When would you start wondering about implantation issues?

[Anonymous]

Anonymous wrote:OP here. Thanks for all the helpful info. My family history is incredibly fertile, and I have 14 first cousins who all had 3 kids each, and most of them are boys. In addition most of my female relatives were very fertile naturally into their mid 40s. I got pregnant right away with #1 and assumed I was also very fertile. Now it's been almost 18 months trying for #2 with not a single pregnancy and I definitely am infertile now. It's just really strange about my immune test results. How can I find out if I'm genetically predisposed to this immune issue? I have no history of autoimmune issues in my family and I don't have any autoimmune issues. I feel the results are accurate based on my whole situation but just am having difficulty understanding why this is happening. I feel like Mother Nature is telling me that I should not have a second child--it's going to take multiple rounds of IVF plus immune treatments just to have a chance (and a very low chance) of becoming pregnant again. The thought of putting myself through all that, plus possible ICSI, assisted hatching, PVD testing, etc. all seems like too much medical intervention.

You don't know this. You sound overwhelmed. I'm not sure what the immune treatments are on top of IVF but I wouldn't not to IVF if I wanted a child. A lot of the medical intervention you mention - icsi, assisted hatching etc- isn't anything you have to undergo. You almost sound like you don't want another child and you're arguing about how hard it's going to be. Take it a day at a time.

[Anonymous]

Anonymous wrote:OP here. Thanks for all the helpful info. My family history is incredibly fertile, and I have 14 first cousins who all had 3 kids each, and most of them are boys. In addition most of my female relatives were very fertile naturally into their mid 40s. I got pregnant right away with #1 and assumed I was also very fertile. Now it's been almost 18 months trying for #2 with not a single pregnancy and I definitely am infertile now. It's just really strange about my immune test results. How can I find out if I'm genetically predisposed to this immune issue? I have no history of autoimmune issues in my family and I don't have any autoimmune issues. I feel the results are accurate based on my whole situation but just am having difficulty understanding why this is happening. I feel like Mother Nature is telling me that I should not have a second child--it's going to take multiple rounds of IVF plus immune treatments just to have a chance (and a very low chance) of becoming pregnant again. The thought of putting myself through all that, plus possible ICSI, assisted hatching, PVD testing, etc. all seems like too much medical intervention.

I'm the PP who asked about family history. My family history is very fertile as well maternal grandmother has 12 kids including one set of twins. I believe in my own case though that the genetics were passed on my paternal side and my dad had several brothers. Not everyone would have inherited the type of genes that I believe my dad did. And obviously he didn't need to get pregnant so this would not necessarily cause issues for him that would manifest this way. No one else in my family experienced issues either. My point is that genetics may be an issue without you really knowing it. Dr. Braverman would be the only one who would do a full HLA and KIR panel on you and that's the only way to know for sure if you have a haplotype that is predisposed.

I've been through many iterations of these test results and have had a dozen or so drawn. I do understand the results and can explain more detail about what treatments will result from them, but what good would that do if you are not considering doing any of the treatments? Not many of us know what having "immune issues" means for our future, but I'm kind of hoping I end up like my great grandmother and live to be 94.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here. Thanks for all the helpful info. My family history is incredibly fertile, and I have 14 first cousins who all had 3 kids each, and most of them are boys. In addition most of my female relatives were very fertile naturally into their mid 40s. I got pregnant right away with #1 and assumed I was also very fertile. Now it's been almost 18 months trying for #2 with not a single pregnancy and I definitely am infertile now. It's just really strange about my immune test results. How can I find out if I'm genetically predisposed to this immune issue? I have no history of autoimmune issues in my family and I don't have any autoimmune issues. I feel the results are accurate based on my whole situation but just am having difficulty understanding why this is happening. I feel like Mother Nature is telling me that I should not have a second child--it's going to take multiple rounds of IVF plus immune treatments just to have a chance (and a very low chance) of becoming pregnant again. The thought of putting myself through all that, plus possible ICSI, assisted hatching, PVD testing, etc. all seems like too much medical intervention.

You don't know this. You sound overwhelmed. I'm not sure what the immune treatments are on top of IVF but I wouldn't not to IVF if I wanted a child. A lot of the medical intervention you mention - icsi, assisted hatching etc- isn't anything you have to undergo. You almost sound like you don't want another child and you're arguing about how hard it's going to be. Take it a day at a time.

