Thank you


0 Posts
Reply Thank you Posted on: Feb 18, 2011 at 3:03pm
Dr. Braverman,

I am not a patient of yours, but like many on this board, I am deep in the throws of "involuntary infertility" and embarking on my quest to find some answers. I have seen several doctors and have not found a single one that even comes close to providing the kind of information you do. Thank you so very much for taking the time to help all of these women, including myself, on a daily basis. I have such a greater understanding and feel like I can really take control of my situation after reading your website and your discussions with others.

I have recently been awarded (ha) with the diagnosis of elevated NKa levels (11.5) and a positive dual-pattern ANA (homo 1:80 and speckled 1:160), both of which, per what I have been told, are only slightly above "normal" levels. It is my understanding that any elevation of NKa is, for lack of a better term, bad and that IVIg or an Intralipids infusion are the only remedies. Is this true? With not-so-elevated levels, is there anything else I can do to even slightly LOWER these numbers? Vitamin D? Diet? I have miscarried twice around 4-5 weeks and have had no luck in over a year. I am 32, am in great health, I am 5'6" and weigh 118. I don't abuse alchohol, I DO NOT do drugs, have one cup of coffee per day, and I haven't had a cigarette in 6 years. No one in my family has a single persistent, congenital, genetic disorder, there are no cancers, no diseases, nothing. In fact, I come from a long line of VERY fertile women with no occurance that I have seen or found of miscarriage on either side for generations.

I know most doctors are going to suggest IVIg, but I simply cannot afford it. My husband's semen analysis came back with astounding results, overly potent and high volumes of good looking sperm. My HSG, progesterone, eggs, hormones all look great, so it seems, physiologically, things are fine, leading me to believe we don't need IUI or IVF, but that is what we have been sold and at about a $25,000 price tag and that's just not possible.

Thank you, in advance, for any suggestions, guidance, or support.

Dr. Braverman

2026 Posts
Re: Thank you Posted on: Feb 19, 2011 at 3:09am
With only a mildly elevated NKa there is no proof that you need IVIG or IL. You certainly need lovenox if you have not already been treated with this. As you may have read the ANA itself may attach to invading trophoblastic tissue from the embryo and lead to activation of the "complement" system which draws a very potent inflammatory response from the mother and eradicates the embryo with a miscarriage. Lovenox does a great job in treating this. Now Im not sure what other immune tests you have had and dont know for sure if you need other treatments but you cant tell from just a mild elevation in NKa.
If your tubes are open we should be able to accomplish pregnancy without IVF and or IVIG or IL.
Please call me and I will complete your workup for you and guide you in a less expensive management.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.