[sharonb]

I just had my 3rd failed IVF last week and have been struggling to cope. After much reading on this forum, I began to wondering if something like an immune condition could be a problem for me. At what point would and RE test for this?

When I saw my RE yesterday, I requested all these tests myself. He agreed, but it doesn't seem to be his standard protocol and I'm not even sure if he'd know how or what to do with the results. Your input would be so helpful.

What sparked your RE's to do the tests?

Thank you in advance.

Sharon

[casb77]

I'm sorry to hear about your failed cycle. I did not have the immune tests done, but did ask about them after our m/c last fall. My RE doesn't include them routinely either and doesn't do them unless there have been several losses, partly because of the cost of $4,000+.

If your RE doesn't know what to do with the results, you might try having another practice do the tests and make recommendations. Don't quote me, but I *think* these tests might be more commonplace at CCRM. I'm sorry I can't be more definite, but I've done so much reading over the last few years that some of it has run together in my head.

[sharonb]

Casb.

Thanks so much for your reply. It does seem more common in other clinics to do autoimmune testing. I am getting the testing done (since I requested them), and I think insurance will cover it. I'm hoping that if it doesn't, they would tell me...right? I'll double check when they call to set up the appointment.

What did they seem to do differently in this successful cycle? Did they change the meds at all for you?

Thanks again!

Sharon

[casb77]

Your clinic may not know for sure whether your insurance will cover the immune tests or not. You may have to call the insurance company directly.

What we did differently:
During our first cycle they wanted me to use Menopur and Bravelle. I knew someone who had leftover Luveris and the clinic said it was no problem to use that instead of the Menopur. (I know, you're not supposed to share meds.) My stim doses were all over the board and they were changing the dose often. One day they wanted me to do a huge 600iu of Bravelle that night but I didn't have that much so I used leftover Follistim from the same person instead. 8 eggs were retrieved, all were mature, 7 fertilized, all were still growing on day 3 but didn't look that great. We transferred two with fragmentation and only one of the remaining embryos made it to blast to freeze.

This time I started out using Luveris and Bravelle again because I still had some Luveris left. Once the Luveris ran out after a couple days they switched me to Menopur with the Bravelle. My doses stayed much more consistent from day to day and I didn't have any huge doses, they were all about the same. 10 eggs were retrieved, 8 were mature, 7 fertilized, all were still growing on day 3. The quality still wasn't stellar, but was a little better than in July with slightly less fragmentation. Both the embryologist and the RE doing the transfer recommended transferring the three that were at 8-cell or 10-cell. All the others were smaller, one even was only 2-cell, and we were given little hope that any of them would make it to blast, even one of the three good ones if we only transferred two.

I don't know much about the meds themselves, but one of the nurses did tell me that Menopur contains FSH and LH while Luveris doesn't, so I'd be able to use less Bravelle, which was nice.

Without the doctor's recommendation or knowledge in between cycles I was also taking royal jelly, bee pollen, propolis until I read that it was for something I didn't have, coenzyme Q-10, and vitamin C. DH was eating almonds every day and taking vitamin C and E. We also each take a regular Centrum multivitamin everyday.

Another difference was that I did my monitoring at my RE's practice which is 2.5 hours from our house instead of doing it at the local fertility practice that shares space in my OB-GYN's office which is what I did in July and Sept. It saved us a little money because the RE's lab charges less for each b/w test, but I also did it for my peace of mind so there wasn't a "middleman", so to speak. I stayed with a friend so I didn't have to drive five hours round trip.

I can't really point to any of that in particular as making a huge difference, but I think the consistent level of stims probably was the most important for egg quality. I'd like to think the supplements helped too, but of course they haven't been proven or anything.