Question on chemical pregnancy and immunology

daisyduck

5 Posts
Reply Posted on: Sep 21, 2014 at 7:41pm
I am 35 years old doing IVF cycles primarily due to blocked tubes and male factor. I have diminished ovarian reserve (AMH=0.6)
2011 - Fibroid removed surgically
2012 - Scar tissues removed but tubes remain blocked
2013 - Hysteroscopy showed normal uterus
2013 - First IVF cycle - Chemical pregnancy, Second IVF cycle - Negative, Third IVF cycle - Negative. All cycles done without PGD.
2014 Tests:
Saline sonogram showed normal uterus.
NK Cell Activation Assay (K-562) showed 9.5%
APA - Negative
ATA - Elevated
No intralipids recommended.
2 IVF cycles to bank embryos. PGD done with 3-day biopsy.
Recently done FET and transferred 2 PGD normal embryos - Ended as Chemical pregnancy. Had taken 5 mg Prednisone in the FET cycle.

My doctor recommends no more immunology testing is required since NK Cell Activation Assay is below 10%. APA is also negative. What do you suggest? Since I am experiencing chemical pregnancies, do you think I may have other immunological issues?

Thanks a LOT!!!

Dr. Braverman

2026 Posts
RE: Question on chemical pregnancy and immunology Posted on: Sep 22, 2014 at 6:29am
I respectfully disagree wtih your doctor. NK cell testing is but a very small fraction of immune testing that is required to make a diagnosis and may even be one of the least important tests that we run. Please look at the Diagnostic Testing and Sample reports on the left side of the home page to understand what a complete workup entails. I would recomend with your history that you get this.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

daisyduck

5 Posts
Reply RE: Question on chemical pregnancy and immunology Posted on: Sep 22, 2014 at 9:11am
Thank you, Dr. Braverman! I appreciate your response.
I am out of state and I am pretty sure my insurance will also not cover these tests. Can you please tell me the total cost (only a ball-park figure) for all the tests you would recommend? I understand if something comes out abnormal, then there is more to it but just wanted to know how much does it cost for the initial testing.
Are all the tests only through bloodwork or do you also recommend biopsy?
Thank you!

Dr. Braverman

2026 Posts
RE: Question on chemical pregnancy and immunology Posted on: Sep 22, 2014 at 9:17am
All bloodwork , a full panel without any insurance I think is around 1500 dollars , I could be off by a few as I dont pay close atention to this . This would include testing on both you and hour hsuband which would be necessary.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

daisyduck

5 Posts
Reply RE: Question on chemical pregnancy and immunology Posted on: Sep 22, 2014 at 9:31am
Thank you so much. If something requires treatment after we test everything, is it possible for you to work with my RE? I have embryos frozen at his facility and don't want to move those as far as possible.
Can I call your office and get an appointment for full panel testing? Or would I need to go through consultation with you with all the previous records transferred? I am sorry I am asking too many questions.

Dr. Braverman

2026 Posts
RE: Question on chemical pregnancy and immunology Posted on: Sep 22, 2014 at 9:52am
Yes they would need to fill out a consult request on our website, once you register with us we will send you the link to give to your RE.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Dr. Braverman

2026 Posts
RE: Question on chemical pregnancy and immunology Posted on: Sep 22, 2014 at 9:52am
Yes they would need to fill out a consult request on our website, once you register with us we will send you the link to give to your RE.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.