First ever pregnancy lost....

Hedger

16 Posts
Reply Posted on: Jun 19, 2012 at 11:10am
Im just waiting to miscarry my first ever BFP after what looks like a blighted ovum. This was my 4th IVF but the first time i have ever had eggs retrieved ((2 eggs, both of which fertilized). I used a low stim protocol with no bcp or down regging (this seems to switch my system off) with clexane, intralipids, prednisolone. I started with 75iu gonal F but early scans didnt show much response but when i raised it to 150iu it seemed to bring 2 follicles to life. Lining was good. I got 2 embryos(3 day 4 cell) both of which were uniform shape with no fragmentation. I got BFP after the 2ww and first bhcg was 90 then 48hrs later was 187. It all seemed good until first scan when no heartbeat was present. A followup scan confirmed the worst.The consultant was positive saying i had got pregnant and most likely it was a chromosone in the egg that caused my body to reject it. There is nothing to suggest there was an immune attack on the embryo (

I am now exploring my options before i have a followup consultation next week. At my age (38) and after trying for 6 years maybe i just dont have the quantity & quality of eggs. I know i will only ever get 1 or 2 eggs max (if Im lucky) at each cycle - maybe i am kidding myself going on using OE.
Maybe i should try one more low stim cycle with maybe dhea for egg quality?
Or are donor eggs my only real option?

Your opinions, however blunt, would be welcome


Hashimoto's, rheumatoid arthritis, positive antithyroid antibodies.
Immune tests notable results =
very high Thyroid Antibodies >3000,
mildly positive ANA speckled pattern,
upper range CD3% 85.3% (60-85) and CD56% 11.6 (2-12)
and very high CD19+, CD5+ cells 22.2% (2-12)
Hashimoto's
rheumatoid arthritis
positive antithyroid antibodies.
Immune testing notable results =
very high Thyroid Antibodies >3000

mildly positive ANA speckled pattern

upper range CD3% 85.3% (60-85) and CD56% 11.6 (2-12) 
and very high CD19+
CD5+ cells 22.2% (2-12)

Dr. Braverman

2005 Posts
RE: First ever pregnancy lost.... Posted on: Jun 20, 2012 at 5:57am
You certanily have many risk factors for autoimmune related miscarriages. This may be playing a part in your difficutly concieving. It does appear from your history that egg quality is a significant issue and your doctor is "most" likely correct. The problem in these cases is that everyone always assumes its "only" the obvious answer, but in many cases there are 2 issues and if the immune issues are not corrected, the one time you finally get a "good" embryo you may loose it due to the immune issues.
I think trying again is a personal decision, so many patients come to me with your situation where by the time we figure out what the immune issues are their egg quality has detiorated. We put together a program where we give our patients one try with our immune management if a problem is found and if they do not get pregnant, we discount an egg donor cycle for them(they would still need immune treatments even with an egg donor cycle, as you most likely would as well).
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Hedger

16 Posts
Reply RE: First ever pregnancy lost.... Posted on: Jun 20, 2012 at 9:58am
Thank you for your reply. In my last cycle I was treated with prednisolone, clexane, aspirin, intralipids (started when I had positive pregnancy test). Should someone like me be on immune treatment for a longer prior period when building up to an IVF cycle to dampen ATA's? I have read in Dr Beers book a 3-6 month immune treatment should take place - but surely 6 months of steroids is not good for the body?
How would you recommend improving egg quality? DHEA?

I have completed many tests at various clinics and results stick out that I have never been treated for...I have very low testestorone, low Vitamin D, very low Ferritin, low adrenal function etc. I have had thyroid problems (overactive then slightly underactive) but I was not on Thyroxine during my last cycle - should I always take thyroxine even if TSH is within range?

Sorry for all the questions but I am trying to find some answers
Hashimoto's
rheumatoid arthritis
positive antithyroid antibodies.
Immune testing notable results =
very high Thyroid Antibodies >3000

mildly positive ANA speckled pattern

upper range CD3% 85.3% (60-85) and CD56% 11.6 (2-12) 
and very high CD19+
CD5+ cells 22.2% (2-12)

Dr. Braverman

2005 Posts
RE: First ever pregnancy lost.... Posted on: Jun 20, 2012 at 12:51pm
I think you need to call for a consult so we can go over your case as there are so many factors. I would be happy to help you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.