Over-active immune system & Inflammation

dance733

0 Posts
Reply Over-active immune system & Inflammation Posted on: Feb 16, 2011 at 3:07am
Hi Dr. Braverman,

I am 31, TTC for 2 years, recently diagnosed with endo stage II with endometrioma on left ovary. I have Factor V Liden, just the one. I have seen an RE and have done 3 IUI cycles. Initial OB diagnosis from LAP indicated my tubes were open, dye only passing through left tube. I went for a second opinion after all 3 IUIs failed and my new OB thinks that the right is closed due to the fact that the dye did not pass, and in surgery it should always go though apparently. I have tried to talk to my RE about an underlying immune issue causing unsuccessful implantation, and he thinks I probably have an immune issue, but states that there is no way to test it effectively even after I tell him about the countless women on these fertility boards that are seeking your help and help from the Beer clinic. I feel as if I am talking to a brick wall. My RE does no analysis outside of a simple testing protocol. My FSH is just a little high and I stim nicely on low doses of follistim and produce between 2-4 nice follicles, but each cycle I have a period like clockwork.

The closest I have come to being pregnant is when trying within the first 3 months, the third month, I believe I had a chemical pregnancy. I have NEVER been late since I started my menstrual cycle at the age of 12. Early sometimes, but never late. I was 3 days late and had a positive HPT, however within 48 hours it was negative and I was having a lot of pain over my left ovary. I went in for US and they found a cyst and tested my HCG and it was 0.

I have chronic allergies in which I am currently taking allergy shots for. My allergist is amazed at how low my tolerance ceiling is because I have reactions every time we try and build me up. He tells me most people are able to build up 200-500 more times than where I am at. I also had a skin reaction to the HCG trigger shot during all of my IUI cycles.

I am collecting as much data as I can on immune issues and I'm taking Fish Oil now for the inflammation and low dose aspirin for the Factor V, even though my RE and OB think that is not an issue since I just have the one.

I think I need your help in solving my immune puzzle. I believe I have implantation issues, and I'm also curious as to whether my hormones are not signaling implantation due to the fact my period has never been late my entire life except that one time I did have a positive HPT and there have been many cycles I have had pregnancy symptoms early on that disappear one to two days before my cycle shows up. I have spent $6k doing IUI and before I do IVF I want to know what impact my immune system is having over my reproductive organs because if I do have immune issues I feel I will be wasting my money until treated properly.

Thank you in advance for your time,
Marci

Dr. Braverman

2026 Posts
Re: Over-active immune system & Inflammation Posted on: Feb 17, 2011 at 2:04pm
Hi Marci, as you may have read on our boards, the allergy shots themselves(pushing you out of a TH2 state that you need for pregnancy) may be a contributing cause of your issues. Your endometriosis pushing you into a TH1 state with higher levels of inflammatory cytokines such as TNF may play a part as well. Also as you know the activated NK cells that come to try and eradicate the endometriosis stay actived in the uterine cavity where the embryo is trying to implant and can lead to implantation failure. The high levels of TNF can lead to oxidative stress to the follicles and affects egg quality. Lastly the high levels of ROS associated with endometriosis can affect sperm motility in the tubes and decrease the chances of pregnancy during IUI cycles.
As you can see there is quite a bit to work up with you and we have solutions for each. Feel free to call my ofice to schedule a telephone consultation and I would be happy to assist you.
Most OBs have never had a course in immunology(not taught in OB residency or fellowship) so dont be upset that they dont understand most of these issues. It would take several hours / day to keep up with all the immunology literature.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

dance733

0 Posts
Reply Re: Over-active immune system & Inflammation Posted on: Feb 21, 2011 at 12:22am
Dr. Braverman,

Thank you so much for the information! I am working on getting my medical records released from my RE so that I can fill out the patient questionnaire. I just have a few more initial questions. Do I need to stop taking any of my current meds/supplements before I have the immune panel done? How should I proceed with my allergy injections for now? Should I stop immediately, taper off, etc? I was having chronic sinus infections until I started the allergy shots. I have been doing injections for 1.5 years now.

Thank you again for your time and I look forward to speaking with you soon.

Marci

Dr. Braverman

2026 Posts
Re: Over-active immune system & Inflammation Posted on: Feb 21, 2011 at 2:21pm
Hi Marci, I cant make recommendations about stopping any medications or shots until I see your current immune status. Fill out the questionairre as best you can, then we can talk. At that time Ill know what to order and within one week Ill have all the results back and we can discuss the allergy shots and the supplements, but I wouldnt want you to stop anything Until I've had a chance to see your history and your new testing.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.