So, I am a new PP -- of course I don't know exactly what protocol has been recommended for you, OP, but thus far mine has not been bad. I did not have to deal with IVF so there's that. I did IUI which luckily worked. My immune and clotting protocol has been the following: prednisone, metformin, synthroid, lovenox, baby aspirin, intralipids as needed. This sounds like a lot but basically it works out to popping a lot of pills (prednisone, metformin, baby aspirin, synthroid, also vitamin D and prenatals which I'd be taking anyway), plus one shot per day (lovenox), plus intralipid infusions as needed. Thus far I have had a grand total of four intralipid treatments and I am 18 weeks along. The intralipids aren't bad at all. The nurse comes and hooks me up and I am free to move around while hooked up to the IV. I am able to work from home and type and do what I need. It takes 3 to 5 hours to infuse, which is enough time to do some serious work on the computer.

Just wanted to contribute my experience. The only difference between this and my prior successful pregnancy is the number of pills I take and the routine bloodwork taken every 2 to 3 weeks. The bloodwork is a pain but you get used to it quickly. I look forward to getting off all these meds after I deliver, but other than that it has been a normal-seeming pregnancy so far (knock on wood). You may have a different experience with a different protocol but if you were willing to do IVF anyway, I would not necessarily let the immune treatments put you off. I too was very worried about them but I have not had any serious side effects (high heartrate from the synthroid, some extra weight gain perhaps from the prednisone) and it's amazing how quickly you get used to them.

If you are ambivalent perhaps list your recommended protocol and let people weigh in.

[Anonymous]

2 unsuccessful IUIs is not a lot, and it's not implantation issues. If you've done several IVFs with no implantation and no other issues identified, then it MAY BE implantation problems (or could be bad egg quality). So you're way, way ahead of yourself, OP.

[Anonymous]

Anonymous wrote:2 unsuccessful IUIs is not a lot, and it's not implantation issues. If you've done several IVFs with no implantation and no other issues identified, then it MAY BE implantation problems (or could be bad egg quality). So you're way, way ahead of yourself, OP.

This. I think it's weird OP has jumped to the conclusion of immune issues. She went to see doctors who are notorious for diagnosing as immune issues.

[Anonymous]

OP here. Let me explain why I jumped to the implantation failure issue. I've seen 4 RES who listened to my history, first baby conceived right away, healthy pregnancy and natural delivery, no issues, started TTC when my son was 10 months and then infertility diagnosis of 16 months duration and all of them said, I think there's something else going on because all my tests are normal. Even my obgyn said that I should have statistically had at least one pregnancy or miscarriage by now, but I've had nothing. All of them said I think there's something else going on. UT since you were recently pregnant and all tests Noral they didn't know what to think. So before I tried if I wanted to test for repeat implantation issues. Does that make sense now?

[Anonymous]

Anonymous wrote:

Anonymous wrote:2 unsuccessful IUIs is not a lot, and it's not implantation issues. If you've done several IVFs with no implantation and no other issues identified, then it MAY BE implantation problems (or could be bad egg quality). So you're way, way ahead of yourself, OP.

This. I think it's weird OP has jumped to the conclusion of immune issues. She went to see doctors who are notorious for diagnosing as immune issues.

At the beginning of this thread OP was already seeing an RE, but was wondering if she should look into immune issues and several PPs said yes do the blood test before dropping $ on IVF. So, she did and her NKs came back at 30. Many of us recommended Abbasi to OP. She has to go to an immune doc because if she goes to someone else they won't even test her for them. OP you are not weird for looking for answers. You conceived easily the first time and it's been 16+ months since you started trying. I think it's natural to look at other reasons why this might be happening, especially if ART is not working. OP FWIW I think you are on the right track, but now you have to decide if you want to pursue immune tx or not.

[Anonymous]

Anonymous wrote:OP here. Let me explain why I jumped to the implantation failure issue. I've seen 4 RES who listened to my history, first baby conceived right away, healthy pregnancy and natural delivery, no issues, started TTC when my son was 10 months and then infertility diagnosis of 16 months duration and all of them said, I think there's something else going on because all my tests are normal. Even my obgyn said that I should have statistically had at least one pregnancy or miscarriage by now, but I've had nothing. All of them said I think there's something else going on. UT since you were recently pregnant and all tests Noral they didn't know what to think. So before I tried if I wanted to test for repeat implantation issues. Does that make sense now?

Well, we all have "something" going on that is preventing us from getting pregnant, right? Quite a lot of people have unexplained fertility, as well. I think it's great to do whatever testing you can, I just wouldn't count on it being immune issues when there are plenty of other possibilities.

[Anonymous]

^Sorry, I mean implantation issues.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:2 unsuccessful IUIs is not a lot, and it's not implantation issues. If you've done several IVFs with no implantation and no other issues identified, then it MAY BE implantation problems (or could be bad egg quality). So you're way, way ahead of yourself, OP.

