Secondary Infertility

Secondary Infertility Posted on: Mar 23, 2011 at 8:05pm
Dear Dr.Braverman,

after a successful pregnancy 2006 and the birth of my son I have had four
2008 blighted ovum / missed abortion 8th week
2009 ovum with yolk sack - no heartbeat / missed abortion 8th week
2010 3 ICSIS (2 neg. results, 1 biochemical pregnancy)

Last week I found out I had naturally conceived but am having a biochemical miscarriage again.
I have now been bleeding for four weeks with an HCG of 30 and have two cysts in
my ovaries filled with blood. My gynecologist told me I have to wait it out and
hope my hcg drops to 0 on its own.

I am a Hashimoto patient, have heterozygote MTHFR and had to have a conisation
2004 due to unexplained (no infection was found) cervicitis. My AMH is low, I am
a low responder but follicle quality at transfer has been good (mostly being
blastocysts). My son was born with a c-section due to my developing a gestosis (high blood pressure, proteins found in urine, and massive water retaination).

I live in Germany. I am frustrated and sad and have to this day not found a doctor who has taken my
question if there might be an immunological problem seriously. The answers given
were "shere bad luck" and I should stop trying because there might be a
genetical problem and great risk of retardation.

To this day no doctor has tested on immune or genetic problems, not even my
Hashimoto specialist who has never heard of immune reactions related to
Hashimoto beeing the cause for miscarriages.

I have not accepted these answers and have found myself a doctor who specializes
in bloodtests concerning immunology and miscarriages. I hope the right tests will be made. Living in Germany I had to make the experience that maybe a handful of doctors at the most see a connection in this area. I did receive lowmoleculare heparin, progesterone and asked for prednisone during my ICSI cycles. Apparently that wasn´t enough.

Even though my AMH is low and my husband has OATIII I have been able to conceive naturally and want to keep on trying on this basis.

I am interested in Intralipid as an additional therapy and have been reading
about gluten free diets.

Do you think I am on the right path? Could my problems be immunological?

With the highest regards,


Dr. Braverman

2026 Posts
Re: Secondary Infertility Posted on: Mar 24, 2011 at 2:10am
As usual patients in your situation usually have more than one significant issue. clearly if your AMH is low you do have an egg quality issue(to suggest that trying hard to conceive would put you at risk for a mentally challenged child is absurd). But the fact is that when you finally get a good egg you cant take a chance that an immune issue would reject this embryo so for this reason I do feel you are on the right path. Good luck on your journey dont quit for what you dream and want.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.