5 Unsuccessful IUI Attempts

jla6295

0 Posts
Reply 5 Unsuccessful IUI Attempts Posted on: May 18, 2011 at 1:47am
Hi Dr. Braverman,

I have been under the care of an RE in Tampa FL for the past 7 months. I am a 27 year old female with well controlled hypothroid(TSH 1.8) for the past 5 years.

I began seeing an RE after my husband was diagnosed with CBAV due to being a Cystic Fibrosis carrier. I then underwent genetic testing and it was determined that I am also a carrier, so we decided to use donor sperm.

I had a HSG with normal results.

I then completed 3 unsuccessful medicated IUI cycles with 100mg of Clomid cycle days 5-9, ultrasounds on day 12, followed by trigger on day 13 and IUI on day 15. Each cycle I had good response with 3 mature follicles on various sides and greater than 50 million sperm per sample. The one questionable factor was the the Clomid seemed to thin my lining to between 6.5 an 7 each cycle.

For the 4th cycle I was switched to Femara 2.5 mg cycle days 5-9. Followed the same parameters above except with 2 mature follicles. Lining improved to 11.3 on trigger day.

At this point I requested blood work to determine if there were any additional factors. The ordered what they called an "Implantation Panel". The results showed positive MTFHR and elevated "thyroid antibodies".

For my 5th cycle, he then started me on Folgard and 10mg qd Prednisone. I then took the Femara 2.5mg, Ovadril, and IUI on day 15. 2 mature follicles present with 58 million sperm, lining at 14.1.

I am currently in the middle of my 6th cycle and the only change this cycle is that I am taking 40mg of Prednisone for the first 4 days following IUI and then moving back to the 10mg dose the remainder of the cycle.

They are pushing me to move onto IVF, but I am worried that I have additional issuse that are not being treated and IVF would just be a waste.

Does this sound like a case you may be able to treat?

Thank you in advance for any suggestions. I am not sure where to go from here.


I

Dr. Braverman

2026 Posts
Re: 5 Unsuccessful IUI Attempts Posted on: May 18, 2011 at 9:44pm
Yes I can assist you with this, the antithyoid antibodies signal that there may be other immune components. Prednisone may not be the best treatment here but rather lovenox as it would interfere with degredation of the complement system that can be activated when thryoid antibodies bind to the invading trophoblast. IVF is not a bad option as well as you can at least over come all other issues that may be preventing sperm and egg from coming together.
I can assist you in managing that as well and you can still cycle at your center in Florida if you would prefer.
Feel free to call my office and ask for Kim she will arrange for a consultation with me. Good Luck , I hope I can be of service to you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

jla6295

0 Posts
Reply Re: 5 Unsuccessful IUI Attempts Posted on: May 19, 2011 at 2:27am
Thank you so much for the response. Do you think it is too late to add Lovenox this cycle? I am 3 days post IUI?

I will definitely call Kim and set up an appointment.

Thanks again,

Jessica

Dr. Braverman

2026 Posts
Re: 5 Unsuccessful IUI Attempts Posted on: May 20, 2011 at 3:57am
no it is not too late at all. speak to you soon. Good Luck.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.