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Immunology Testing

reproductive immunology dr. beers sher institute ivf failure ivf BFN

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#1 Myrtle

Myrtle
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  • 435 posts
  • Gender:Female
  • Dx:Unexplained
  • My Clinic:McGill

Posted 15 November 2012 - 03:55 PM

I would like to hear from anyone who has had any reproductive immunology testing done. After our second failed IVF, I am seriously debating holding off on our third, until we have ruled out immune issues. We are currently unexplained secondary infertility. We had one child together four years ago, and have had two unsuccessful ivfs, the second one with PGD to rule out chromosomal abnormalities.

I am pretty sure my fertility clinic does not test for or treat immune issues. I have searched and found the Sher institute does- I am not sure how they are connected with Dr. Beers, but I am reading his book called, "Is your Body Baby Friendly" which seems over confident in that everyone has a diagnosis or a reason as to why they are not getting pregnant.

I am not sure how we would proceed if I tested positive for an immune issue. We have one more govt. funded IVF left here in Quebec, but it seems like a complete waste to bother if there is some immune issue.

I wonder if we can get tested here and have out bloods sent out, or will we have to travel to NY? I have family in NY and there is a Sher clinic in Westchester, so that was a thought. Does anyone know which clinics this kind of testing? Anyone had it done and what were your results? Do you feel that this testing helped you get pregnant?

I'd love to hear others opinions on this subject as it seems like it is definitely not the first thing most REs test you for, and some not at all.

See my profile for more details.  

 

Me: 42 DH: 37

DS #1 conceived naturally, born Dec. 1st, 2008

January 2010, Begin TTC #2
September 2011 start charting
April 2011 Consult with RE.
All tests normal. No problems found.
Two IUIs. BFN.
February 2012 IVF #1 -BFN.
FET July 2012- BFN.
IVF#2  Fall 2012
Hysteroscopy Tues. 8/21
PGD 2 out of 11 embryos are normal and put back in. Beta November 7th. BFN.

 

Further testing - the RPL test- results in suspected immune issues.  Recommended protocol to take baby aspirin 

and possibly steroid.

Start taking baby aspirin.

April 4th 2013. Surprise BFP, chemical pregnancy.

IVF #3 - May 2013

April 8th start BCP.  Keep taking baby aspirin.  

April 19th - start 5mg/day of dexamethasone (steroid) 

Starting weekly acupuncture April 19th.  

May 1st- blood test come back positive for hyperthyroidism.  STOP EVERYTHING.

Referral to endocrinologist.  Appointment on June 20th, 2013.  

Have a prescription for vitamin d and for propylthiouracil.  started June 26th.

Blood tests at the end of July and end of August to see if all is well.  

Doctor hinted I might be cleared to go back to IVF as soon as September.  

 

October 8th, thyroid is now fine.  Cleared to start IVF.

 

IVF #3.5 October 2013

Oct. 18th - start BCP, dexamethasone and baby aspirin.

Nov. 1st - start .5ml buserelin each night.

Nov. 4th - last BCP

Nov. 14th - 1st u/s.  

Nov. 27h - ER.  11 Eggs Retrieved.  

Nov. 28th- Embryo update:  12 eggs retrieved.  10 mature.  8 fertilized.  

Dec. 2nd 2 embryos transferred 5-d-t.  Also mild OHSS diagnosis.

Dec. 13th - Beta blood test.  BFN.

 

Done with IVFs.  

 


#2 Myrtle

Myrtle
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Posted 15 November 2012 - 04:50 PM

This is a recent article talking about it: http://www.theaustra...6-1226513987254

See my profile for more details.  

 

Me: 42 DH: 37

DS #1 conceived naturally, born Dec. 1st, 2008

January 2010, Begin TTC #2
September 2011 start charting
April 2011 Consult with RE.
All tests normal. No problems found.
Two IUIs. BFN.
February 2012 IVF #1 -BFN.
FET July 2012- BFN.
IVF#2  Fall 2012
Hysteroscopy Tues. 8/21
PGD 2 out of 11 embryos are normal and put back in. Beta November 7th. BFN.

 

Further testing - the RPL test- results in suspected immune issues.  Recommended protocol to take baby aspirin 

and possibly steroid.

