Mum cradling her baby

Fertility can be complicated: PCOS, autoimmunity, clotting and poor semen quality.  While the emphasis is put on the female partner, the man can often be overlooked with disastrous consequences, as this clients story shows.

Suzanne has a complex and traumatic medical history.  She came to me a year into her quest to conceive after suffering three miscarriages before 12 weeks.  All her miscarriages ended with intense pain, vomiting and in two cases surgical management, following collapse and being rushed to Accident and Emergency. She had been told to keep trying and she’d just been unlucky.  At her initial consultation, alarm bells were ringing loud and clear for me; why weren’t this couple being investigated?

 

Starting treatment

Her medical history showed PCOS, and some underlying though non-specific autoimmunity marker.  We started to address her diet and stress levels, she found acupuncture extremely relaxing, though was very sensitive and anxious.  Her periods became regular, having previously being irregular and we achieved manageable pain levels in three months.  Having being dismissed by the NHS, she went to a private clinic. I asked my client to ask for her thyroid to be tested more thoroughly, as this is linked to miscarriages, but the clinic dismissed this. Then due to finances we paused treatment for four months.

 

Another miscarriage

Unfortunately she miscarried again during this time and we resumed acupuncture. She went to another private clinic, the consultant detected thyroid antibodies, suggesting an autoimmune disease and she was prescribed levothyroxine medication, but this was not investigated further, which was an oversight in my view. A blood-clotting tendency was detected in other tests.

I encouraged my client to ask the consultant to test her partner’s semen.  Sadly too much emphasis is placed on the woman in fertility, though men carry 50% of the genetic responsibility. The consultant dismissed my client and her partner for making this suggestion.  She was crying in my clinic, traumatised by this clinician’s treatment of her.  I recommended a fertility consultant who would do further testing which I was keen for my client to explore.  I emphasised that she must not get pregnant until all the tests were finalised, which though hard for her, she agreed to do this.

 

Further tests

The consultant ran a series of tests which revealed:

  • Thromoelastogram confirmed clotting tendencies, so she would have to take an anticoagulant – clexane.
  • She tested positive for MTHFR mutation which affects her folate levels and can cause pregnancy loss.  She would be prescribed high dose folic acid
  • Not surprisingly given her autoimmune disease, she tested positive for natural killer cell toxicity, which can attack any embryo tissue causing miscarriages. The steroid prednisolone was to be prescribed during her IVF.

This consultant tested her partner’s semen which showed poor shape (morphology) and he did a karyotyping test looking at the chromosomes inside the cells.  The results that came back were a huge shock.  Her partner carried a genetic defect which would cause a miscarriage or result in a severely disabled child. 

 

We now prepared for a fresh IVF cycle to collect embryos which were to be genetically tested for the abhorrent gene.  This was her best chance, though the financial cost weighed heavily with her; they remortgaged their house. She saw a nutritionist I recommended and we arranged her acupuncture to support her IVF, helping to improve blood flow to her ovaries, and manage the medication side effects of nausea, headache, bloating and fatigue.  She responded well, the embryos were tested and then she underwent a frozen cycle and at aged 39 this resulted in a positive pregnancy test.

 

My final thoughts

My takeaways from this are – if this woman had continued to ‘keep trying’ because ‘she was unlucky’, it would have resulted in more miscarriages; if the first private fertility consultant had managed her she would have continued to have miscarriages because her partner wasn’t investigated; if the NHS had managed her she would have continued to have miscarriages as they do not agree with clotting, immune and genetic testing. 

 

Her story shows the complexity of fertility treatment, the need to investigate thoroughly both partners and get support, both biomedically and complementary.  With all this in place and against the odds, this couple managed to get pregnant on their first round of IVF and yes reader, they had a healthy baby girl!

 

I’ll leave the last words to my client:

“We are shell shocked.  I am frustrated that it’s been over a year of speaking to specialists, one we paid for and one at Kings in the recurrent miscarriage clinic and their fertility specialist clinic and neither suggested there were other tests to do, let alone anything to do with Fred.  In fact we asked (the private consultant) if the reason could be anything to do with Fred, she laughed at him and completely discounted him!”

If this is your experience, come and talk to me.

Names have been changed

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