Again Failure (FEB, IVF) after a Baby Boy

Ina

0 Posts
Reply Again Failure (FEB, IVF) after a Baby Boy Posted on: Oct 4, 2011 at 11:45pm
Hello Dr. Braverman,

I have tried contacting your clinic - but due to time difference have not been able to speak with anyone yet. I'd like to post a short version of my treatment and some questions:

I am 36, my husband is 39 - married since 1998 (no natural conception/pregnancy ever).

From 1998/99 - 4 IVF+ISCI - all failed, never a positive pregnancy.
In 2005 - 1 IVF+ICSI - failed.
In 2006 - 2 TDI (own eggs) - all failed.

In 2007 - immune testing at the Beer Center: Results
NKcells: 22.9
TNF: 27.8
IFN: 11.7
LAD:
T-cellsIgG: 1.0
B-cellsIgG: 23.0
IgM-Cardiolipin: Borderline
PAI-1 4G/5G Gene Polymorphism: Heterozygous Mutated
Factor XIII V34L Gene Polymorphism Homozygous Mutated

Immune Treatment:
Dec 2007 - 1. LIT/Nogales
Jan 2008 - 2. LIT/Nogales, 4 shots of Humira (February and March)

Immune Results: February 2008
NKcells: 15.6
LAD
T-cellsIgG: 77.7
B-cellsIgG: 77.3

Fertility/Immune Treatment:
May 2008 - IVF+ICSI: 4 developed Day 3 Embryos, all 4 transferred
(on IVIG, Dexamethasone, Lovenox/Fragmin, Metformin, Baby Aspirin, Calcium, Folgard)
June 2008 - positive pregnancy test (for the first time ever!)
Continued with all above meds (IVIG/once a month until 26 weeks of pregnancy - difficult to get it in Canada)
December 24/25. 2008 - Premature Rupture of Membranes (??? reason???)
December 29, 2008 - healthy but tiny Baby Boy born at 32w+4d

Since then no natural conception

Immune Tets: March 2010 (before next IVF+ICSI)
NKcells: 14.9
TNF: 29.8
IFN: 17.4
LAD: T-cells - 70.7
B-cells - 99.9

(This time - did not do LIT, no Humira, but several IVIGs prior to conception, all other meds like in 2008)

Repeated/Fresh IVF+ ICSI: December 2010 (same clinis)
6 Day 5 blasts: 3 Grade II transferred (2 Grade II/1 Grade III embryos - frozen)
Jan 2011 - pregnancy test negative

FET: July 2011 (same clinic)
June 2011 - 2 shots of Humira/preconception (+ every other week until end of August/until 1. heartbeat)
July 1 - 1. tripple LIT/Nogales
July 22 - 2. double LIT/Nogales
June + July - 2 IVIGs (second prior to transfer)
(all other meds like in 2008 - Dexamethasone, Lovenox, Baby Aspirin, Metformin, Calcium, Prenatals)
2 Grade II /extended blasts/ transferred
August 2001 - positive pregnancy test (2nd positive in 14 years of marriage), Beta rose consistently
August 29: 1. ultrasound - 1 heartbeat, one empty gestational sac
Sep 16 - 2. ultrasound - 2 empty gest. sacs
Sept 28 - D&C - no genetic testing on emrbryos (in Canada)

Our questions:
1. How do you see our last IVF/ICSI and FET (after the birth of our boy)? Could it be the immune rejection?
2. Is there anything we have not tested yet? Are there any other meds that could help us?
3. Could there be a relation between the immune system and the premature rupture of membranes?
4. How would you assess our chances of another pregnancy?
What would you recommend to us?

Thank you very much, Dr. Braverman. We really appreciate your help and support as we are considering our next steps.

Sincerely,
Ina

Dr. Braverman

2026 Posts
Re: Again Failure (FEB, IVF) after a Baby Boy Posted on: Oct 6, 2011 at 1:52am
Hi Ina I have seen your emails, you have quite a complicated history (I think I answered your post above?). regardless yes there is still more to be done, most important is your complete HLA screening. I need you to call me between 9 and 5PM New York Time. If it is after hours please leave a number with my answering service and we WILL return your call.(you can tell them its an emergency) but better just to call during our working hours. Yes the PROM can be from Immune issues, but there are many other reasons for this as well. There is certainly more that I would to but need to spend time talking with you and getting more history. Its not as simple as throwing out a few recommendations as you need to get this right and straight away.
Braverman Medical Team
Braverman Reproductive Immunology P.C.