**Sensitive** Another miscarriage and not sure what to do next

[Holdingontohope36]

Hi ladies,

Merry Christmas and well done to those getting positives and good outcomes during the festive season.

Unfortunately my Christmas has been very sad so far - yesterday, on Christmas Eve, I had to have a D&C to remove my fifth failed pregnancy at seven weeks (a natural pregnancy). It was a twin and I lost the other one two weeks ago. Both have been sent off for cytogenetics but my strong feeling is that there will be a chromosome issue.

I’ve seen every recurrent miscarriage specialist out there, and the only thing they’ve identified that could be wrong is raised natural killer cells and TNF alpha levels, both of which have been treated with a combination of intralipids, hydroxy and Humira. But I feel the root cause of my miscarriages may be egg quality, not immune issues.

I did IVF twice this year and ended up with one twin miscarriage and seven embryos identified as abnormal through PGS testing. It was a hugely abnormal result, the doctor said, given I’m still relatively young (36) and have good hormone levels.

I’m now thinking that returning to IVF and doing PGS really is my only option. I want to keep using my own eggs but do you think, at this stage, I should start seriously considering donor eggs? I’m so confused. Everything on paper seems fine, I have good ovarian reserve for my age and I get pregnant relatively easily. But they all end before seven weeks. I’m losing hope.

[Millbanks]

Hi lovely, I don’t have any experience I’m afraid and no advice but I just wanted to say how sorry I am to hear this. I hope you are able to take some time to heal. Sending lots of love and strength xxx

[Hidden]

I am so sorry to read this and send you a hug.

I am a lot older (43) but in a similar situation - been ttc for 5 years and had a mix of IVF and natural BFPs but had four miscarriages (over 6 weeks) - one after I had seen the heartbeat .. and three other chemicals at around 5 weeks

We have been told it’s egg quality because I have a great egg reserve (11.8) for my age .. and they’ve said it’s pointless trying again - so now trying to work out if it’s donor or embracing life without children

The one difference is I never get enough embryos to PGS so great that you do and I definitely think that’s worth a try!

Anyway thinking of you xx

Sorry should add been diagnosed with Lupus and sticky blood etc but that’s all been treated and I still continue to miscarry so assume it had to be egg quality xx

[Peanutchips]

Oh lovely, this is just so cruel and heartbreaking. I’m so so sorry you’re having to go through this. I don’t have any experience to give advice, only to say another round with PGS when you’re ready sounds like a good idea, every batch is different. 36 seems too young to not have any normals. Sending lots of hugs and light xxx

[Zebedee1971]

I'm so sorry to hear you're going through this. How long have you been on nk cell treatment and how many cycles have you had taking all the drugs?

Honestly, the fact you're 36, have good ovarian reserve and got so many embryos last time... I wouldn't jump to donor eggs just yet. I'd try again with your own eggs and bear these two things in mind:

1. Every cycle is different. Science won't always put the right egg and sperm together. In natural pregnancies, your body selects an egg and the strongest sperm fertilises it... In ivf, all sperm have equal chances of fertilising. Its a bit like putting Usain Bolt in a race against Fat Steve, but putting them both at the finish line. You may have had 7 wrong combinations this time but next time you might get the right mix. My last cycle of ivf, I only got 2 embryos; both were abnormal. The rest all deteriorated after day 3. It's easy to convince yourself that this will always be the case, that all the embryos will be bad.... But they won't, its not possible when you have so many eggs.

I'm currently 13 weeks pregnant- I got pregnant naturally 2 months after these abnormal embryos made me completely paranoid all my eggs were duds. So please don't think these 7 represent your entire egg reserve, you just had a bad cycle that's all. Science, on this occasion, got it wrong.

2. Nk cell treatment does work. I'm only pregnant because of the drugs I'm on, I'm 100% sure of this. So please do believe in it.

I am similar to you, I have good amh and always got 15+ eggs through ivf. No problems with my other half's sperm. I never understood why all my pregnancies ended before 7 weeks and I did convince myself it was my dud eggs. We had terrible ivf cycles, ivf just didn't seem to work for us at all. And yet, one month taking all the nk drugs and it happened naturally. Just out of the blue. We were so shocked, and still are really. I'm proof that eventually, sometimes, things just 'click' - right egg, right sperm, right drugs, right time. It took 3 years but we got there. And I never ever thought we would.

The only other thing to bear in mind is that pgs testing isn't 100% reliable. I won't go into a big monologue about it, but I am cynical about it personally (I know some people will say the complete opposite). But I don't necessarily think it's as accurate as it should be considering the stakes at hand. Because you get so many embryos, I understand why you'd choose to do it, but sometimes I think it's better just shoving them in and seeing how they get on. Most embryos with abnormalities will end really quickly so these will probably end in chemicals anyway.

