Not sold on immunology, but kind of want to do the testing anyway

[Anonymous]

I am considering leaving Shady Grove, so I have been going to consults at other clinics, including seeing Abbasi at CFA. I know immunology testing and treatment is her big thing and most of the other doctors around here are not in favor of it/don't do those tests. I'm not really sold on the concept (although I have more research to do), BUT at the same time I'm at a point where I will take any possible test someone will give me to try to figure out why my transfers keep failing.

Did anyone become an Abbasi patient just to do the testing and then peace out of there? Are there any other doctors locally who will order the testing?

[Anonymous]

I'm the poster with the test results below. I'm taking it one step at a time with this. Go for the testing especially if it is covered under insurance. She doesn't pressure you at all. Just presents the results and lays out some options.

[Anonymous]

Ah, good point about the cost. I'll have to see if I can find out anything from Aetna, and if not contact RFU I guess.

[Anonymous]

OP, is there a reason you aren't really sold on immune testing? I think the role of the immune system in pregnancy is not well understood at this time but part of that is due to the complexity of our immune systems. The tests are getting closer to telling us what we need to know. If you are having issues with implantation and egg quality is not a concern then I think looking into the immune connection makes sense. This is the missing piece of the puzzle for many of us.

[Anonymous]

OP here: I also met with Dr. Humm at GW (and loved her) and her opinion is that there probably is something to reproductive immunology, but that the field isn't sufficiently developed so that anyone really knows what they're doing. It's too much guesswork, to paraphrase. According to her, the experts can't even agree on what's "normal" in terms of the measurements, so how do you work with that?

I do want to do my own research (someone recommended the book "Is Your Body Baby Friendly?"), and I have some time before I do anything. I am in the middle of ERA testing and I have one more frozen embryo. But if I transfer that one and it fails, I'm pretty sure I want to leave SG. It just doesn't feel like a good fit anymore.

[Anonymous]

Anonymous wrote:OP here: I also met with Dr. Humm at GW (and loved her) and her opinion is that there probably is something to reproductive immunology, but that the field isn't sufficiently developed so that anyone really knows what they're doing. It's too much guesswork, to paraphrase. According to her, the experts can't even agree on what's "normal" in terms of the measurements, so how do you work with that?

I do want to do my own research (someone recommended the book "Is Your Body Baby Friendly?"), and I have some time before I do anything. I am in the middle of ERA testing and I have one more frozen embryo. But if I transfer that one and it fails, I'm pretty sure I want to leave SG. It just doesn't feel like a good fit anymore.

The book is a good place to start and I would argue that the model that Dr. Braverman sets up (there are details on his blog on his website) is as close to truth as we can get right now given the tests and our level of understanding of Reproductive Immunology. The book isn't going to to into the latest and greatest treatments. There are many things that can impact your T regulatory and T effector cells, but those are the cells that are the rulers of the uterine environment. Lots of parallels drawn here between reproductive immunology and transplant immunology. I would say that if you live/eat/breathe RI and have seen it work for thousands of women then there is no question in your mind that their is something to it. OTOH if you are an RE who is just looking at it from the outside and you have a handful of patients that you know of who had success using it then maybe it still feels like guesswork. For the RIs using these treatments they know why they are doing what they are doing and are more familiar with the biochemistry behind what the test results show. For the lay person getting treatment the best thing to do is say something like well for elevated NKs we treat with prednisone, IL or IVIG, but a lot depends on what else is going on behind the scenes.

Also part of the issue Dr. Braverman is having is that he is so busy with his patients he doesn't have a ton of free time to be able to publish his findings. So within the last few years he has a research team (part of the reason for his fees) who are working on getting some published pieces out there for REs to read. If more people can be educated then I think it would open up the playbook so to speak for some women who are more difficult cases.