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Stacey, thanks for your reply

I have actually had quite a lot of immune tests done by my clinic in Spain. I had them done before my first donor egg cycle last year. I had every test they offer. I don't know if quite as comprehensive as say Dr Gorgy, but it did include a lot and all came back normal. I will look into the immunes testing you mentioned in Athens though and see what that includes and if it varies much from what my clinic offers.

Like you say I do feel I have immune system reactions which is also why I am wondering about thyroid and possibly hashimoto's as that doesn't always get detected with standard thyroid tests...

But treatment wise to cover off immunes I had prednisone 10mg this cycle (increased from 5mg last cycle on my request). They said they didnt see a reason for me to have more than that as my blood results didn't show raised NK cells or anything. But I did also have intralipids a few weeks before transfer and then a few days after positive pregnancy test and another lot in week 8 (though by then it would seem the heart had stopped). I also had the standard clexane 40mg injections for blood thinning and better blood flow and I am wondering about maybe having aspirin as well next time in case it was a blood flow issue.

As to recurrent miscarriage clinics, I would love to be referred, but I am 45 nearly 46 now (which is why I am doing donor egg) and from looking at clinic info for London - like the well known one at St Mary's -  they don't accept referrals for women over the age of 40 or maybe 42 maximum... I am also not sure what they would test me for that I haven't had done? I have been tested for thrombophilia and other blood clotting issues, some immunes etc. Plus from what I gather from a friend who did go to St Mary's, people who are diagnosed with an issue usually are just given aspirin and/or clexane. But maybe that is not the case always??

I do think that getting my thyroid completely ruled out and/or treated if necessary is important. And maybe seeing an endocrinologist they can advise if they think I should have other testing done for other immune problems. People on here seem to mention Professor Conway so I thought I could try and see him.

Thanks for responding and for your support. It has been hard and having no answers is the hardest thing. It's also difficult because it's hard to compare each of my miscarriages or see if there is an actual pattern pointing to my body as the issue, given the 1st miscarriage was with my own eggs, and then the 2nd was a different egg donor to this one (plus the sperm wasn't great that time). However this time everything seemed good, though as we all know that doesn't guarantee there isn't a problem with the embryo as it develops. So it could just be bad luck, or it could be something identifable we can/should treat relating to me and pregnancy and maintaining a pregnancy.
 

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I would look at upping your prednislone to 20 mg 5-10 mg are just the basic amounts given and don’t do much if you do have some type of immune problem, it’s usually 20+ mg that’s prescribed. Maybe also look at testing for Alpha DQ matching with your partner. Hopefully you’ll be able to get to the bottom of this. Also just as a thought there is a lady on here that was using donor eggs and she is r- and was have r+ donors, she changed to a r- donor and had success. Also check for mthfr gene mutation as well. xx
 

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Poppy I looked into thyroid & immune issues too and had a lot of miscarriages previously (6+), had relatively normal thyroid blood results but elevated anti thyroid antibodies and nodules in my neck. I took 25 mcg levothyroxine per day during my pregnancy (just alternate days before that) and quite high prednisolone dosage plus just before the final cycle I had hydroxychloroquine via the recurrent MC clinic in London. I did get a really bad chest (like bronchitis?) early in the pregnancy as I think my immune system was lowered a lot from the medication, but the pregnancy finally stuck thankfully. I was also on aspirin after 12 weeks and clexane. I saw the Drs at Locus Medicus previously too, who were really nice and I was already in Athens for a hysteroscopy, but I decided it was too far to go for further treatment from them (I think they suggested LIT which seemed a bit complicated). Good luck xx
 

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Hi I don’t know whether anyone can advise.
I have just completed my 2 ww with a 5 day blast frozen. I am pregnant but along with other immune drugs I should have been taking throxine which the clinic hadn’t picked up on. I have just paid for a blood test ( clinic complaint will be following ) and my T-SH levels have come back at 5.5 so have been prescribed 100mg to start ASAP. I have just called for my T4 results and it looks like they haven’t tested for these. She is checking with the doctor but do they need to test the T4.
Any advise appreciated. I’m currently around 5 weeks pregnant but going crazy wondering if it’s now too late and I’m at risk of miscarrying again.
 

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Hi tiredmum

Congratulations on your pregnancy I am sure you are feeling pretty anxious right now, 100 mcg will be exactly the right thing to do to get your TSH up to a better level, and it will not take long to get there so do not panic. T4 will not affect your treatment at all, they treat on the levels of TSH, abnormal T4 will not make any difference. MY TSH was over 100 at one point (not whilst pregnant) and I was prescribed 100mcg of levothyroxine and felt better very soon after so hopefully it won't take long for you.

Wishing you lots of luck with your pregnancy x
 

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Hi artypants
Thanks for your reply.
I’m just praying it’s not too late. This cycle has been so stressful. I’m so annoyed at the clinic as I’ve had to basically chase all my meds and basically telling them what I took in my last successful cycle. I was even told by a clinic nurse that throyid has no impact on cycling and pregnancy🤬🤬🤬🤬
 

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Thats shocking tiredmum, it totally does have an impact if its over or under, your results are not hugely abnormal and shouldn't take too long to normalise so I hope you can take that as a slight positive,

Good luck! xx
 

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Hi guys, would appreciate some advice. Have hashimotos, though no one actually called it that but I have antibodies and hypothyroidism. Just had 2nd early miscarriage from deivf. I think I need to see reproductive endocrinologist. My clinic is giving me aspirin and clexane next transfer but have no ideas or info on thyroid stuff.  Has anyone got any suggestions for next step and recommendation for a specialist I might be able to Skype with? Also should I get referred to miscarriage clinic. Only 2 embryos and funded transfers left and not getting any younger. Thanks guys, as ever, incredibly grateful for this community xxxx
 

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Hi brooky,

Sorry about your miscarriages.

