Various ?s for Dr. Braverman

Hadleigh

35 Posts
Reply Various ?s for Dr. Braverman Posted on: Jan 8, 2011 at 11:38pm
Dr. Braverman:

I have heard a lot of good things about you from people on the yahoo reproductive immunology group. I would like to see if I could ask you a few questions? Your opinions and medical experience would be very much appreciated. I have had two children on full immune treatment and know how the research in reproductive immunology has helped so many of us. Thanks and blessings to you and all of the Drs. that have made it their lifes passion to help women like me with immune issues.

1. This may sound like a weird question, but is it possible that ones immune system would reject male embryos and not female? We have all girls and have had many losses and the losses in which testing was done, they were male losses. This is just something that I have always wondered about, but never asked.
2. I read that you recomend supplements for those ttc to inprove egg quality ect. I wondered if you recommend certain supplements for women in their mid 40's prepairing to do a frozen donor embryo cycle?
3. Does being on a low carb/high protein/no sugar diet hinder or help with inplantation/pregnancy success?
4. While I am waiting to do another frozen donor embryo cycle, my RE has me on a Estrace/Provera protocl to keep my cycles regular (I'm peri-m). Do you ever do this type of protocol and if so, would you mind sharing the protocol you use and for how long?
5. Would you recomend choosing frozen donor embyos from a 41 year old?
6. I know that you use Humira. Do you just use it preconception or do you also use it during early pregnancy, and if so, how long into the pregnancy?
7. Do you prescribe the dosage of Lovenox in regards to a patients weight when she requires it (the AEB center uses 30mg 2xday under 140lbs and 40mg 2xday over 140lbs)?
8. Do you have your patients start Lovenox on CD6 of the cycle of conception or do you have them on it a month or two prior to the cycle of conception?
9. I read that you prefer freezing embyros at the blast stage. Do you ever freeze embryos at the 2pn stage? What is your experience with freezing/thawing at the 2pn stage?
10. Do you file insurance for the immune testing and the phone consultaion that you provide? What is the cost of a phone consultation?

I hope that I didn't ask to many questions. Thank you for your time in answering them.

Dr. Braverman

2026 Posts
Re: Various ?s for Dr. Braverman Posted on: Jan 9, 2011 at 1:34pm
Hello Lize,

I am happy to hear so many patients benefiting from our work. Generally with this many questions that were very well thought out it is easier to speak so I can cover them in detail. Quickly however, on the lovenox I will adjust to dose to weight , but always follow the heparin anti XA to confirm correct dose.
The immune testing coverage varies depending on insurance, if you call my office and ask for Kim she will go over all insurance questions with you regarding the testing and consultation.
As for the question about rejecting male embryos as you read on the site there are HY restricting alleles that only pick up male antigen, but generally these will cause rejection of all future embryos after a male baby. Regarding estrogen and provera prior to donor egg I agree as it is good to return estrogen to the uterus that has been missing it since you are making so much less prior to placement of embryos. Otherwise the lining may not thicken properly and this could lead to a failed cycle. I generally do not recommend using donor embryos from a patient that is 41(if I read that correctly) as the succes rate with eggs from a patietn that age are very poor. I perfer freezing at blast but if we cant 2PN is the next best. Not a fan of day 3 freezing tend not to thaw out as well. except for difficult cases I normally do not prescribe Humira during pregnancy. I hope this helps if you need any more information or help feel freee to call me.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.