I'm stuck! What is your advice?


1 Posts
Reply Posted on: Feb 10, 2013 at 1:39pm
Hi Dr. Braverman! I have read so many wonderful things about you online with girls in various message boards. I am at a point where I need some advice and am really stuck between a rock and a hard place. We live in south Alabama and from my research, I have found no RE in the 200 or so mile radius that deals in immune issues. Unfortunately, my current RE does not support immune related questions and his response was to "stop reading the internet." We do not have the funds to fly to NY and consult with you as much as I would LOVE to do so. I need basic advice from you as to what I can do here at home to hopefully get some answers. Here is my history in short:

*1 healthy child born in 2004 on second round of clomid (100mg)
*m/c at 15 weeks (fetus was approx 12 week old) Nov 2009 after conception on first round of clomid (100mg)
*since then visited two REs, first said I had no ovaries (um...I do have a child...lol) b/c they were up high in my stomach and hide behind my uterus and very hard to find, currently still with second RE- I have done SEVERAL rounds of clomid and produce great follies but no pregnancies since m/c in 2009, also done 6 IUIs with 3 on clomid and 3 on various doses of gonal-f, all used triggers, none resulted in pregnancy but all had good follie results and lining, hsg was clear, lap showed stage 1 endo which was removed in 2010, also I have asthma as an FYI, hubby's numbers look great, RPL was normal accd to RE, genetics test on me (not been done on hubby) are normal, AMH was low at .46 but FSH was 6
*pregnant 4 more times since first m/c all when on breaks from RE (5/11, 10/11 and 10/12), 3 were chemicals with confirmed low betas to begin and the last was in December and was ectopic with beta never above 350, 3 rounds of MTX to get my numbers to drop
*following ectopic, wound up in hospital while on vacation in Orlando with a foot issue that caused my entire ankle to stop moving and foot to swell, dr was perplexed and diagnosed it cellulitis however it moved to my wrist joint a few days after leaving hospital then to the knee joint.
*set up appt with a rheumatologist as follow up b/c I believe the foot issue was not infection but joint related. Appt was Friday and he ran a battery of bloodwork. I did tell him about my losses and asked if he thinks this is all connected. His theory at this point is that my joints were being reactive to fetal tissue from ectopic but said we will know more with test results in a few weeks.

So, that is where I am. What should I do? Can I visit a regular immunologist around home? Would they understand what I need and could they provide me with blood tests results? I worry if they would refuse b/c even with results, they do not know how to treat. Could I press my rheumatologist for more testing? I feel like I am stuck and while I can't get to your office, there is no one here that can help me either. If you were in my position, how would you work to find answers? I feel pretty sure I can get the tests covered by insurance if a dr requires them. It's just a matter of getting a dr to order them, read them and rx me on what to do when trying to conceive. Please advise me if you are willing and have a free moment. I know your patients come first and totally understand if you are tied up though. Thanks for any info you can share with me. We are just so desperate to give our sweet son a sibling and we are so tired of the continuous losses. Thanks so much!

Leigh in Fairhope, Alabama

Dr. Braverman

2026 Posts
RE: I'm stuck! What is your advice? Posted on: Feb 10, 2013 at 9:24pm
why dont you call my office for a free 10 min chat and we can go over options for you. We can not consult with you over the phone Im afraid but if your local OB/GYN calls us for a consult we can reveiw the case wtth him. If you call we can discuss this and review your case briefly to decide on the need for our services.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.