Start taking baby aspirin.

April 4th 2013. Surprise BFP, chemical pregnancy.

IVF #3 - May 2013

April 8th start BCP.  Keep taking baby aspirin.  

April 19th - start 5mg/day of dexamethasone (steroid) 

Starting weekly acupuncture April 19th.  

May 1st- blood test come back positive for hyperthyroidism.  STOP EVERYTHING.

Referral to endocrinologist.  Appointment on June 20th, 2013.  

Have a prescription for vitamin d and for propylthiouracil.  started June 26th.

Blood tests at the end of July and end of August to see if all is well.  

Doctor hinted I might be cleared to go back to IVF as soon as September.  

 

October 8th, thyroid is now fine.  Cleared to start IVF.

 

IVF #3.5 October 2013

Oct. 18th - start BCP, dexamethasone and baby aspirin.

Nov. 1st - start .5ml buserelin each night.

Nov. 4th - last BCP

Nov. 14th - 1st u/s.  

Nov. 27h - ER.  11 Eggs Retrieved.  

Nov. 28th- Embryo update:  12 eggs retrieved.  10 mature.  8 fertilized.  

Dec. 2nd 2 embryos transferred 5-d-t.  Also mild OHSS diagnosis.

Dec. 13th - Beta blood test.  BFN.

 

Done with IVFs.  

 


#3 sheba

sheba
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  • 221 posts
  • Gender:Female
  • Location:Toronto, ON
  • Dx:Unexplained
  • My Clinic:Markham Fertility Clinic

Posted 17 November 2012 - 11:37 PM

Hi Myrtle,
It sounds like it's been a long and exhausting journey for you, and I think it is very proactive of you to consider any immune issues. As you can read in my signature, we TTC for over 6 years, had 3 fresh IVF cycles and 2 FETs (all with great embryos) with absolutely no success (no implantation, no pregnancy, nothing). I read Dr, Beers book and I was fairly convinced it was pretty evidence based. I felt it addressed a portion of us labelled with "unexplained infertility", especially those with implantation failiure. When I brought it up to my RE at the time, in one of the biggest clinics in Toronto, she laughed at me and told me to stop wasting time and start mentally preparing for donor eggs. My husband had looked up a doctor who also believed in reproductive immune issues in Markham and we switched clinics. This new RE, Dr. Virro, worked with the Alan Beers Centre in the US to have his patients complete immune testing. Following the recommendations of my Dr and of the Beers Centre I did a whole lot of treatment to manage the immune issues (over the course of 2 months), and when we tried IVF the following month I got pregnant with twins!! I know the immune testing, a good stim protocol, and the treatment (specifically IVIG) lead to me getting pregnant. And if I'm lucky enough to try again I will be following the same treatment protocol.

You can have testing done through the Beers Centre without travelling there. You need to have bloodwork and an endometrial biopsy sample sent to them; once analyzed you have a consult with a Dr at the Beers Centre. Is there a reason you want to have this testing done at one of Dr. Sher's clinics? As far as I know the Sher Institute is not linked to the Beers Centre. I had a consult with Dr Sher 2 years ago and while he was pretty well versed in many things, his focus was not solely immune issues. I do kow that Dr Sher is a big proponent of intralipid therapy, instead of IVIG, so he is open to looking at immune issues. Sorry for the long winded answer, but overall I would encourage you to look into immune issues as well. You could do a consult with Dr. Sher (over the phone), which is free and might be a good starting point...Seems like you've had a great number of eggs and decent embryos, Anyways, best of luck with whatever course you take!
Sana
  • Lisa1995, gibasgirl and Myrtle like this
TTC#1 since January 2005
6 IUIs- BFN
IVF 1(one day 3 embyro)-BFN
FET 1 (three day 3 embryos)- BFN
IVF 2 (two day 3 embryos)-BFN
IVF 3 (three day 5 blasts)- BFN
FET 2 (two day 5 blasts)- BFN
IVF 4 (two day 5 blasts) with LIT, IVIg- BFP!!!!
Beta 12dp5dt- 930!!
April 20/11 viability scan- TWINS!! Heart rates of 154 and 143!!
October 21/11- welcome baby girl and baby boy!!

