recurrent chemical pregnancies with genetically tested embryos in IVF?

[Anonymous]

If you're in NYC go see Dr. Tortoriello at SIRM. He will look for everything, including immune issues. He is very thorough.

[Anonymous]

Thanks. I'm with dr Grifo at nyu, who is supposedly "the best." But maybe worth a second opinion. It's drew tortoriello? Does he prescribe immune meds?

[Anonymous]

Anonymous wrote:Op here. My tsh in July was 1.7

Prednisone when? During cycle?

Did you have success by switching to this?

The notion that there's something I'm missing that's causing me to "waste" genetically normal embryos that are not implanting is really scary.

Prednisone and synthroid starting a week before my IUI and continuing until end of pregnancy (22 weeks now). I actually had to cut the already low synthroid dose in half because I became hyperthyroid within a few weeks since I don't have TSH issues, just antibodies. Also several intralipid treatments and blood thinners and baby aspirin for a clotting issue. And metformin for possible PCOS -- docs said better safe than sorry. It's a lot of meds and a lot of monitoring/bloodwork! My RE tests blood every couple weeks, looking for particular things that she believes indicate that my body could be reacting negatively to the fetus. And adjusts treatment based on those. Before this I had one healthy first pregnancy, though I developed a minor blood clot after giving birth. Then the next 3 pregnancies were all early miscarriages (before 9 weeks). Age 34/35 so not young but not terrible either, and all my other tests checked out fine, great even. I read about immune theories on this board, and I knew there were immune and clotting issues in my family, so I sought out an RE who specialized in them to get tested. And voila.

But of course there are so many variations that it's impossible to say what will work for you. But if you suspect any immune issues or just want to be thorough, get a work-up. Braverman is the acknowledged expert in this field and he is on Long Island. He is kind of a concierge service though, very expensive - I believe he charges $3k just to get in the door -- so perhaps you can find someone else. I am not familiar with NY area doctors. But google Braverman's website where he explains stuff. The immune "Bible" is by a guy named Beers and is called Is Your Body Baby Friendly. A lot of doctors don't accept these theories. Hell, my husband doesn't really accept them. But he can't argue with the fact that untreated we had 3 miscarriages in 12 months and the docs we were seeing had no idea why; then we switched to a new doc who does immune treatments, got pregnant on the first try, and with treatment I am now 22 weeks. So I am a believer. Though obviously not everyone will have these issues or, conversely, may have them much more severely and require more aggressive treatment.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Op here. My tsh in July was 1.7

Prednisone when? During cycle?

Did you have success by switching to this?

The notion that there's something I'm missing that's causing me to "waste" genetically normal embryos that are not implanting is really scary.

Prednisone and synthroid starting a week before my IUI and continuing until end of pregnancy (22 weeks now). I actually had to cut the already low synthroid dose in half because I became hyperthyroid within a few weeks since I don't have TSH issues, just antibodies. Also several intralipid treatments and blood thinners and baby aspirin for a clotting issue. And metformin for possible PCOS -- docs said better safe than sorry. It's a lot of meds and a lot of monitoring/bloodwork! My RE tests blood every couple weeks, looking for particular things that she believes indicate that my body could be reacting negatively to the fetus. And adjusts treatment based on those. Before this I had one healthy first pregnancy, though I developed a minor blood clot after giving birth. Then the next 3 pregnancies were all early miscarriages (before 9 weeks). Age 34/35 so not young but not terrible either, and all my other tests checked out fine, great even. I read about immune theories on this board, and I knew there were immune and clotting issues in my family, so I sought out an RE who specialized in them to get tested. And voila.

But of course there are so many variations that it's impossible to say what will work for you. But if you suspect any immune issues or just want to be thorough, get a work-up. Braverman is the acknowledged expert in this field and he is on Long Island. He is kind of a concierge service though, very expensive - I believe he charges $3k just to get in the door -- so perhaps you can find someone else. I am not familiar with NY area doctors. But google Braverman's website where he explains stuff. The immune "Bible" is by a guy named Beers and is called Is Your Body Baby Friendly. A lot of doctors don't accept these theories. Hell, my husband doesn't really accept them. But he can't argue with the fact that untreated we had 3 miscarriages in 12 months and the docs we were seeing had no idea why; then we switched to a new doc who does immune treatments, got pregnant on the first try, and with treatment I am now 22 weeks. So I am a believer. Though obviously not everyone will have these issues or, conversely, may have them much more severely and require more aggressive treatment.

NP here. I am currently a Braverman patient but if my current FET is a fail, I may need to seek someone else due to his costs. Do you mind sharing who your Dr is?

[Anonymous]

I am with Dr Dicken at SIRM. They are big on immune issues. Prednisone startin with my cycle thru 12 weeks and intralipids every other week thru 15 weeks. It worked. Get a second opinion before you waste anymore embryos

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op here. My tsh in July was 1.7

Prednisone when? During cycle?

Did you have success by switching to this?

The notion that there's something I'm missing that's causing me to "waste" genetically normal embryos that are not implanting is really scary.

Prednisone and synthroid starting a week before my IUI and continuing until end of pregnancy (22 weeks now). I actually had to cut the already low synthroid dose in half because I became hyperthyroid within a few weeks since I don't have TSH issues, just antibodies. Also several intralipid treatments and blood thinners and baby aspirin for a clotting issue. And metformin for possible PCOS -- docs said better safe than sorry. It's a lot of meds and a lot of monitoring/bloodwork! My RE tests blood every couple weeks, looking for particular things that she believes indicate that my body could be reacting negatively to the fetus. And adjusts treatment based on those. Before this I had one healthy first pregnancy, though I developed a minor blood clot after giving birth. Then the next 3 pregnancies were all early miscarriages (before 9 weeks). Age 34/35 so not young but not terrible either, and all my other tests checked out fine, great even. I read about immune theories on this board, and I knew there were immune and clotting issues in my family, so I sought out an RE who specialized in them to get tested. And voila.

