[jencat]

I have been TTC for 2.5 years and have just sufferd our second m/c from our second IVF. I was a bit insensed when I was ushered into the phlebotomist's chair to have my blood type and RH factor test when my first ultrasound for my second IVF showed that again, the fetus had disappeared. Fortunately I knew better than my clinic and had requested that my OB have my RH tested so i could go into the first IVF knowing that would not be an issue.

I had originally wanted to do extensive testing before diving into IVF, as a sort of insurance that I wasn't throwing money out the window. I had at least 4 chemical pregnancies and feared there was something wrong. Unfortunately the places i called for testing would not accept me because I had no confirmed losses. The irony is that I had to do IVF to prove to them there is a problem (of course my clinic won't do any testing, either!)

So I am wondering what sort of tests you may have had and how the results have changed your outcome...

Thanks for any stories... I really apprecaite your input.

[sharonb]

Hi Jencat.

I'm sorry that I don't have answers for you but I am trying to figure out the same answers to questions that you have. I just suffered my 3rd failed IVF this last week and before doing another IVF, I want to know if there's anything else going on with me in order to improve my chances.

At my meeting with my RE, I requested many tests and he agreed to most, although since it seems to be outside his general protocol, I'm not sure what will happen if something does show up. I just want to stop guessing with treatments and have all the information, once and for all.

If you have found out some information, I sure would appreciate hearing about it.

Thanks so much!

Sharon

[bunniswife]

I've never done IVF but I had suffered four miscarriages and had tested positive for anitcardiolipins, antinuclear antibodies and lupus anticoagulant after my second miscarriage. Unfortunately my ob/gyn had no idea how to treat Antiphospholipid Antibody Syndrome and let me miscarry two more times before I insisted she send me to the recurrent pregnancy loss clinic at Women and Children's Hospital. There, I met with a perinatologist and a haematologist who put me on a regimen of heparin, progesterone, and baby aspirin and I was finally able to carry my daughter and subsequent twins to birth. Immune issues play a huge role in early miscarriage, and the sad thing is that alot of doctors, even specialists don't believe that APS causes early miscarriage, only fetal demise in later pregnancy. My haematologist told me that APS causes "disordered" implantation of the embryo resulting in poor rising or non-doubling betas and leading to miscarriage in the first twelve weeks. I strongly urge you to get tested before putting any more money into IVF. Passing early losses off as "chemical pregnancies" is not always the case and doctors need to do further testing to make sure the immune system isn't playing a role. I'm so sorry for your loss, I know how much it hurts. Hope you find your answers...Hugs

[sharonb]

Bunniswife.

Thank you so much for sharing your experience and for your advice. I am having some testing done right now and I hope to have the results soon. My RE doesn't really believe in it too much, but after 3 failed ivf's I want to make sure that there isn't something easy to fix that we're missing.

Sharon

[jencat]

Thanks for the input....

I have found a Dr. (infertility OB) who does alot of testing and investigation. I had laproscopic surgery to remove my endo (and to look around...everything looked good, he said), and I also had a D&C. I am awaiting the results of 9 vials worth of blood tests and the pathology report from the D&C. What a difference a Dr. makes!!

I will post the tests I had and the results when I get them in about a month.

Good luck everyone...

[sharonb]

Hi Jen.

I'll be getting most of my results tomorrow over the phone, so I will post mine as well.

Sharon

[Lauralillies529]

Sounds like you all have been through so much!! Please post your test results, Im interested to see that they tested for and what your results were. Thanks!

[sharonb]

I'm so sorry for the delay in posting my test results. I hit a bit of a sadness slump and hadn't been online. Just so many people around me getting pregnant with IVF this month, that my heart and hope sank for a while, although I was happy for them.

Here is a list of the tests I had done. All came back normal, so I'm not sure what to do next. I did see another RE in out of state that had some recommendations that I will bring up to my current RE.
All tests came back normal.
Thrombophelia (Clotting Tests)-normal
Factor V-normal
Protein C-normal
Prothrombin-normal
Protein F-normal
Antithrombin-normal
Lupus Anticoagulant-neg
Anticardiolipin Antibody-neg for both
Thyroid Peroxidase Antibody-neg
Globin A1c-normal
Blood Sugar-normal
Insulin-normal
MTHFR-neg
NK Cells-neg

Phew! I think that is all of them. The consult recommended the following: possible poor egg quality due to overstimulation and recommended retrieving eggs earlier, not waiting for all to mature and for my husband to have a sperm dna analysis (even though all other tests for him were normal-motility, counts, morphology.)

I hope all this helps and if you hear of any helpful information, please do share.

Sharon

[bunniswife]

Goodness, they did run you through the gamut of tests. I don't see anything there for antinuclear antibodies...please ask him if that test was included or is an "umbrella term" for some of the tests you did have. What do they seem to think about your FSH going up?

[sharonb]

I will certainly ask about the ANA. I've been playing phone tag with the office all week so hopefully I'll get to find out some answers this week. All this has been so frustrating.

I've got a couple more consults set up to see what other RE's might say, but its so difficult. I want so much to get pregnant and I can't seem to find a doctor that appears to be doing everything they can to help me. I wish I knew which RE here in MA would give me the best chance at getting pregnant.