This. I think it's weird OP has jumped to the conclusion of immune issues. She went to see doctors who are notorious for diagnosing as immune issues.

At the beginning of this thread OP was already seeing an RE, but was wondering if she should look into immune issues and several PPs said yes do the blood test before dropping $ on IVF. So, she did and her NKs came back at 30. Many of us recommended Abbasi to OP. She has to go to an immune doc because if she goes to someone else they won't even test her for them. OP you are not weird for looking for answers. You conceived easily the first time and it's been 16+ months since you started trying. I think it's natural to look at other reasons why this might be happening, especially if ART is not working. OP FWIW I think you are on the right track, but now you have to decide if you want to pursue immune tx or not.

All Op has tried is two IUIs.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here. Let me explain why I jumped to the implantation failure issue. I've seen 4 RES who listened to my history, first baby conceived right away, healthy pregnancy and natural delivery, no issues, started TTC when my son was 10 months and then infertility diagnosis of 16 months duration and all of them said, I think there's something else going on because all my tests are normal. Even my obgyn said that I should have statistically had at least one pregnancy or miscarriage by now, but I've had nothing. All of them said I think there's something else going on. UT since you were recently pregnant and all tests Noral they didn't know what to think. So before I tried if I wanted to test for repeat implantation issues. Does that make sense now?

Well, we all have "something" going on that is preventing us from getting pregnant, right? Quite a lot of people have unexplained fertility, as well. I think it's great to do whatever testing you can, I just wouldn't count on it being immune issues when there are plenty of other possibilities.

This. I'm unexplained. No idea why I couldn't conceive. Tests results were always fantastic. IVF worked for me on the first time.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here. Let me explain why I jumped to the implantation failure issue. I've seen 4 RES who listened to my history, first baby conceived right away, healthy pregnancy and natural delivery, no issues, started TTC when my son was 10 months and then infertility diagnosis of 16 months duration and all of them said, I think there's something else going on because all my tests are normal. Even my obgyn said that I should have statistically had at least one pregnancy or miscarriage by now, but I've had nothing. All of them said I think there's something else going on. UT since you were recently pregnant and all tests Noral they didn't know what to think. So before I tried if I wanted to test for repeat implantation issues. Does that make sense now?

Well, we all have "something" going on that is preventing us from getting pregnant, right? Quite a lot of people have unexplained fertility, as well. I think it's great to do whatever testing you can, I just wouldn't count on it being immune issues when there are plenty of other possibilities.

OP here. But it is immune issues. I got the immune testing done and was diagnosed with immune issues. So that is one explanation for my "unexplained" infertility.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. Let me explain why I jumped to the implantation failure issue. I've seen 4 RES who listened to my history, first baby conceived right away, healthy pregnancy and natural delivery, no issues, started TTC when my son was 10 months and then infertility diagnosis of 16 months duration and all of them said, I think there's something else going on because all my tests are normal. Even my obgyn said that I should have statistically had at least one pregnancy or miscarriage by now, but I've had nothing. All of them said I think there's something else going on. UT since you were recently pregnant and all tests Noral they didn't know what to think. So before I tried if I wanted to test for repeat implantation issues. Does that make sense now?

Well, we all have "something" going on that is preventing us from getting pregnant, right? Quite a lot of people have unexplained fertility, as well. I think it's great to do whatever testing you can, I just wouldn't count on it being immune issues when there are plenty of other possibilities.

OP here. But it is immune issues. I got the immune testing done and was diagnosed with immune issues. So that is one explanation for my "unexplained" infertility.

What else have you had tested besides NK cells? Ruled out endometriosis? Polyps/fibroids? HSG? Clotting issues? What is your AMH currently?

[Anonymous]

Op here. I had hsg and sonohysterogram nothing found except a small polyp which I had removed that was a year ago. I had all the usual blood tests for infertility workup. My amh is .8. My afc ranges from 8 to 10. I have not been evaluated for endo specifically
but I not getting a laparoscopy. I don't have any glaring infertility issues other than no pregnancy in 18 months after getting pregnant on the second try naturally with my son. I have no health issues, dh has no health issues and all sperm tests have been fine.

[Anonymous]

Anonymous wrote:Op here. I had hsg and sonohysterogram nothing found except a small polyp which I had removed that was a year ago. I had all the usual blood tests for infertility workup. My amh is .8. My afc ranges from 8 to 10. I have not been evaluated for endo specifically
but I not getting a laparoscopy. I don't have any glaring infertility issues other than no pregnancy in 18 months after getting pregnant on the second try naturally with my son. I have no health issues, dh has no health issues and all sperm tests have been fine.

Do an IVF, IUIs at your age have very low chances of success.