I also have underactive thyroid and antibodies, I thought you would be prescribed steroids for the antibodies, that was what I was given during my last cycle.

I am looking to see an endo too but I live in northeast and I can’t seem to find one nearby but I would say that might be your next step. Some ladies get other immunes tested too, have you looked into that?

I hope some of the ladies on here can help further x
 

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Hi gumdrops, thanks for your reply. They didn't give me anything extra before. She now is saying aspirin and clexane but not streroids because they lower your immunity and so at this current time wouldn't reccomend it. I really don't know what to do. I have just gone from being under the impression that I had two fresh cycles funded including transfer of any frozen, to being told I have one transfer left. This is because they didn't inform and communicate correctly with me, even though I asked all the questions at the beginning. It's such a headf%%k. I have 2 embryos left and don't really want to transfer them at the same time because of the potential risks. Anyway there just is so much more riding on all this now.

I havne't had my immunes tested and having looked at it and now feeling even more worried about all the potential things that could be causing these miscarriages. For the first time I properly feel that this may never work for me.
 

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Ah ok, that makes sense why they aren’t giving you steroids, could you maybe put it off until things return to normal and are able to take steroids? I know you probably just want to get cracking.  Were your antibodies very high?

It may only be something minor that can be tweaked, ie taking steroids, to prevent any further miscarriage, the good news is you are getting implantation, you just need to maintain it.  I know looking into immune tests is very confusing, I have just started to look into it, does you clinic carry immune tests out?


I am now looking into a clinic abroad called Zlin for my next donor cycle x
 

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Hi there, I'm totally new to immunes/thyroid issues, and after getting told 3 different things by 3 different clinics (looking for a new clincclinic so have met with 3), I'm so confused and wondered if anyone could help at all?

My TPO (thyroid peroxidase antibodies) has come back at 112 (meant to be 0-34). One clinic has suggested Thyroxine 25mg for this starting now to prep in time for my FET in 2/3 months time. The other two clinics didn't even mention the result so obviously wasn't an issue to them?!
My NK 50:1 has come back at 18.5% so one clinic (who wasn't bothered about TPO) has suggested intralipids, clexane, steroids, progesterone.  However, the clinic who suggested thyroxine isn't a fan of intralipids but said I can add on if I want to?! SO confused.
My thinking was to start on thyroxine and then to cycle with prednisilone, clexane, aspirin, intralipds day of transfer and another 4 weeks after just so i feel ive checked every box.......  Can I take thyroxine and steroids together?
Thanks in advance for any help you can offer!
 

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Hi, been off the radar for a bit, it's been too exhausting to think about everything. but thankyou for your reply gumdrops. My clinic doesn't carry out immune tests as far as I know, at least they haven't mentioned it. . My next step is to talk to a reproductive endo. Just had full thyroid profile and my TSH is 5.36 and my TPO is 65. How are you getting on with your investigations etc?

Babybird: It is soooo confusing isn't it, and it really seems to depend on what their interest/speciality is at each particular clinic. I haven't watched it yet but have this webinar from OLGA fertility clinic to watch, all about immunes and pregnancy loss/implantation failure...might be worth a look.

You any further on in your investigations?

Lots of love x
 

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You can take thyroxine and steroids together.

My thyroid just came back at 3.2 it’s preferable for it to be under 2 for assisted fertility. So I’m on 50mg now. Upped from 25.

Steroids - I’ve been upped to 6mg of medrone for next cycle with clexane. No intralipids.

I don’t know that you take aspirin and clexane together as they are both thinners. Clexane is just better.

Best of luck.
 

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Thanks ZC,

Maybe my consultant didn't communicate it very well, I thought she said clexane and aspirine.. but it was a bad phone line so maybe she meant clexane is like aspirin in that it is a blood thinner ...

With you being on steroids, are you going to be sheilding? also do you know if the steroids are taken for the first 3 months? or just until transfer?

I am going from 75 two days 100 on third to 100 every other day because my TSH is 5.3. Seeing nutritionist and RE for any further advice/tests then will go for it with transfer once TSH below 2.5.

Best of luck to you.

 

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I was on aspirin 75mg and clexane throughout both my pregnancies
 

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Evening all,
Yes I was told I’d be on Clexane and aspirin for my next cycle. Has everyone been told you can’t use steroids or intralipids right now due to the current pandemic? I’ve just not seen much talk of this but know, if it’s the care across the board, then so many people must be having to delay their cycles?
 

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My clinic are still using steroids in the FET protocol. 
Good to know about the aspirin and clexane
 

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Brooky
I live in Ireland. We have really low levels of covid due to our lockdown protocol. So that’s helpful.  And treatment is in Spain where they too have control. 
I will wear a mask and gloves and be tested for covid at the clinic and travelling.


 

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Where are you ZC? As far as I know no UK clinics are allowing steroids/intralipids as per the HfEA advice? I’d like to be told I’m mistaken though as could get on with my cycle!
 
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