What different approach do out of state clinics take?

[Anonymous]

I did testing with Coulam here - did not travel. But maybe it's changed recently?

[Anonymous]

OP here.
10:02, thanks for the details. Did you know finally know what issues you had? Did you get pg finally?
12:11, right, I saw they have clinics in NY and NJ. Are all doctors immunology testing friendly at SIRM? I will try get an appointment for an initial consult to see what they think. If they do both immunology and IVF, I'll be less overwhelmed (hopefully).
Thank you for responding to my question. I feel motivated to travel out-of-state now.

[Anonymous]

This is 12:11. Yes, all SIRM clinics are immunology friendly. I ended up at the NY clinic primarily because I knew the doctor there was open to treating not only immune but also Beta-3 integrin issues. I strongly suspected I had both (yes, I truly hit the infertility jackpot). Similar to the immune stuff, testing/treatment for missing Beta-3 integrin is considered controversial. They do it routinely at CCRM but not many other places. If you've never had a single BFP in 5 years of trying, I'd strongly suggest getting tested for that too. FYI, here's a link with more information about the test. It requires a simple endometrial biopsy. The treatment is 3 months of medical menopause (Lupron Depot) prior to transfer. I've done it twice (once for each kid) and it sucked, but that--in conjunction with immune treatment--is the only thing that allows me to implant successfully. Good luck!

http://www.etegritytest.com

[Anonymous]

12:11 - do you also have endometriosis? my understanding is that beta-3 integrin issiues are related? if I'm remembering correctly?

Good luck, OP! Keep us posted!

[Anonymous]

Anonymous wrote:12:11 - do you also have endometriosis? my understanding is that beta-3 integrin issiues are related? if I'm remembering correctly?

Good luck, OP! Keep us posted!

Yep, you're right. For whatever reason, endo seems to be correlated with both immune and Beta-3 integrin problems, although I also know women without an endo diagnosis who've had either one or the other.

[Anonymous]

OP here. I had a laparoscopy last year and my doctor told me he did not "see" endometriosis. I don't think any tissue was tested. Can endo situation change in 1 year? I do not have symptoms but should I again get checked?

[Anonymous]

10:02 here. My problems were more or less related to egg quality - after concluding immune issues were not it, I went to CCRM (tested beta integrin but that was not a problem, plus I had had a naturally conceived child already), did one more cycle with CGH testing, got one normal embryo, transfered it, and now 28 wks pregnant. I strongly believe if my local clinic had better embryology lab and better transfer protocols I wouldn't have needed to shell out the big bucks at CCRM (not to mention the stress of an out of town cycle). But such is life.

[Anonymous]

Anonymous wrote:OP here. I had a laparoscopy last year and my doctor told me he did not "see" endometriosis. I don't think any tissue was tested. Can endo situation change in 1 year? I do not have symptoms but should I again get checked?

I wouldn't. Sometimes endo can hide and isn't readily detected by laparoscopy, but if you have it it's probably a mild case. I doubt that surgery would help enough to make another lap worthwhile.

[Anonymous]

Great thread. I'm hoping to go to Cornell for ivf #4. I've been at SGF and the level of care isn't adequate for my particular conditions. Did anyone else have issues getting their DH to commit to going out of state? Mine refuses to leave DC, but both our families (and me..the walking fertility pincushion) think it's our best shot. Advice?

[Anonymous]

Anonymous wrote:Great thread. I'm hoping to go to Cornell for ivf #4. I've been at SGF and the level of care isn't adequate for my particular conditions. Did anyone else have issues getting their DH to commit to going out of state? Mine refuses to leave DC, but both our families (and me..the walking fertility pincushion) think it's our best shot. Advice?

Ask him to at least do consult?

[Anonymous]

I am OP. My husband has been apprehensive about going out of state. He has started believing that all this is sheer luck based. I dont completely disagree with him but I feel we should try everything possible so there are no regrets at age 50. I think he understands that but has the question that I initially posted - what different do out of state clinics do. Thanks for all responses, I have legitimate reasons to convince him.

[Anonymous]

Anonymous wrote:Also, if you suspect immune issues (why do you?) you can try an anti-inflammatory diet.

How is your thyroid? TSH should really be down around 1-2.

What is anti-inflammatory diet?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Also, if you suspect immune issues (why do you?) you can try an anti-inflammatory diet.

How is your thyroid? TSH should really be down around 1-2.

What is anti-inflammatory diet?

I'm sure you can google for more details, but here are my notes:
- avoid red meat, wheat, dairy, trans/satuated fats, yogurt, refined carbs, yolks, caffeine, chocolate)
- eat hormone-free chicken, salmon, berries, walnuts, olives, veggies, lentils, herbal teas, water

[Anonymous]

Anonymous wrote:This is 12:11. Yes, all SIRM clinics are immunology friendly. I ended up at the NY clinic primarily because I knew the doctor there was open to treating not only immune but also Beta-3 integrin issues. I strongly suspected I had both (yes, I truly hit the infertility jackpot). Similar to the immune stuff, testing/treatment for missing Beta-3 integrin is considered controversial. They do it routinely at CCRM but not many other places. If you've never had a single BFP in 5 years of trying, I'd strongly suggest getting tested for that too. FYI, here's a link with more information about the test. It requires a simple endometrial biopsy. The treatment is 3 months of medical menopause (Lupron Depot) prior to transfer. I've done it twice (once for each kid) and it sucked, but that--in conjunction with immune treatment--is the only thing that allows me to implant successfully. Good luck!

http://www.etegritytest.com

I had asked about beta-3 integrin to someone before and they said it does not matter because we use progesterone. Isn't that true?

[Anonymous]

Anonymous wrote:

Anonymous wrote:This is 12:11. Yes, all SIRM clinics are immunology friendly. I ended up at the NY clinic primarily because I knew the doctor there was open to treating not only immune but also Beta-3 integrin issues. I strongly suspected I had both (yes, I truly hit the infertility jackpot). Similar to the immune stuff, testing/treatment for missing Beta-3 integrin is considered controversial. They do it routinely at CCRM but not many other places. If you've never had a single BFP in 5 years of trying, I'd strongly suggest getting tested for that too. FYI, here's a link with more information about the test. It requires a simple endometrial biopsy. The treatment is 3 months of medical menopause (Lupron Depot) prior to transfer. I've done it twice (once for each kid) and it sucked, but that--in conjunction with immune treatment--is the only thing that allows me to implant successfully. Good luck!

http://www.etegritytest.com

I had asked about beta-3 integrin to someone before and they said it does not matter because we use progesterone. Isn't that true?

No, not true. I did many, many cycles with progesterone but nothing stuck until I did the Depot Lupron therapy. If your doctor tells you this, ask why CCRM--the most highly regarded fertility clinic in the country--treats beta-3 integrin deficiency with Lupron Depot.