#4 Myrtle

Myrtle
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Posted 18 November 2012 - 08:51 AM

Thank you so much for all your information. I had just done a search on clinics doing reproductive immunology tests and the Sher institude came up with their blog. I wasn't sure if they were the same as Dr. Beers clinics or what. On the Dr. Beers webpage- I only see that they are located in Los Gatos, CA. The Sher institute has a clinic in NY near my family, so I was kind of hoping they could do the testing but the more I search, I don't see them really focusing on the immune aspect- like you said.

Since I've already had all those other tests done, I'm ready to do these immunology tests. How did you find the doctor who worked with you via the Dr. Beers clinic in the US? Was he in Ontario? Maybe there might be one floating around Quebec that I could find.

I love hearing your story of success. Congratulations on your babies!!!

See my profile for more details.  

 

Me: 42 DH: 37

DS #1 conceived naturally, born Dec. 1st, 2008

January 2010, Begin TTC #2
September 2011 start charting
April 2011 Consult with RE.
All tests normal. No problems found.
Two IUIs. BFN.
February 2012 IVF #1 -BFN.
FET July 2012- BFN.
IVF#2  Fall 2012
Hysteroscopy Tues. 8/21
PGD 2 out of 11 embryos are normal and put back in. Beta November 7th. BFN.

 

Further testing - the RPL test- results in suspected immune issues.  Recommended protocol to take baby aspirin 

and possibly steroid.

Start taking baby aspirin.

April 4th 2013. Surprise BFP, chemical pregnancy.

IVF #3 - May 2013

April 8th start BCP.  Keep taking baby aspirin.  

April 19th - start 5mg/day of dexamethasone (steroid) 

Starting weekly acupuncture April 19th.  

May 1st- blood test come back positive for hyperthyroidism.  STOP EVERYTHING.

Referral to endocrinologist.  Appointment on June 20th, 2013.  

Have a prescription for vitamin d and for propylthiouracil.  started June 26th.

Blood tests at the end of July and end of August to see if all is well.  

Doctor hinted I might be cleared to go back to IVF as soon as September.  

 

October 8th, thyroid is now fine.  Cleared to start IVF.

 

IVF #3.5 October 2013

Oct. 18th - start BCP, dexamethasone and baby aspirin.

Nov. 1st - start .5ml buserelin each night.

Nov. 4th - last BCP

Nov. 14th - 1st u/s.  

Nov. 27h - ER.  11 Eggs Retrieved.  

Nov. 28th- Embryo update:  12 eggs retrieved.  10 mature.  8 fertilized.  

Dec. 2nd 2 embryos transferred 5-d-t.  Also mild OHSS diagnosis.

Dec. 13th - Beta blood test.  BFN.

 

Done with IVFs.  

 


#5 Lisa1995

Lisa1995
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  • 1417 posts
  • Gender:Female
  • Location:Toronto
  • Dx:Unexplained
  • My Clinic:was Lifequest, now Markham

Posted 18 November 2012 - 03:40 PM

Exactly what Sheba said. Alan Beer Centre and Sher are not connected. My clinic is also Markham Fertility (in Markham north of Toronto) and Dr Virro tests and treats immune issues (I also credit him with my success after many unexplained failures elsewhere). Your blood is sent by Fed Ex to the Alan Beer lab in California for testing. You then do a phone consult with one of their doctors. Dr Virro in Markham also gets the results and goes over your protocol with you afterwards. A lot of women have had success with Dr V after failures elsewhere. Even before Dr V started consulting with the Alan Beer Center he was offering IVIg for unexplained infertility all on his own as he had seen first hand a lot of success with it. I am not sure if there are any Drs in Quebec that would treat you with an immune protocol. I know there are a couple more clinics in Toronto who now offer intralipids (an alternative treatment to IVIg), I think I have seen women post about this on these boards who are at Hannam and Create. Even if you can't get a Dr to agree to the US immune testing you may find one willing to give you intralipids and blood thinner as part of your protocol....Good luck!
  • gibasgirl likes this

