Testing from Ireland

Mrs Powers

2 Posts
Reply Posted on: Jan 20, 2015 at 2:50pm
Dr Braverman,I have never attended a doctor or a hospital in my lifetime until I got pregnant, it has been a nightmare every since, but one little miracle. I seem to definitely have immune issues. I have ready a lot about the help that you have provided others. I was going down the ARGC London ivf route in October of this year when we fell pregnant naturally. I am thinking at this stage of looking at freezing sme eggs and maybe doing IVF in Gennet in Prauge (my sister had great success there and you can do most of it from Ireland). But first I need to get to the bottom of these immune problems and from what I am reading you are one of the experts on this front and maybe you could help me get some answers. My history is as follows1)Jan 2011 - Miscarriage 4-5 weeks 2)April 2011 -Miscarriage 5-7 weeks3)Jan 2012 - Miscarriage 5-7 weeks4)Feb 2013- delivered healthy baby boy at 40wks+3 days5)Sept 2013 - Ectopic Pregnancy, discovered at 7-8 weeks , left tube removed6)Feb 2014 - Miscarrige4-5 weeks7)Jan 2015 - Miscarriage - 11-12 weeks . D&C planned for Wed 21st January.All the above pregnancies were natural conception.In July 2014, after 3 unsuccessful medicated cycles trying to produce more eggs on the right ovary, I tried an IVF cycle , this was unsuccessful, we retrieved 6 eggs, all fertilised naturally and we had 2 early blasts transferred on day 6. nothing to freeze. I felt myself the stimulation process has gone very slow as in there was hardly any growth in the eggs for the first few days but the dose was increased as we went along ..225 Gonal F to 300 to 450 . I have all of that detail in my file.Immune issuesFor my successful pregnancy I took the following: Note I had no tests to confirm any immune issues)Predisolone 25mg from day 7 of cycle to 12 weeksClexane - 20ml pd from day 7 to week 14Baby Aspirin - 1 daily from day 7 of cycle to week 27Cyclogest 400mg * 2 dailyFolic Acid 5mg dailyVitiman B complex - 1 dailyEltroxin - varous levels depending on regular blood tests, levels were closely monitored.For pregnancy 1-3,5,6 I was NOT on any of the above drugs.In October 2014, I went to meet the ARGC in London who would work with a lot of immune issues. I did the Chicago blood tests and it was confirmed that I had raised TNF cytokines (40.2) and raised NK cells CD 56 (16) . Their advice was that I needed treatment with Humaira to lower these cyctokines, the plan was to do the Humaira treatment and start IVF with them, however I found out the same day I was pregnant.The ARGC had performed a monitoring cycle (prior to the results of the immunes coming back) and at mid cycle scan they advised we had a follicle on the right hand side and I was about to ovulate. We decided to take steroids from that date and try to get pregnant naturally. It worked and I started all of the above meds, the only extra meds the ARGC advised was additional Gestone 100 ml per day and intralipids at 5 weeks, 7 weeks, 10 weeks and 12 weeks. We had 3 early scans 6 weeks, 8 weeks and 10+5 weeks and all was great with baby, good measurements and great heart beat. We went for our 13 week scan this and the baby had no heartbeat. I have a D&C next Wednesday and they will do some testing on the tissue so I am hoping we may get some answers from that. I must also mention I did a food intolerance tests and soya did come back as one of my problem areas, in fact all dairy and gluten. I do have an underactive thyroid, and positive TPO's, my thyroid is managed very closely during pregnancy.Please let me know how to proceed from here, I am sorry if I have sent you too much information. The ARGC felt themselves my only issue was the immunes (IVF not really necessary, however I'm not sure I can try again naturally) so if I could just get them sorted I may be okay. On the repeat immune testing at 5 weeks pregnant the TNF cytokines had dropped to 28. The NK cells had gotten worse but despite this the pregnancy continued and we got to nearly 12 weeks. so again,I have had no other immune testing done, my question is then what other immune tests should I undergo and how many are necessary given I have had one healthy baby. How could I work this from Dublin ?Thank you,

Dr. Braverman

2026 Posts
RE: Testing from Ireland Posted on: Jan 20, 2015 at 3:05pm
You have never had a complete Immune profile , you cant base decision on TNF or INFgamma ratios which is what you have had done. See my diagnostic testing and sample report section on my website to see a complete workup. We can do this from IReland, simply fill out a consult request from the website and we can schedule a free 10 minute consult to reveiw your case by SKYPE or telephone.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.