Implantation failure caused by immune issues?

Kris71

4 Posts
Reply Implantation failure caused by immune issues? Posted on: Oct 5, 2011 at 10:19pm
Hi Dr. Braverman,
I am suffering from secondary infertility. I got pregnant with my son (who is now 4) very easily and naturally. For the past 3 years, we have been trying to conceive another baby. 18 mos on our own with not even a hint of a pregnancy. All testing came back normal for both myself and my husband. i seem to ovulate normally every month per the positive i get on my ovulation kit. HSG test normal as well. The past 18 mos , we started ART, 2 failed IUIs, 1 positive IVF but had a m/c due to chromosome abnormality. 1 failed FET and subsequent failed fresh IVF. i had an immune panel done in April 2011. i have Thyroid antibodies (knew about these already and am on synthroid), low positive ANAs, low LADs, high TNFAlpha cytokines, hetero for MTHFR, high natural killer cells. I did 2 LITs, 2 humira injections and retested in august and my --'s looked great. Was cleared for TTC taking 1mg of Dex, Lovenox, folgard and baby aspirin and progesterone supplements. Did a FET (with frozen embryos from my failed fresh IVF in Feb) and it failed. We are currently trying on a natural cycle with the dex, lovenox, folgard and aspirin (i have now just turned 40). My thought is this, would these immune issues cause me not to get pregnant at all or could something else be going on entirely? I read a lot of women with immune issues have multiple miscarriages. I am not in that category. I just can't get pregnant. Even tho i had a m/c with my first IVF, testing showed the fetus had a Trisomy 9. I am baffled by what might be going on with me. is there something that we could be missing here? My RE keeps telling me the reason for the ART failures are probably bad embryos but my FSH Is a 6. i stim well (last IVF i got 20 eggs, 13 fertilized with ICSI, 7 made it to blast. Previous IVF, i also had 7 high graded blasts). I have transferred 10 embryos and only the 1 chromosomally abnormal one stuck.)It seems statistically improbable that all of them were bad and let's face it, even bad embryos stick. Do i just need to give the immune treatments more of a chance? I just feel like we're missing something here. Any thoughts? Thanks.
- Kristen

Dr. Braverman

2016 Posts
Re: Implantation failure caused by immune issues? Posted on: Oct 6, 2011 at 1:34am
Many of these cases turn out to be some type of HLA issues, either inherent in the mother herself or several bad combinations between mother and father. Many of these are seen after the first born is a male. Please call me and I would be happy to organize that part of the workup for you. I have many cases exactly like yours and we have great success with our treatments(go to our boards some of them have posted their stories). Dont give up, I agree its most likely not an embryo quality issue. Im assuming both of you have been karyotyped by now.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Kris71

4 Posts
Reply Re: Implantation failure caused by immune issues? Posted on: Oct 8, 2011 at 5:26pm
Thanks Dr. Braverman. I will call your office. We have not been Karyotyped yet. Is this something we should do prior to doing the HLA testing?

Thanks.
- Kristen

Kris71

4 Posts
Reply Re: Implantation failure caused by immune issues? Posted on: Oct 8, 2011 at 5:44pm
Also, i've read the LIT is the treatment for the HLA issue and since i did 2 of these already, what else can be done (if HLA is my issue).

THanks.
- Kristen

Dr. Braverman

2016 Posts
Re: Implantation failure caused by immune issues? Posted on: Oct 8, 2011 at 7:03pm
I have had great success with other therapies when LIT does not work.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.