Thank you for all your help.

Sharon

[jencat]

Wow, sharon... you make me look like a novice!

First, I wanted to post this website I found that explains alot of the tests, in case anyone is curious and/or unfamiliar:

A Complete Guide to Reproductive Immunology

Here are my results:

Chromosome Analysis: Negative (or normal karyotype....included Factor V (Leiden) Mutation Analysis, and Blood Chromosome analysis)
Cardiolipin AB Screen w. reflex to IGG and IGM: Negative
Anachoice (TM) Screen w/ reflex to titer, IFA: Negative
LUPUS Anticoagulant Evaluation with Reflex: Not detected

My prolactin was a bit elevated, which can be an indicator that my thyroid is causing problems. As a result, I have been put on a low dose of Thyroid medication. My TSH was only 2.8, but apparently when trying to get pregnant, any measurement over 1 can be a problem (If your count is over 1, go see an endocrynologist. You might need care ESPECIALLY after you get PG. You might not be able to trust your RE to take care of this...it it generally NOT their specialty...)

In our state (MN) the NK cell test is not available, so as a precaution, the second I get PG my Dr. will be putting me on a low dose of prednisone. It prevents your body from rejecting the embro if it sees it as a foreign body.

When I get PG I will have to be in immediate contact with the endocrynologistas well, as the thyroid can really freak out the first trimester and needs to be monitored if you do have thyroid issues.

I am also on baby aspirin to prevent clotting.

I start an IUI next week.... wish me luck!!!!

Good luck to everyone else... I hope this helps.

[sharonb]

Hi Jencat.

Not a pro at all...more like a blood donor!

Thanks for sharing your results. Good luck of course with the IUI...but just curious, why IUI after 2 IVFs?

[jencat]

Oh, such a common question (with no short answer..).

I felt at the time that I was under the care of an RE that I was getting the best care possible (it sure COST like I should be getting the best care!). BUT as I told in the first post on the thread, I was just one of the cattle going through the door.... and I should have done a better job of keeping them on task, asking questions, and insisting certain things happen. It was way too easy for them, due to my age, to just say 'it must have been a chromosomal problem, let's just try again'

SO I started asking around after I started this thread, and found a place that would do some of the immulogical testing....I have friends and relatives who had gone to this OB who specialises in difficult cases. His name is Dr. Phillip Marcus. He LOVES a challenge. He is NOT an RE, but he has a really good record that I have seen just from the people I know. The only person (out of 4) who couldn't get PG with him had a bicornate uterus, so she had to adopt. Marcus' clinic does the testing! as a STANDARD PRACTICE! (I mean really, how hard is it to do blood tests??) He also does exploratory laproscopic surgery to check on the condition of the organs, and take out any endometriosis he finds. He feels very strongly that endo is the culprit in alot of IF cases.

So I had the surgery, and started on the thyroid meds (which also help keep the endo from growing back!) Then we started talking about my history.

Now. When we first started TTC, the 2nd and 3rd month, my period was a day or two late (I am SUPER regular) and my boobs grew, I had cramping in my uterus, then boom, my period. Now this happened again the cycle before we did IVF (we were doing super ov. IUI), and the nurse called me w/ the PG test results and said 'I waited and waited, but the number never got over 13'. I confronted the RE about it (thinking it was a PG) and he told me I was just experiencing a hormonal surge, and the symptoms didn't mean anything and he dismissed the 13 as nothing. He also told me the same thing had happened the month before... that I had a registered number, but it wasn't 20, so no one mentioned it.

Dr. Marcus was amazed that the RE was so nonchalant about it. He considered those chemical PGs, and that it indicates there was possibly an issue with implantation. So that added another 4 'miscarriages' to the list of the other 2 that we had from both IVF.

SO, long story... DR. Marcus concluded that IVF would show more definitive results, but he was OK with IUI as well, since we may have treated what was causing the implantation issues. My gut was screaming for IUI, so that what it is. My health insurance covers the drugs, so its ALOT cheaper, too. I also see IUI as a sort of productive break from IVF....He oversees IVF with another clinic, so that is also an option with the same clinic.

He also told me something interesting... he has found he has better results when he provides weekly u/s for his patients. he thinks it may have something to do with relieving the stress of waiting. I know some of you have that luxury, but I didn't at my RE. Attitude and stress relief helps!! do some yoga!

I wish you all well. I will let you know what happens with my IUI.

Thanks for all the input.

[sharonb]

I've been posting in so many places, that I forgot to post here!

So, the ANA test came back fine and so did the chromosomal testing on myself and my husband. Next, we're doing an endometrial biopsy to look for a protein (beta-integrin) which is needed for implantation to occur. Apparently in some women, its there when it needs to be and in others, its there at the wrong time or not at all. Another test that came back different was my fsh...it dropped to 6.7, but my E2 rose up to 67. I'm not sure what this means, but the RE doing some testing mentioned its not quite normal, and does this when there is an issue going on...fluctuation between fsh/E2.

So...more tests and more worries. I'd love to her how you're doing and your thoughts or discoveries.

[sharonb]

jencat...one more thing...why the thyroid meds? Did they find you have a thyroid issue?