Consult on Thursday, October 27, 2011

Scotch76

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Reply Consult on Thursday, October 27, 2011 Posted on: Nov 2, 2011 at 12:49am
Hi Dr. Braverman,
As predicted, after digesting the information that you gave to us we have some questions for you.
Here they are:
We mentioned to you that we had the six embryos frozen. We also discussed doing a frozen cycle. Since you recommended that we should take anti-oxidants for three months, do you recommend taking three months completely off to see what happens and then do the frozen cycle or do it simultaneously? The recent frozen cycle had me on birth control and then on lupron to supress me so there would not be a chance to get pregnant naturally.
My other question is if we did have to do a fresh cycle possible with a split sperm situation, what protocol would you recommend? My best cycle was on the long lupron stimulation again using birth control and lupron to supress me. The local RE has recommended the long stimulation protocol.
My husband is currently on Humira for his Crohn's/Colitis. Would that interfere with clomid if it is recommended to him? We have read the Humira website that is can cause low sperm count. When my husband called the company, they had no information that proved this was true. HIs GI doctor thinks that is false information. Do you feel this is false and the quality issue we are having is more related to his inflammation?
Would it be possible to e-mail the information to my private e-mail address? crknj123@aol.com/smendel748@aol.com

Thank you for your time,
Cindy M

Dr. Braverman

2024 Posts
Re: Consult on Thursday, October 27, 2011 Posted on: Nov 2, 2011 at 11:40am
Hi Cindy , why am I not surprised you had a "few" questions!! We can communicate privately of course, just send me your email to JBraverman@reproductiveimmunology.com and I will get right back to you. But I do agree I do not think Humira is an issue for your husband.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Scotch76

0 Posts
Reply Re: Consult on Thursday, October 27, 2011 Posted on: Nov 3, 2011 at 10:48pm
Hi Dr. Braverman,
I received your response and have a few more questions.
You mentioned in your e-mail to myself and my husband, that if we decided to do a frozen cycle, that I could do the intralipids. What day of the cycle would I have to do this procedure? Also, if we had the embryos tested using the ACGH method, could we still put back embryos provided some come back normal?
Do the intralipds take longer than an hour and who would distribute them? Would you still recommend taking the anti-oxidants for me (and husband) while I am on birth control and lupron getting ready for the FET?
Thank you so much for your time!
Please respond to crknj123@aol.com/smendel748@aol.com
Cindy M.

Dr. Braverman

2024 Posts
Re: Consult on Thursday, October 27, 2011 Posted on: Nov 4, 2011 at 1:56am
1. yes you can do the aCGH after the thaw and place in the normal ones and refreeze the rest
2 . Intralipids take about 2 hours, they should go in 5-7 days prior to transfer of the embryos.
3. some studies show resveratrol can assist with implantation so no harm in going on the antioxidants now.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Scotch76

0 Posts
Reply Re: Consult on Thursday, October 27, 2011 Posted on: Nov 4, 2011 at 8:51pm
Thank you so much for answering our questions Dr. Braverman.

Just one more for now:
I requested to have my medical records sent to my home so that I would be able to bring them to my local RE. I was looking through the results and I noticed that it said I am positive for the MTHFR PCR gene. What does that mean exactly? Does this affect my treatment or is the way we are being treated what is usually done for this gene, when it is positive, as well? If I am interpreting it wrong, please let me know

Thanks!
Cindy

Dr. Braverman

2024 Posts
Re: Consult on Thursday, October 27, 2011 Posted on: Nov 5, 2011 at 2:35am
which MTHFR was positive and what did I recommend for your treatment already ? did we discuss baby aspirin or lovenox?
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Scotch76

0 Posts
Reply Re: Consult on Thursday, October 27, 2011 Posted on: Nov 5, 2011 at 3:05pm
Hi Dr. Braverman,
In my medical records that were sent from your office, it says that I am compound heterozygous for the MTHFR PCR (C677T and A1298C)gene. When we met with you on the 27th, you did not recommend baby aspirin or lovenox. You recommended that we try antioxidants as well as intralipds. What exactly does it mean to be compound heterozygous for the MTHFR gene and does this mean that baby aspirin and lovenox would be added to a fresh cycle or done with a frozen as well?
Thank you for your quick response,
Cindy Mendelsohn

Dr. Braverman

2024 Posts
Re: Consult on Thursday, October 27, 2011 Posted on: Nov 6, 2011 at 2:21am
This mutation is very common and present in about 15% of the population, when both copies of the C677 are present I treat but one single mutation would require we treat too many people. some have placed patients with this mutation on at least baby aspirin just to address the issue. But this is not a significant issue.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Scotch76

0 Posts
Reply Re: Consult on Thursday, October 27, 2011 Posted on: Nov 12, 2011 at 4:56pm
HI Dr. Braverman,
After speaking with my RE, he feels that if we are going to do the ACGH testing that we should do a fresh cycle. This way we would have "fresh" embryos and "frozen" embryos to test. Additionally, he feels that we should not do Intralipids b/c he does not believe NKcells have anything to do with implantation. According to my records, I have slightly elevated NKCells. If we did a fresh cycle and used intralipids, would we have a slightly higher chance since the intralipids would kill off the cells? Could it still work without the intralipids? Also, what is your opinion on the lite D and C, hysteroscopy protocol for someone who is about to embark on their fourth fresh cycle?
Please respond via crknj123@aol.com or smendel748@aol.com
Thanks,
Cindy

Dr. Braverman

2024 Posts
Re: Consult on Thursday, October 27, 2011 Posted on: Nov 12, 2011 at 10:55pm
For a more immediate response please email my at the office so I can look over your records, and i can keep a copy of your questions. I want to look over all your records before advising you on what you should take. I do not disagree with a fresh cycle to get more embyros as long as it doesnt change the cost of the aCGH.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.