Posted 05 June 2013 - 03:26 PM
It's a good idea to start a thread devoted to this exclusively. I know that there is a similar thread in the Markham section but it's good for others at other clinics to have access to info.
I had extensive immune treatments and was a Markham patient too and landed there after our second IVF at another clinic after having a missed miscarriage of twins. Our primary reason for doing IVF is my DH's vasectomy and on paper everything looked perfect for me from all my initial tests. But...we discovered that I was a poor responder to meds with a diminished reserve along the way. On our second IVF I got PG with twins but had a missed m/c. The doctor blamed "advanced maternal age" (I was 38). While this could have been the case, something wasn't totally sitting well with me. I just had a feeling that there might be more going on so I pursued immune treatments (Alan Beer Centre) through the Markham clinic. IVF is a very costly and emotionally draining experience and I wanted to get ALL possible testing done before pursuing it for the 3rd time. Plus, I have a family history of m/c so I thought that I should look into things more. Even if my tests came back perfect I figured it would be worth it just for the peace of mind of knowing that I knew what I was dealing with.
My tests did not come back perfect. I have two MTHFR mutations that are linked to blood clotting issues that can be linked to m/c. I had another mutation (PAI...something) that is also linked to m/c. My LADS were very, very low. My anticardiolin was borderline and my ANA was positive. My NK cells were highly elevated. As a result it was recommended that I do: two shots of Humira before cycling, 2 treatments of LIT (only offered at the time in Mexico...It's now offered at Markham), two IVIG treatments, baby aspirin and Lovenox shots.
I was a poor responder in my cycle (surprise, surprise) and only produced 3 follicles. The doctor got 2 eggs, both fertilized and we did a 3 day transfer. My DD is the result of that cycle so it really does just take one.
We were actually recommended for a 3rd treatment of LIT (with my husband's blood and donor) as my numbers never increased. We decided to go with Dr. Virro's recommendation of going ahead with the cycle and just doing IVIG.
The Alan Beer Centre is excellent BUT I did find that they made me crazy by telling me I needed MORE and MORE testing to check my levels after I became PG. My levels were never good but they created just enough doubt in me that I continued to pursue IVIG until 18 weeks, including traveling to the States to get it at one point when it wasn't available at the clinic. Not sure I would do that again...but hindsight is 20/20 and the important thing is that I sustained my pregnancy and have a beautiful little girl.
I should mention for anyone reading this that the Alan Beer Centre mentioned to me that one of the hallmarks of an immune issue is sometimes poor response to meds. This was definitely me. But...the good news is that just because you may produce low numbers doesn't mean that the eggs are crappy. It just means that you have more to work with. Another thing that I wonder about with immune issues is not just m/c but missed m/c. It seems that a lot of people with immune issues have this happen. My missed m/c experience was absolutely devastating. Being told there were no heartbeats just killed me.
I think that immune testing is an avenue that more doctors should pursue. I think that when you can mix a good immune protocol with a good stimulation protocol then it can make all the difference.
gibasgirl, Lisa1981, My_time and 1 other like this
Dx: DH: Vasectomy; need IVF/ICSI
ME: D.O.R. and many immunological issues. (Initially presented as "normal" but issues were only discovered after IVF attempt #2 and #3 after testing at new clinic)
IVF attempt #1 Nov.2009, Age 37: Long "Lupron" protocol
Dec.2009: Cycle cancelled due to oversuppression
IVF attempt #2, Age 38: April 2010: 3 eggs retrieved, 2 mature, 2 fertilized, ET of 2 embryos BFN
IVF atempt #3 at new clinic: November 2010, Age 38: 5 eggs retrieved, 4 mature, 4 fertilized, ET of 2 blastocysts BFP
Strong beta numbers but babies not measuring on track but one heartbeat is present. Followup u/s reveals no HB's
Had D&C--so sad.
Moved to new clinic closer to home + more of a focus on testing for potential immunological factors:
Further testing reveals three mutations related to inherited thrombophilia (2 MTHFR mutations and PA1-1 mutation), positive ANA, elevated NK cells and cytokines and low levels of leukocyte antibodies (LADS), Recommended Immunological treatment: Humira, LIT, IVig
and blood thinners if PG
IVF Protocol: Low stim for me/ TESE needed for DH; took Humira in late August and early September; taking DHEA plus Co-Enzyme Q10, vitamins for DH just for good measure! September--two trips to Mexico for LIT treatment, treatments 3 weeks apart
Initial re-testing through Alan Beer Centre after some of the immune treatments reveals only cytokines were lowered, NKs still high and LAD numbers still low. Another LIT in Mexico is recommended. We decide to begin cycle on doctor's recommendation of just doing IVIG
IVF#4, Age 39 : November 2011: Worst AFC EVER--a whopping 4! Three follicles responded, two eggs were retrieved. Three day transfer of two Grade 1 8 cell embryos: "Fahita" & "Burrito" Stick, stick, stick little ones!
BFP! Beta of 569
Viability u/s at 6 w 2d shows TWO babies measuring on track with heartbeats of 121. Looks like babies might be sharing the same amniotic sac.
Second u/s at 7w 2 d shows ONE baby with hb of 150, measuring 7 w 3 days. No sign of twin. Vanishing twin syndrome?
Third u/s at 8 w 2d shows ONE baby with hb of 170, measuring 8 w 3 days. Looks like a little jellybean!
12 week u/s at 12 w 2 days and baby is measuring 12 w 5 days with a heart beat of 150. Baby mooned us and waved at us with one hand....looked like a "royal" wave to me!
13 week doctor's appointment, HB=155 on doppler
14 week u/s to check cervix, HB=148
16 week u/s to check cervix, HB=138, baby had hiccups!
20 week u/s--everything looks good! HB=130, looks like we're having a GIRL!
IPS results very good!
39 weeks: Our baby girl arrived!!! She is healthy and beautiful! We are so happy!