Should I see a reproductive immunogist?


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Reply Should I see a reproductive immunogist? Posted on: Mar 28, 2011 at 5:00pm
Hi, Dr. Braverman. I am wondering if I should see a reproductive immunologist. Here's my history:

I have a seven year old daughter, conceived via IUI, when I was 30. I was on heparin therapy during pregnancy, as I tested positive for several APA markers in 2003 after a miscarriage (and various autoimmune conditions run in my family). I have now been trying to conceive a second child for 2.5 years. I've done many IUIs, had one failed IVF, one definite miscarriage, one probable chemical pregnancy (no beta to prove it), and am now 5w1d on a donor egg cycle, with a proven donor at a top-notch clinic. Repeat testing suggested that I was not positive for either ACA or LAC, but I am heterozygous for MTHFR. My beta started spectacular (81 at 6dp5dt) and has not risen appropriately (only 437 at 14dp5dt). I'm going in for an ultrasound tomorrow to rule out an ectopic. I fully expect that this pregnancy will end in a miscarriage. I am already on Lovenox, and have been for most of my cycles, following my second miscarriage. I was also on Medrol around transfer, but I wonder if longer term use of steroids might be warranted in my case. I appreciate whatever perspective you have to offer.


Updated to add: Well, ultrasound yesterday revealed an appropriately sized gestational sac, despite hcg levels that are still not doubling appropriately. So the situation might not be as dire as I thought... but my RE isn't particularly optimistic about a positive outcome.

Dr. Braverman

2026 Posts
Re: Should I see a reproductive immunogist? Posted on: Mar 30, 2011 at 10:16pm
ok good luck with the next sonogram. Feel free to contact me with questions should there be any issues. There is quite a bit of information you need to determine how long and what dose of medications you need. If all is good , call me and we can review how to follow you through your first trimester.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.