Immune Issues maybe at play or just 'old eggs'?

Kim

5 Posts
Reply Posted on: Jan 30, 2016 at 10:06am
Hi Dr. Braverman,


I am in the process of evaluating our next steps after a failed first IVF in Aug 2015. Before we move onto another cycle, I would love your opinion on if it is possible we are dealing with immune issues are just DOR/bad/old eggs. I should mentioned that we have submitted a request for the 10 min consult with you.


A quick history, I am currently 41 (Oct) and we have been trying for #2 since April 2013. We have one live born son who we conceived easily in 2010 (no medication/ART) and was carried to full term. After his birth I experienced postpartum thyroiditis which was controlled with medication. I have since been on a compounded T3 medication only (and TSH is usually around 1.3). After one full year of trying naturally, and experiencing 2 missed miscarriages (April 2014 & Dec 2014) we began working with our local fertility clinic and did 3 rounds of clomid/IUI where we had another missed miscarriage (Mar 2015 - clomid cycle) and all others failed. We moved onto IVF (Aug 2015) and was deemed a poor responder on an antagonist protocol (7 follicles, 4 eggs mature and only two fertilized and transferred on day 2- failed cycle) with max dose of meds after day 4 of stims. My AMH is 0.7 ng/nL (May 2015) Prolactin 11 ug/L (Oct 2015) TSH 1.31 mIU/L (Oct 2015)

We have consulted with another clinic in Canada who was open to doing more immune testing and ran the following tests:

Rheumatoid factor quant 11 kU/L

Beta 2 Glycoprotein 1 Antibody -negative

Cardiolipid Antibody - negative

Thyroglobulin Antibody 15.5 kIU/L

I was also diagnosed stage 1 endometriosis in Dec 2015 following a lap (no specialist here in Canada, but gyno did combo of cautery and excision). ​He found an endometrioma on both ovaries, no adhesions on tubes.


No other health concerns and I exercise regularly. Husband has only low morphology, all other tests have been normal.


I've done MHTFR testing and have no snps at those locations.

Supplements I have been on include: CoQ10, PQQ, Folate, Prenatals, NAC, Probiotics, EPA/DHA, Melatonin, Resveratrol, Pycnogenol, Activated B Complex, Vit D.

I have also done fertility acupuncture for the last two years regularly.


At this point I feel that we should do further investigations into why I cannot seem to get pregnant any longer, but maybe I am just in denial about my age and should just accept the fact that it's likely my age that is our 'problem'. Are we wasting our time pursuing this with my 'old' eggs?


Thank you for your time.
Kim

Dr. Braverman

2026 Posts
RE: Immune Issues maybe at play or just 'old eggs'? Posted on: Feb 2, 2016 at 1:20pm
No I do not beleive this is simply an age related issue. Endo can play a part in egg quality , but also underlying immune issues that trigger the endo need to be "completely" evaluated and treated after your surgery has been performed. Your supplements are correct (use our endo optimize to replace many of your current supplements)
Braverman Medical Team
Braverman Reproductive Immunology P.C.

Kim

5 Posts
Reply RE: Immune Issues maybe at play or just 'old eggs'? Posted on: Feb 2, 2016 at 2:06pm
Thank you for your quick reply Dr. Braverman.


Just a quick correction, it was stage 2 endo (reread my report over the weekend). Do you feel that a complete immune work up and treatment could be successful in our case? Regards.

Kim
Kim

Dr. Braverman

2026 Posts
RE: Immune Issues maybe at play or just 'old eggs'? Posted on: Feb 2, 2016 at 2:09pm
yes even if stage 2 recommendation still the same, in fact studies showed affects on mitochondria even with mild endometioisis
Braverman Medical Team
Braverman Reproductive Immunology P.C.