Miscarriage with PGT-A tested embryo. What next?

[gina71]

Dear All

I am grateful for the support that this community has given me over the last years and I wish to pay my respect to all of you who persist on this difficult journey!

My IVF story began 3 years ago (with 41). My second transfer with two (untested) embryos ended with a miscarriage at 7 weeks. After this painful experience, we decided with my doctor to bank embryos and PGT-A test them. My next try (with 42) resulted in no euploid embryos (a devastating realisation). After this I decided to undergo PRP treatment and I also invested in supplements like Ubiquinol, regular exercise and some acupuncture sessions. The result (after 4 months) was a very positive one as we got 3 blastocysts which made it to day 5, two of which were tested euploid.

I was very hopeful for the single embryo transfer which followed last month with 43 (on the day of my birthday, so extra hopeful!) but unfortunately things turned out differently than I hoped. After a positive pregnancy test and good HCG results on the 12th day, I got blood and cramps on the subsequent day and my HCG started falling (despite taking extra progesterone, prednisolone and aspirine).

I still have a last chance with a euploid embryo and I was wondering what do you think could possibly be tested before I give it a last go (so that I can be sure that I did the best that I could). My doctor does not believe that i should test NK cells as I have had two implantations. He mentioned only bad luck as the cause of the miscarriage. Also, prior to the embryo transfer I had gone through antibiotic treatment for uterine bacteria and subsequently had taken steadily probiotics until the day of the transfer. In December I also had a hysteroscopy.

If you would have any advice about what to do at this stage and prior to the next embryo transfer, I would be grateful 🙏

I wish to every single one of you best of luck on this journey and many blessings 🫶

Gina

[JA-fnuk Partner Nurse Fertility Network UK]

Hope you get some replies that are helpful as this forum is an excellent source of information and support Make sure you have people around you for support

Thinking of you

Janet-Partner

[gina71 in reply to JA-fnuk]

Thank you so much for your thoughts, dear Janet! ❤️

[Nes1005]

Hello

I just wanted to say, I am so sorry that things didn’t work out and I hope you are doing okay from that.

Have you been tested for ‘sticky blood’ - blood clotting disorders? It is a common cause of miscarriage, I had treatment for it on my last cycle and it worked. I’m 44.

Wishing you the very best with your remaining embryo.

V

[Anisha29 in reply to Nes1005]

Hi Nes. I have mild sticky blood and the consultant said just to take around 100g of aspirin. What was your medication?

[gina71 in reply to Nes1005]

Thank you very much for the suggestion. I did not have any special tests for blood clotting issues but I was taking one innohep 4500 per day when the miscarriage happened. If you have any further suggestions or specific tests to recommend before the next try I would be grateful. All best, G.

[Millbanks]

Hi lovely,

I'm so sorry to read your story - its rough this IVF journey.

I had similar last year where I had an mmc at 6+4 weeks with a euploid embryo. I was baffled too - as I know it's not a silver bullet but I don't know what would make a chromosomally correct embryo miscarry.

I did a bit of reading and essentially what I learned is that some embryos simply don't have enough energy to continue to grow - even if they are "normal" - there's something missing that we cannot test for and for want of a better term it's just bad luck.

I think the protocol you were on seems like a good one - and seeing as you have had implantation I would say it's possible that your next one might be the one. Its just so hard when really all we want is reassurance that it's going to work....

Sending a big hug xx

[gina71 in reply to Millbanks]

Thank you so much for sharing your story. I hope things worked out for you after last year's difficult experience. It is so difficult to manage all these feelings but I try to be optimistic for the next try. A big hug to you as well xx

[Twiglet2]

I’m so sorry 😢 that must have been so tough! Only thing I would say is maybe ask about clexane instead of the aspirin next time or test for sticky blood etc as sometimes clots can be an issue as the embryo grows and implants further. Other than that I have to agree does sound like you’ve done so much and the ‘luck’ element may have played a part here 😢 and that’s the hardest part as we can’t plan or change things for that xx

[gina71 in reply to Twiglet2]

Thank you so much for your comment and understanding. Ι very much appreciate it. I was not tested for APS but I received innohep and aspirin before and after the embryo transfer and I hope they guard me against blood clotting.

[Angelikid88]

i am sorry it hasn't worked yet. As the others said already it sounds more like an issue with the embryos and not your body. I am thinking I should have a consultation with an immunologist or a good GP Dr as I am also worried it can be something with my immune system. Maybe you could try this too? You can also ask for a low prednisone dose and also (though not as important) take vitamin D and folic acid.

xx

[gina71 in reply to Angelikid88]

Thank you so much for your comment and thought, very much appreciated! I am thinking of doing the NK cells before the next transfer, just to be on the safe side. I was on 5mg Prednisolone before and after the embryo transfer and I am also taking a multi-vitamin including folic acid and Vitamin D. I wish you all the best as well! xx

[Angelikid88 in reply to gina71]

oh yes do the NK test! all the best and hope to see a positive update from you soon

[Arlie123]

Hello, sorry for your loss, it’s so tough. I’m in a similar boat age wise and only had two euploid embryos after four egg collections. Because of that I decided to do all the tests up front. I did immune testing (I don’t know why you’re doctor is saying no immune issues because you had implantation - that’s just not true!), Emma, Alice, Era, microbiome, cytokines and NKC plus a hysteroscopy. My protocol is clexane, progesterone, prednisone, intralipids, IVIg and LIT. Personally I would look into all avenues up front to maximise your chances. Good luck!

[gina71]

Thank you so much for your reply! I am sorry to hear that you are on the same boat and I truly hope that you will get a positive result soon 🙏 I am a bit puzzled with the immune testing: I had tested for NK cells in the blood in the past and it was negative but isn't it the uterine NK cells we should be looking for? I will ask for Emma, Alice and Era (when is the right timing for those before the embryo transfer?) Last December I had tested my microbiome (after detecting some bacteria I had a treatment with antibiotika and probiotics which I plan to take before my next transfer) and had a hysteroscopy as well. My protocol involved innohep (I think it is the same as clexane), progesterone and prednisolone. No intralipids though (from a quick search IVIg and LIT look expensive and a bit controversial). Thank you very much again, and I hope you will have success 🙏🙏🙏

[Arlie123 in reply to gina71]

No worries - I’m actually 10 weeks now with my last embryo. Ivig is very expensive but was offered at my clinic as well as the RI I went to see. LIT is cheaper than ivig but is offered less. Generally the evidence for immune treatment is not very robust though anecdotally people have success with intralipids, ivig where they’ve not had success before. As well as NKC check cytokines (and yes lots of people check uterine NKC- I didn’t)

[gina71 in reply to Arlie123]

Very happy to hear that you are pregnant, this is so hopeful! 🌟 I hope all goes well 🙏 Thank you so much for all the suggestions. I will look into as much as I can before the next transfer xx