failed donor egg cycle - + ana

ja7508

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Reply failed donor egg cycle - + ana Posted on: Oct 11, 2011 at 1:56pm
Hi Dr. Braverman,

Was wondering if you could shed some light for me. I am 40 years old My situation:

- at 3 yrs old diagnosed with Juvenile Rheumatoid Arthritis - never bothered me again
- college - got alapecia areata. since then - I have had is 4 times on my head only. Hair grows back.
- history of hives - Dermographism at one point but has seemed to disappear
- at 35 I was diagnosed with premature ovarian failure. My FSH came in at 117.
- i have been tested for many autoimmune diseases including RA and Lupus. Everything comes back negative but I do have a positive ANA.
- did my first donor egg cycle this month. donor was healthy 25 years old. 15 eggs retrieved. 12 fertilized. 11 matured. Did a 3 day transfer of 2 "good looking" 8 cell embryos. Only 1 of the remaining 9 were freezable.

Pregnancy turned out to be biochemical. HCG only got to 7.2 at beta.

I'm writing to you because my husband and I just spent thousands of dollars on a donor cycle. I can not believe we only have 1 egg in the freezer. Ridiculous. I'm concerned that my +ana/autoimmune issues played a role in this most recent chemical pregnancy and don't want it to happen again. I only have the 1 frozen egg left (if it makes it through the thawing process). I'd like to be ensured that I'm taking every precaution necessary for a successful implantation.

Thoughts? Also - do you provide donor egg services?

Thank you.

Dr. Braverman

2017 Posts
Re: failed donor egg cycle - + ana Posted on: Oct 13, 2011 at 12:32am
Ok this is clearly one of three issues

1. Immune the positivie ANA even if not associated with a documented autoimmune disease is related to failed IVF and donor cycles if not treated. The antibody itself can attach to the invading embyro and activate the complement system. (look for further explanation about this on the website)
2. Male factor not diagnosed
3. problem with the donor or the stimulation of the donor

All three are resolvable issues Certainly number one above should have been addressed.
Yes I run donor cycles at my center all the time , and all my positive ANA patients get a full immune profile (not autoimmune disease) and are treated.

I would be happy to assist you evaluating your immune status prior to placement of your last embryo. Please give my office a call and schedule a consultation.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

ja7508

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Reply Re: failed donor egg cycle - + ana Posted on: Oct 13, 2011 at 8:25pm
Thanks for the reply Dr. Braverman -

What I forgot to mention...

- huge male factor issue. No semen found in fresh sample on the morning of egg retrieval so they had to use my husbands frozen sample. my doctor insisted he freeze a sample months ago due to his first semen analysis. you see...my husband had a vasectomy reversal last year and his first analysis showed low volume and mobility so my doc suggested he get some in the freezer. he said sometimes after a reversal, it takes a while for the semen to flow correctly but other times scar tissue can build up and cause issues in semen flow. apparently this is what happened. but would a reversal effect the actual quality of the sperm? what can be done to fix that?

with all that being said there is nothing i can do about the male factor with regards to the embryo i have in the freezer right now. it is what it is. knowing this info - do you still think the +ana was a major factor here? should i take precautions before we implant this one? so frustrating not knowing if it was the male factor or the +ana.

thanks for your thoughts.

Dr. Braverman

2017 Posts
Re: failed donor egg cycle - + ana Posted on: Oct 15, 2011 at 2:02am
yes there is certainly evidence of a male factor here but if this embryo has made it to freeze you MUST address the p ostive ANA prior to transfer.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

miracle

9 Posts
Re: failed donor egg cycle - + ana Posted on: Oct 21, 2011 at 9:27am
I have positive ANA too. Is prednisone the only treatment for ANA? Can neupogen and/or IVIG treat ANA or is there any other treatment?

Thanks.

Dr. Braverman

2017 Posts
Re: failed donor egg cycle - + ana Posted on: Oct 21, 2011 at 4:38pm
all of them are viable treatments in addition you would benefit from lovenox which would bind to Factor X and prevent the complement breakdown that is associated with binding of ANA to the embryo trophoblast.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.