos but talk to the clinic about the risks as some may not survive the process. However, it may be worthwhile for the peace of mind.

Good luck, I hope you can work it out soon! xxx

RS43
RS43 in reply to Lisichka

Thank you for your reply. You have given me a few things to research before my appointment on Thursday. X

Cinderella5
Cinderella5 in reply to RS43

Sorry to hear about your struggles. I would agree with Lisichka and say the ERA may offer you some answers. I had this done I we discovered that my implanation window was out by 24hrs compared to "normal" people. We had lots of negatives before messing around with my progesterone timings which then got me a very late BFP which I spontaneously lost and then a chemical. Im currently pregnant after using our adjusted protocol from the ERA.xx

RS43
RS43 in reply to Cinderella5

Thank you. Congrats on your pregnancy. X

Lilly12255
Lilly12255 in reply to Lisichka

What is hcg wash?

Lisichka
Lisichka in reply to Lilly12255

“The latest studies report that intrauterine injection of hCG before embryo transfer (ET) significantly improves pregnancy rates in IVF/intracytoplasmic sperm injection cycles. It is suggested that hCG exerts multiple direct influences on the endometrium”

One of my friends has just had it done for her second FET (she said it was not pleasant) as well as intralipids and Lovenox (Clexane) and she just got her bfp. She didn’t have any immune issues but her clinic just put her on everything. HCG wash is very common in the States after the first FET failure.

Lilly12255
Lilly12255 in reply to Lisichka

Is there anything else they do in the states, outside what you listed above? I had multiple miscarriages, so looking for all possible ways to avoid it happening again.xx

Lisichka
Lisichka in reply to Lilly12255

Sorry to hear about the miscarriages, it’s just plain unfair.

I think that’s pretty much all that I know and all that I’ve done personally after multiple implantation failures.

I think I did a post where I listed everything. It took about 6 months to do all the tests and a new cycle but it was worth it.

Read this article (you need to scroll down a bit), it talks about all the options they recommend for recurrent failures. Clinic matters a lot and how much they’re willing to do. My old clinic were so conservative and didn’t want to add anything at all.

cnyfertility.com/boosting-f...

Have you seen a miscarriage specialist? We saw one this year and I'm on hydroxychloroquine, intralipids and predisolone. I also took humira at the start of the year... The specialist identified high levels of nk cells, meaning my body was attacking the embryos at implantation stage. The initial tests were expensive but the meds aren't, compared to ivf anyway. Unfortunately we only had one cycle of ivf this year due to covid, and the two embryos were abnormal so I couldn't test if the meds work! But I have had two natural pregnancies in the last 2 months (currently trying to work out if the light bleeding I've got right now is another chemical or implantation bleeding). I haven't been pregnant naturally since June 2018, so the meds must be doing something. Worth looking into. I'm like you- I never get past 5 weeks x

can you take all these drugs ( hydroxychloroquine, intralipids and predisolone) when trying naturally, not via IVF?

Yes, so I originally took humirain February, which calms down the nk cells, it lasts 9-12 months and is an injection.... I started taking Hydroxy a couple of weeks before my ivf cycle, (june/July-ish) and the idea is that I was supposed to start taking omeprazole and predisolone on the day of embryo transfer. However, I got pregnant naturally so went in for an intralipid on the day I got the positive result on the first response, then started the other drugs on the same day, alongside 2x 400 progesterone pessaries. It is a lot of pills but no side effects from any. If you're London /Surrey based, I can pm you the name of my specialist in Epsom / london. He's easily found online too x

RS43
RS43 in reply to Zebedee1971

Thank you for your reply. I do feel that I need to get tested for the nk killer cells as I have been looking into this. My drs answer to this seems to give me prednisone without any testing. I would love to have the details of your specialist. I am based in London too. Fingers crossed for your pregnancy. Xxx

BettyBe
BettyBe in reply to Zebedee1971

Hi ladies, could you possibly send me the details too please?? I’d be interested to get tested before Christmas. Thank you xx

NIdris
NIdris in reply to Zebedee1971

Hi there, can you share details with me too please

Yes please send me the details PM

Same. Mine is to do with my immune system x

sorry to here that 💔I had a chemical and my doctor did uterus biopsy and we found out I had a sever uterus infection which has been gone so hard, we also improved many factors mostly for sperm quality ( my husband sperm DNA was pretty hight and we did TESA) so don’t know what helped but I got pregnant in my 4th transfer and 3th ivf fresh cycle . It can be many factors involved just you need more investigation, my prayers is with you ❤️

RS43
RS43 in reply to Natasha62

Thank you for your reply. I agree that we both need more testing as it could be the embryos. X

Prednisolone 20mg, and hydroxychloroquine twice a day along with double dose cyclogest (2x am and 2x pm), high dose folic acid, and clexane seems to have been the dose that has stopped me miscarrying within the first week or two after a positive.

I’ve had countless chemicals plus 4 early losses. Not that this one is a happy ending, as we think it’s a blighted ovum, but it’s seems to have been the right mix to keep me pregnant.

I used locus Medicus in Greece to get extra immune testing and hidden infection testing, I would have thought you would be given some more miscarriage testing beyond the hysteroscopies such as blood clotting disorders and karyotype tests etc xx

Thanks for your reply. I am based in the UK but will definitely look at immunology. X

The best person to see for immunology in the UK is Dr Shehata at the CRP clinic. I’m now under his care for recurrent miscarriage (I’ve had three miscarriages and a chemical pregnancy). He’ll run a lot of tests that do cost quite a bit but the drugs he prescribes (things like steroids, hydroxy, Humira etc) don’t actually cost that much. Good luck x

Thank you. Zebedee also recommended him. I have looked him up. X

And good luck 🍀

RS43
RS43 in reply to BBHH1

Thank you. X

Thank you for your reply. I’m sorry you are going through this. It’s such an emotional rollercoaster. I’m already on an increased dose of folic acid but will look into the further testing. X

Oh I just thought of another thing - as part of recurrent pregnancy loss panel get the MTFHR gene tested as if you have it, one or both, it’s been associated with increased miscarriage risk AND your body can’t absorb folic acid. In this case you’ll need high quality folate supplement.

RS43
RS43 in reply to Lisichka

Thank you. X

i have no advice to give but with 4miscarriages im definitely going to be looking into this. Thank you for thr great advice everyone

I’m so sorry to hear this lovely, it’s heartbreaking and exhausting to go through. Have you done an ERA test? There is a chance you might be missing the correct window to transfer. Also, have you had your progesterone tested on the day of transfer to check it’s at an optimal level? Xxx

Ps my first transfer was a fail, progesterone was checked on my second transfer and it was too low so I introduced lubion injections. I had a MMC but it worked x

RS43
RS43 in reply to Peanutchips

Thank you for your reply. Sorry for your Mmc, it’s so unfair. I haven’t had progesterone levels checked at time of transfer before. It’s definitely something to check. X

I am sorry you have gone through this. I had 2 ectopics and 4 MCs before ivf.. I ended up going private regardless under nhs reoccurrent miscarriage unit. The dr at the private clinic did a hysteroscopy and the EMMA/ERA/ALICE test. Everything came back clear. I had NKcells test two years ago... clear. Maybe have a look at this. Last month I had a chemical pregnancy and my prof isn’t worried and said it’s a numbers game as not all embryos are normal xxxxxx

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