TTC #1: starting in Feb 2005 "unexplained" (immune issues, elevated NK cells, 2 heterozygous MTHFR and 2 heterozygous thrombophilias - Factor XIII and PAI-1 mutations)
me-42, DH-42, married since 1995!
Tried: Naturopath, Chinese herbs, Acupuncture, Homeopathy
4 un-medicated IUI's BFN
IVF # 1 18 eggs retrieved, 16 mature, 8 out of 16 fertilized (1/2 ICSI, half IVF), 5 made it to day 5 blast, transferred two, froze 3
first ever BFP m/c
FET #1 medicated, transferred two, started spotting 2 days later, full blown AF 5 days later (decided I don't react well to Estrace, will do natural frozen next time) BFN
FET #2 natural (but still with progesterone (crinone) support, transferred last blast from IVF #1 BFN
IVF #2 16 eggs retrieved, decided not to do ICSI this time since cycle #1 showed eggs could fertilize on their own, only 3 fertilized! None made it to blast for transfer no transfer! Disaster!
IVF #3 decided to add some repronex to the stims and do all ICSI. 18 eggs, 17 mature and 15 fertilized, 8 made it to day 5 blast. Transferred two blasts, froze 6 BFN
FET#3 added 3 HCG booster shots and doubled up on the crinone to prevent me from spotting early (as I often do), transferred 2 blasts, no spotting but a BFN anyway
FET #4- added ovidral just before my natural ovulation so they could pin point it more accurately with the 36 hour window, HCG shots again, plus double crinone BFN
January 2009 Consult with new RE in Markham - he finds a small septum, resected April 29, 09 - tells me to now try my last two frozen blasts
FET #5 - ET scheduled for June 15 (natural cycle with trigger, HCG booster and crinone) - BFN
On to Plan B- Switch clinic to Markham for
#4 Fresh IVF with IVIg, exploring immune testing - start BCP Sept 20. ER around week of Oct. 25
9 eggs retrieved, 1 immature, 1 fractured. 7 to work with. 4 out of 7 fertilized (Day 3: 1 8 cell grade 1, 2 8 cell grade 2 and 1 morula). Day 5 transferred 1 great blast and 1 morula (1 morula and 1 10 cell did not make it to freezing).
Beta Nov. 11 - BFP! (550) I am in shock!
Issues with spotting, Nov 20, second beta 11,000 and early ultrasound: saw gestational sac and yolk sac in the right place but concern about a cyst or possible ectopic near my ovary as well, 4 more ultrasounds over a 10 day period, last ultrasound on Dec. 2 'cyst' has not grown and baby measuring on target at 7wks, 1day with a heart beat of 153bpm.
Now taking Lovenox due to 2 heterozygous thrombophilias
Ultrasound on Dec. 18 (9 weeks, 5 days) baby on track, hb 167
Ultrasound on Dec. 22 due to extra heavy spotting, baby still measuring on track, hb 167 and dancing
Ultrasound on Jan. 8 (12 weeks, 5 days) baby on track, hb 160, baby doing crunches!
18 week anatomy scan scheduled for Feb. 16 - they lost my blood work for the second part of the IPS so no results for that today (they took blood again) but the 18 week scan went great, baby looked awesome and even gave us a little wave in between sucking her thumb and inspecting her toes. Yes, I said "her" - it's a little girl!
20 week ultrasound at Mt. Sinai and they agree, so far so good.
IPS results are in and they are excellent!
EDD: July 19, 2010
Baby girl arrived at 39 weeks, 2 days! July 14, 2010 3:12 am, weighing 7 pounds even.
May 2013 - The IVF Journey continues...one last try to see if a sibling is in the cards...
Did LIT, IVIg, Lovenox and low dose aspirin. 5 eggs retrieved, 1 immature, 1 fractured, 3 to work with, 2 fertilized with ICSI.
June 5, day 3 transfer of 2 8 cell grade 2 embryos.BFN
April 2014, one very last try - natural IVF with intralipids this time, 2! dominant follicles, 2 mature eggs retrieved, both fertilize with ICSI, day 3 transfer scheduled for April 13, transferred 1 8-cell grade one and 1 6-cell grade one (also using Lovenox and low dose ASA) -BFN, we are really done, not sure if it is now my immune system, or old eggs now too.






Also tagged with one or more of these keywords: reproductive immunology, dr. beers, sher institute, ivf failure, ivf, BFN