Anyway, sorry for the essay. Mostly I just wanted to say give your eggs another shot (or 2 or 3). Please don't give up on them yet. They deserve another chance before you start looking at other options xx

[anz07 in reply to Zebedee1971]

Hello, I just wanted to say that, even though this isn’t my post, reading your reply has helped me so much. Everything you said makes such sense and has helped me demystify all the reasons and theories I so often cling on to. I have only had two transfers, both of which ended in chemical pregnancies, the first at almost 5 weeks and the second just before 6 weeks. I have been desperately searching for a reason as to why this has happened twice in a row. Even though I know embryo abnormality is the most likely reason, I am still paranoid that there is something wrong with me etc. It was so lovely to read your story and hear a voice of reason in all this madness! Thank you so much xxx

[Holdingontohope36 in reply to Zebedee1971]

Thanks so much for your reply, it’s really helped during this horrible time. My hunch is not to give up on my eggs either. Like you say, it seems bizarre that at the age of 36 (and we started TTC when I was 34, my husband 32) that we are unable to find a good embryo. That said, counting up how many embryos have been ‘wrong’ is pretty damning - considering all my miscarriages, plus the PGS abnormal ones we tested, there’s been something like 14 now. (Two of those miscarriages, admittedly, we don’t have a reason for as we weren’t able to test the remains. But all of the losses follow such a similar pattern - heartbeat seen at six weeks, then it dies a few days later.) I wasn’t on the NK cells treatment for long before this pregnancy. I did the Humira and started on hydroxy, then a few weeks later I found out I was pregnant. Perhaps it happened too soon? Can I ask - how many rounds of ivf did you do and did you PGS test all the embryos you created? How many came back abnormal? Xx

[Zebedee1971 in reply to Holdingontohope36]

So I had the humira in February, and we tried naturally with no luck (as had been the case for over a year beforehand), then we had our third ivf cycle in July. I started taking Hydroxy a couple of weeks before this cycle and had an intralipid during the cycle too. So this was the first time I had Hydroxy, humira and intralipids in my system.

I got pregnant naturally the first month after the failed cycle (we never transferred as the 2 embryos were abnormal). That pregnancy ended in a chemical very early on however I didn't take the steroids (I think I was in shock, and I didn't refer to my plan, as I was expecting an ivf pregnancy) and I also made the mistake of delaying the intralipid because I had to work Monday-Wednesday... So I had saturday-thursday before I took the intralipids.

Then I got pregnant again naturally the following month and I started taking the steroids and progesterone straightaway and booked the intralipid for the same day.... Miraculously, the little one is not only still going strong but our 12 week scan showed a perfect baby, no worries at all. This is the first time I've taken all the drugs together, and the first time we've ever had a heartbeat.

My ivf cycles just weren't very good-- my first clinic messed up my egg collection so we got two poor/average that didn't take. My second cycle we got 2 again, average/good but it was a very early chemical. Whether this failed because of embryo quality I can't say... I'd say it was more likely the nk cells, as my pregnancies always ended super early-- my lines never got darker, only ever stayed faint.

We only ever got 2 embryos in all our 3 cycles, never an 'excellent' and most of our embryos deteriorated after day 3.

We only tested the two embryos in the summer. The consultants insist that miscarriages are due to chromosomal issues 99% of the time and so they pushed for us to do it... I regretted it instantly. I just don't think it's helpful to be told your embryos are sh*t. My miscarriage specialist told us not to test them. His theory is that you can't judge a whole ovarian reserve on one batch of embryos. Nature has a way of terminating chromosomally abnormal embryos really early on (only three abnormalities can go on to full term or past the heartbeat stage-- trisomy 21, 18 and 19 I think). So his theory is- shove them in and see how they get on. A lot of embryos correct themselves anyway, and some abnormals have gone on to result in normal pregnancies (in the US).

I think because the nk cell treatment is relatively new to you, my advice would be to keep going with it. You didn't say if your recent pregnancy was natural or ivf? If natural, then make sure you're taking the Hydroxy, (I have been on it since July and no side effects or anything like that) and if you can, ask for an intralipid around the time of ovulation or similar. I know they say to take them every 4 weeks but they can stay in your system for up to 6. I'm convinced that's why I got pregnant naturally, it was the little push my body needed. Then, if you get even the faintest line, take the intralipids (and steroids if your clinic is prescribing) straightway. No waiting around. If ivf, keep faith that it only take one. I really can't believe all your eggs are duds. I told myself this in the summer and now we're 1 week away from our 14 week scan. Have faith xx