Dr. Abbasi
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Anonymous
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NP here... I'm in my first IVF cycle and I keep seeing posts about immune, clotting, and thyroid issues (beyond basic TSH check). I'm about to do my first FET and I'm sitting here wondering - why DON'T we throw the kitchen sink at testing for this stuff before embryo transfers? Wouldn't we want all the best information before transferring an embryo that made it through so much time/money/luck to get to blast?
I'm trying to remind myself that we have nothing to worry about unless we are seeing sustained problems, but OMG I don't want to stim again if I don't have to. |
Anonymous
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What's the point if you don't have any indications?
Immune tests will be very expensive and out of pocket. |
Anonymous
Not necessarily. My insurance (Federal BCBS) paid for quite a bit. My part wasn't cheap but it was hardly out of pocket. Still, I agree it's not worth it unless there is some indication -- but the indications may be more subtle than what people think. I'm the poster from above with normal thyroid numbers except for antibodies, indicating a thyroid autoimmune issue. My mother has lupus and other autoimmune issues and blood clotting problems, so in retrospect not too surprising for me. |
Anonymous
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We don't throw the kitchen sink protocol at every patient because it is absolutely possible to prevent implantation by over suppressing the immune system. Which would also be bad. So you treat what needs treated without over treating.
There are risks to taking Neupogen if you have lupus as it can cause a flare and risks to taking lovenox if you don't have a clotting condition due to the obvious bleeding risks. Not to mention expensive to do all this if you don't NEED to. You can absolutely go to a doc and get testing but don't expect your RE to test you prior to transfer unless there is some indication. |
Anonymous
| 15:25 here... I didn't realize the tests were expensive, I keep seeing blood tests and thinking basic stuff. Thank you for the info! I try to skip over this stuff but remember that it's here in case I have problems with FETs not sticking. Best of luck to everyone. |
Anonymous
It does depend on your insurance. The tests are very expensive if you have an insurance that doesn't cover the diagnosis, or under which the lab is considered out-of-network. Like the PP above, I have Federal BCBS Basic and all labs are covered 100%, including the initial immunology testing and the bi-weekly follow-ups during treatment. |
Anonymous
PP here whose wife worked with Dr. Braverman. I think that many women have success with regular old IVF. For those who don't, there's is often something else at play that can be remedied through an immune protocol. PP is right - immune testing is super expensive because it's often considered experimental, too new, people don't believe in it, etc. The PP who got a lot of it covered is EXTREMELY lucky. I think I stated this in this thread, but we can OOP about 15k to work with Dr. Braverman. I know many, many women who have worked with Dr. B and MAYBE two or three have gotten his services covered by their insurance. We were only able to do this because our IVF was covered through my work, and because we worked our asses off to pay down our credit card bill (we are absolutely not wealthy people, especially for this area). I think that if all women went through immune testing, there would likely be something going on with everyone to some degree. I think it's the severity of the immune issues that warrant intervention with a specialist. I think there is also a line that many women draw and saw "enough is enough." We were lucky - my wife's pregnancy with our first son, though an IVF pregnancy, was textbook and easy, right through delivery. Then three consecutive losses, and we were in a very dark place. Dr. B was our last resort, throw everything at it and see what sticks attempt. We couldn't afford more beyond working with him. And we got lucky - it worked on our second try with him. Some women aren't so lucky. |
Anonymous
Abnormal thyroid antibodies, and family history of lupus and clotting issues are NOT subtle. They are out of the book strong indications. |
Anonymous
Well, my point was that even after multiple miscarriages and the standard RPL panel, and with the family history of lupus and clotting issues, my RE at Shady Grove did not see a need to look into immune issues. She didn't run a test for thyroid antibodies, only for TSH. When that was normal, she said I was fine. I sought more specific tests on my own, with a regular endocrinologist, after reading about immune issues on this board. Even after I presented the abnormal results to Shady Grove, they weren't interested. That's when I went to Abbasi. And even if Shady Grove had thought there was an issue, they would not have treated it the way Abbasi did. "Strong indications" don't mean much if the doctors don't believe in the treatments that could address them. This board has really been a godsend for me. I am sure I would not have had my daughter without the folks here. |
Anonymous
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Once I was successful I did email my doctors at SGF who dismissed concerns about the 4 miscarriages I had before coming to see them - and the 2 additional I had under their care. I let them know what therapies worked for me and that immune issues might not be common but they do exist and the therapies used to treat them can work. That was my only symptom, no history of autoimmune disease although my mom has colitis now in her 60s. She has no pregnancy issues and neither did my sister. Sometimes you can't even guess when this is going to happen but the miscarriages should have been an indicator and some doctors will still ignore that.
I did not hear back from my SG RE or my nurse. |