Endometrial Function Test and HLA Matching

linn25

2 Posts
Reply Posted on: Aug 13, 2012 at 6:07pm
Dr. Braverman,
I was hoping you could give me your thoughts on the Endometrial Function Test conducted through the lab at Yale, as well as how it relates to our case overall.
We have one healthy son who will be 3 this Fall conceived via IVF (1st IVF = trisomy 22 miscarriage, FET = our son). We pursued IVF after learning that my husband had mot/morph issues due to a varicocele. Since last May we have been trying to conceive a second child - we tried on our own for some time (husband had varicocele repaired) and then started with the clinic again in Nov. Since December we have had a failed FET (from the batch that got us our son), a failed fresh cycle (with OHSS - I produce 20+ eggs everytime), and a chemical pregnancy from FET. In June we began with a new doctor who tested me for NKAs and "HLA tissue match" with my husband, as well as did this Endometrial Function Test. We found out we "match" in 3 spots and our doctor felt 3 or more was significant (my NKAs were not elevated - they were 13 and he said 15 or greater is elevated) and we were counseled to take Intralipids during the stimulation process. We just recently had our egg retreival (I was on what this doctor felt would be a more "mild" stimulation protocol) and we are waiting to find out if we have any PGD normal embryos. But we also just got the results of our EFT back and were told that the results were "very abnormal" and that I had a "very promiment issue with glandular development arrest" (the lab report says "luteal nuclear cycle E > 50" is "Extreme GDA") and our doctor has recommended not transfering any embryos until I have completed a 3mth course of Lupron.
Is this a test that you use with your patients? Is the situation as dire as we are being told and how could it have gotten so bad since having our son? Do you think this is related to our "HLA Matching" issue? Why do you think so few clinics use this test - is it's validity in question? and lastly, do you agree with the recommendation to treat this with 3mths of Lupron (and will it help)?
THANK YOU!

Dr. Braverman

2005 Posts
RE: Endometrial Function Test and HLA Matching Posted on: Aug 13, 2012 at 7:04pm
I dont think the two are at all related. I do not use the EFT in my practice and I think it simply is another sign of etiologies we already test for and treat. I have never had to stop treatments for 3 months of lupron. I also do not think 3 matches is significant. I think you should give me a call and maybe schedule a consult as you seem to be all over the place with your current recommendations. I would be happyt to have a brief chat with you if you would like. What center are you currently at?
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

linn25

2 Posts
Reply RE: Endometrial Function Test and HLA Matching Posted on: Aug 13, 2012 at 7:10pm
do you think it would be a waste of time for us to transfer any genetically normal embryos given the EFT results? We've been made to think that my uterus will not be receptive to any embryo right now and that we would be wasting the embryos until the problem is treated. What is the best way for me to arrange a quick phone call with you? I

Dr. Braverman

2005 Posts
RE: Endometrial Function Test and HLA Matching Posted on: Aug 13, 2012 at 7:16pm
email your phone number and Ill give you a quick call now.
jbraverman@reproductiveimmunology.com
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.