But of course there are so many variations that it's impossible to say what will work for you. But if you suspect any immune issues or just want to be thorough, get a work-up. Braverman is the acknowledged expert in this field and he is on Long Island. He is kind of a concierge service though, very expensive - I believe he charges $3k just to get in the door -- so perhaps you can find someone else. I am not familiar with NY area doctors. But google Braverman's website where he explains stuff. The immune "Bible" is by a guy named Beers and is called Is Your Body Baby Friendly. A lot of doctors don't accept these theories. Hell, my husband doesn't really accept them. But he can't argue with the fact that untreated we had 3 miscarriages in 12 months and the docs we were seeing had no idea why; then we switched to a new doc who does immune treatments, got pregnant on the first try, and with treatment I am now 22 weeks. So I am a believer. Though obviously not everyone will have these issues or, conversely, may have them much more severely and require more aggressive treatment.

NP here. I am currently a Braverman patient but if my current FET is a fail, I may need to seek someone else due to his costs. Do you mind sharing who your Dr is?

Dr. Abbasi at Columbia Fertility Associates, DC/MD.

[Anonymous]

These SIRM people are in NY or ??? Dr dicken? It's impossible to get appt with tortoriello right long wait? I don't really want to wait months and months just to get the tests -- the thing is I had a chemical before each live birth. Yes I've had 2 in a row now, but I also conceived each kid after them. So confusing

[Anonymous]

Also this is OP does the immune stuff affect doing a fresh cycle with freeze all and biopsy? part of me wait want to do a fresh cycle while I wait to get immune testing --- do you need to know that stuff for a fresh cycle ? only matters really for once you're transferring right

[Anonymous]

Your implantation window may be not synchronized (slightly off) with the speed of development of blastocyst. I'm not talking about EAR? (Spell?) Where some women has late implantation window and only rest to confirm this is EAR??

All you need to do is start your progesterone 12hrs early /one day early to start on the scheduled time but transfer 12hr late than initially scheduled.

Also, you want to have good number of Vitamin D even for the FET.
Here are some suggestions other than immune. Might be worth looking.

[Anonymous]

OP, I am sorry you're going through this. I'm in a similar boat. Two live births (although first baby died soon after birth due to cord accident at term) with one mc and one negative cycle in between the two. Then another negative, and now three chemicals in a row - the last two with PGS normal embryos.

All IVF - 8 transfers total, 7 FETs, 1 fresh. My issue is PCOS so I don't ovulate regularly.

I was told that immune issues kicked in later in pregnancy, and that the endometrial implantation window test was for women who were not getting pregnant at all.

Going to do an HSG next to see if there could be a tube issue, then another round. Leaning against PGS this time as it's expensive and both embryos in last round were normal but it still didn't work.

Maybe it's a numbers game? It is certainly frustrating and draining.

[Anonymous]

wow PP, sounds like we're in a similar situation, although honestly your baby dying after birth is nothing to be compared to EVER because that's the saddest and most heart breaking thing, my heart goes out to you.

How would a tube issue affect things? Did you ever have an HSG earlier on? I had one when I first started TTC before DC #1, and tubes were clear. I guess they could have changed.

You're out of frozen embryos and will move on to fresh now?

What does that mean "immune issues kicked in later in pregnancy"?

[Anonymous]

PP 15:48 here again. Thanks for your kind words.

I never had an HSG first time round as I was not ovulating but did not respond to clomid and overstimmed with injectables. So we went to IVF without an HSG. Doc thinks there is slim possibility that fluid could leak from tubes if there is an undiagnosed tube issue, washing out embryos as they try to implant. It is unlikely but they want to rule it out. I had two c sections but ultrasounds suggest everything is fine with uterus.

I guess they mean that an immune issue would cause a later miscarriage, not a chemical. I saw three clinics (just switched from CFA to SG) and they all seemed to think we just had to keep trying.

[Anonymous]

15:48, this is OP again. Interesting re: fluid from tubes theory. I had two C sections as well. I actually developed scar tissue in my uterus after DC 1, and I had a hysteroscopy with a surgery to remove the scar tissue. It healed fine, had a follow up saline sonogram, and got pregnant with DC #2. I had another saline sonogram before this round of FET's, and it showed scar tissue again, so I had another hysteroscopy, again it healed beautifully. Since I got pregnant once before after the scar tissue removal, I don't think it's necessarily that but maybe cumulatively my uterus is suffering?

Did your RE's have any thoughts why you'd have chemicals with tested embryos????

[Anonymous]

OP again, also I feel like you had 3 chemicals in a row, I had 2 in a row, that just doesn't seem likely odds. Then again someone once told me the PGS normal ones are more likely to be a chemical because they're more likely to implant somewhat rather than not at all. ??? seems far fetched

[Anonymous]

15:48 again. OP, no, they didn't. One said it could be something wrong with the embryos that wasn't chromosomal but was some other issue which can't be tested for. He also said that it might be a random combination of several factors. Another was like 'maybe you have some issue that no one can test for yet and you will end up having to use a surrogate'. The consensus seemed to be that it was worth doing an HSG and then just ploughing on with another round and hoping that we just strike it lucky next time. They all said that it was rare to have two chemicals in a row with PGS normal embryos. My chemical before that was with an untested embryo so I don't know if it was normal, but I was 33 during that round so youngish (am now just 37, was 36 during last PGS all freeze cycle). Apparently it is usually only a 10 per cent chance of miscarriage or chemical with a PGS normal embryo. So two in a row is fishy. I guess there is still just a lot they don't know about fertility stuff.

Will you do PGS testing again?