13. Professor Quenby and hope

Whilst we had been trying the fourth time, we had started to do our own research for recurrent miscarriage support, but had found precious little for people in our situation. When our consultant mentioned Professor Quenby and her team in Warwick / Coventry, we latched on to it like a life belt. As soon as I finished on the phone to our consultant, I was searching for everything I could and emailed to find out more. We heard back really quickly, and it was such promising news:

1) We could self-refer (no waiting for an appointment)

2) The clinic is a research unit linked to The University of Warwick, so although there was a charge for the consultation and the test (uterine natural killer (uNK) cell density) they carry out, it was subsidised and charged at cost (£360 vs. the same test I was quoted nearly £2000 to have done privately!)

3) It was something new (at that point we were willing to try almost anything)

I had to wait a cycle following the last loss and contact them once I received a positive ovulation test and we’d then be booked in 7-10 days later. It seemed magically quick and we anxiously waited for a cycle to pass and for me to ovulate. In the meantime, Matt went along to do his sperm analysis test, so we could confirm everything is okay with him. I also did some searching on the Miscarriage Association forum and spoke to a lady who had experienced 11 miscarriages before seeing Professor Quenby, and getting her miracle babe. Hope rose.

Once I ovulated, I got in touch and we were booked in for 31st May 2013. In spite of everything, this was our glimmer of hope and we were excited (although I was apprehensive about how painful the test would be).

We actually saw Professor Quenby’s colleague, Professor Brosens and he was so reassuring. He took a full history and then outlined their proposed treatment protocol and what the test would involve. This consultation was slightly different from those we’d had in the past – there was no talk of ‘just bad luck’ and we felt optimistic. Once the consultation was over, we went ahead with the test. There was an internal scan, followed by an endometrial biopsy. I won’t lie, I found it pretty painful. Thankfully, it only took 10 seconds (else I think I might’ve broken Matt’s hand I squeezed so hard!). Prof Brosens was happy that he got a good sample. The results, we were told, should be back within 4 weeks.

What now… The treatment protocol they follow is quite standard (as far as I’m aware) for everyone, there was just a additional step should they have found that my uNK cell levels were higher than normal.

a) The biopsy itself formed the first part of the treatment protocol and is therapeutic in itself; it shocks the uterine lining to regenerate. So, thankfully it was two birds killed with one stone – the sample had been taken and the first part of the treatment was underway

b) Progesterone. The day 21 bloods I had had done suggested that progesterone was an issue for me, so we were really pleased when we heard this would be prescribed. Prof Brosens actually prescribed progesterone there and then, for us to pick up from the hospital pharmacy. I would need to take this from day 21 of each cycle until day 28, at which point I would need to do a pregnancy test. If pregnant, the progesterone therapy would need to be continued until 12 weeks, if not then I would need to stop taking it and retry again the following cycle. We could only use this for a maximum of three cycles

c) Heparin. Following a positive pregnancy test and a 6 week scan to confirm an intrauterine pregnancy, I would need to inject heparin daily, again until 12 weeks. Apparently this would help protect the uterine cells and would aid implantation

[d) Prednisolone. Should my uNK cell levels come back as raised, then I would need to take this steroid from a positive test

Three weeks later and we received the results. My uNK cell levels were normal, so we would proceed with the plan without the addition of Prednisolone. I had a telephone consultation with Prof Quenby to discuss the results and any concerns. I raised the question of what would happen if we conceived and lost another baby and she told me that they had plenty more tricks up their sleeves. We felt positive.

I commenced the progesterone the following cycle. It wasn’t very pleasant, but not too bad. Day 28 of my cycle rolled around. I tested. It was negative. Month 1 of our 3 months of this protocol was over and we’d been unsuccessful. We ploughed on…

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