4 failed attempts at IVF

lild

3 Posts
Reply Posted on: Jan 9, 2012 at 10:25pm
Hello Dr. Braverman,
I wonder if you think reproductive immunology might relate to my difficulties conceiving given my history. I am 39 (DOB 1/16/73; a normal BMI of 24) and began TTC in 2009. I immediately went to Shady Grove Fertility in Baltimore for an evaluation. These were the results:
-a follicular ultrasound report indicating a low ovarian reserve
-Bloodwork (6/19/09):
E2-72.6 pg/mL
LH-6.78 mIU/mL
TSH-6.44 uIU/mL
PRL-32.9 ng/mL
FSH 12.8 mlU/mL

I was told I carry antibodies for hypothyroidism, so I've been on Levothyroxine 75 mcg OD.

-A Saline sonogram then revealed a 4.3 x 2.7 cm partially submucous and partially submural myoma
-More Blood work
LH- 4.88 mIU/mL
E2-62.5 pg/mL
FSH-7.97 mIU/mL

Follow-up Blood work from GP (7/17/09)
TSH-3.363 uIU/mL
Thyroid Peroxidase (TPO) Ab 2012
Prolactin 11.6

-Hysteroscopy took place at Mercy Hospital, Baltimore on 10/7/09
-Husband and I re-located to Boston, MA where I visited Boston IVF. Unfortunately the same myoma had pushed out into the uterine cavity requiring a 2nd hysteroscopy that took place 1/14/10.

After healing I then did 4 rounds of IVF that failed. Every egg retrieval yielded 2-6 eggs, on average 50% of embryos would fertilize. (No problems with husband's sperm quality) 2-3 embryos were transferred every time, and they were always rated the highest quality. We decided to take a break from IVF after they all failed.

Unfortunately a heavy period indicated more problems with fibroids. A pelvic assessment on 6/4/2011 revealed a fibroid uterus with largest fibroid being an anterior intramural with a submucosal extent approximately 30%. Normal ovaries.
Bloodwork (6/7/2011)
Platelet count 532
TSH 3.0 uIU/mL
Another hysteroscopy took place 7/15/11.

I am now taking:
Levothyroxine 75 mcg OD
Prenatal vitamin OD
Xanax .25-.50 mg PRN (only when I know there's no chance of pregnancy)

Supplements:
Saw Palmetto and milk thistle OD to control re-growth of fibroids
Fish oil 1000 mg 2x Day
*Inositol powder 2g 2x Day
*Vit D3 2000 iu OD
*Co Q-10 200mg OD
*Pycnogenol 60 mg OD
*Melatonin 3g OD
*Resveratrol 400mg OD

*taken at the advice of my acupuncturist, whom I see every other week.
I appreciate your time, Dr. Braverman, and would appreciate your input.
Sincerely, Lil D

Dr. Braverman

2024 Posts
RE: 4 failed attempts at IVF Posted on: Jan 10, 2012 at 12:20am
the fibroids are a concern, as they reoccur and have a submucosal component. I think there are other issues here. the thyroid antibodies clearly show there is an immune component to both implantation and egg quality as these are many times tied in to ovarian antibodies as well(this should be tested).
Regardless you should avail yourself to a complete immune workup and come up with a plan to treat every problem . this will give you the best chance to succeed when you do make a good quality embryo. I would be happy to help you with this, feel free to call my office and schedule a skype or telephone consultation. I am sure i can get you answers for all of this.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

lild

3 Posts
Reply RE: 4 failed attempts at IVF Posted on: Jan 17, 2012 at 8:30pm
Dr. Braverman, Thanks for your reply. I am considering a visit to NY to see you in person because my health insurance will not cover a telephone/Skype consultation (only an office visit). If I do this, is it possible for you to treat me long distance re: reviewing tests performed by other doctors? I live in Boston. Thanks for your time.

Dr. Braverman

2024 Posts
RE: 4 failed attempts at IVF Posted on: Jan 18, 2012 at 10:30am
absolutely , I look forward to meeting you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.