I am pleading for some hope we live in the middle east

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Reply Posted on: Nov 2, 2014 at 10:59pm
Dear Dr I have never been pregnant naturally . I suffered from Irregular painful periods since the age of 15.A Scan showed a huge mass when i was 30 years old . I had an Open surgery to remove tubal mass, right ovary removed and right tube.Mass was said to be due to Pelvic TB. Treated for TB
Started my 1st ivf at 35 years old I have no issue producing A grade eggs .My body and 1 ovary respond very well to the stims. I have PCOS as well1st IVF failure –Produced 22 eggs 13 excellent quality embryos fertilised and 2 transferred chemical pregnancyPGD carried out on all embryos11 frozen embryosWent for a tube dye test water was found in one tube went thru a laproscopy to tie remaining tubeDid a frozen embryo transfer 3 months after laproscopy and 2 sessions of intralipids once before embryo transfer and one after resulted in pregnancy.At 6 weeks found to be carrying identicle twins, prgesterone started dropping miscarried at 6.5 weeks.Did full cycle ivf resulted in nothingNote PGD carried out on all embryosTests Carried out after 3rd IVF failureAnti Thyroid Antibodies Panel, serum by ECLIAActivated Protein C Resistance (APC-R) byElectromechanical Clot Detection Method*Protein C Functional by ChromogenicProtein S Functional by ElectromechanicalClot Detection MethodTYPE OF DEFICIENCY REMARKSType I Decreased Protein S activity &antigen levelType II Decreased Protein S activity with normal levels of free &total antigenType IIIDecreased Protein S activity with normal free antigen level &decreased totalantigen levelAntithrombin Activity, Functional byChromogenic Method*101.00CHROMOSOME ANALYSISSPECIMEN : Heparinized Peripheral bloodINDICATION : -CULTURE TYPE : 72 HRS PHA STIMULATEDBANDING TECHNIQUE : GTGBANDING RESOLUTION : 400CYTOGENETICS REPORTMetaphases Counted : 20Metaphases Analyzed : 20Metaphases Karyotyped : 10RESULTSKARYOTYPE : 46,XXCOMMENTS : The karyotype report is enclosed herewith and is normal.There is no evidence of any structural or numerical abnormality in any of the metaphases
Factor V Leiden Mutation Analysis by Real Time PCR*Factor V Leiden Mutation* NOT DETECTEDProthrombin Gene Mutation* NOT DETECTEDMTHFR Gene Mutation* NOT DETECTEDInterpretation:RESULT COMMENTSHomozygous mutation detected Both copies of the gene carry mutationHeterozygous mutation detected One copy of the gene carries mutationNot Detected Mutation not detectedTests Sent Abroad Carried Out in Chicago Labs DQ Alpha in Range –NK ESSAY FULL PANEL –%CD19 OUT OF RANGE 12.8 (h)%CD19 + CELLS,CD5+ OUT OF RANGE 1.5(L) Based on above tests my dr suggested there is clear but mild problem of you having immune rejection and therefore, we will be expecting that problem to be dealt with Intralipid, one dose during treatment along with other immune modulation medication.Therefore the protocal was as followsProtocal for 4th Time IVFStarted with Progyluton to bleed on particular dayStarted with Pentoxiphylline 3 months before planned date of ivfStopped Pentoxiphylline before ivf started.Started Prednisolone5mg a day and went up to 20 mg a day after egg retreivalStarted Metformin 1000 mg a day continued till Pregnancy TestStarted Myoinositol 1 tablet a day continued till pregnancy testStarted Vaginal Viagra after egg removalDaily injections of Clexane till Beta HCG testDaily Progesterone Injections till Beta HCG testNeupogen every second day starting on day of egg retreival
Daily injection of Cetrotride during stimsLow dose of asprin after egg retreival till the beta HCG test1st Intralipid on the 3rd day of bleed2nd Intralipid after egg removalTriggered with GonalpeptylPregnyl shot on day of egg collectionCollected 17 eggs fertilised 13 microarray on 13 resulted in 7 beatiful A grade embryos
Transfered 3 embryos.
Unfortunatley in the middle east it is a rule that no embryos can be frozen so i have to due another full cycle.
Please Dr i need some direction what are we missing help me please
I need help

Dr. Braverman

2026 Posts
RE: I am pleading for some hope we live in the middle east Posted on: Nov 3, 2014 at 10:19am
There is still quite a bit more testing you need for a complete immune evalutaion , which I suspect will give you answers for your failrues. Please fill out a consult request from our website and we will schedule a free 10 minute SKYPE or PHONE consult for you to discuss how we can help you. We work with many patietns from the Middel East this is no problem.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.