RES disagree on diagnoses
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Anonymous
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I have seen 5 RES. They all disagree as to my diagnosis which makes it hard to know how to proceed. What I do know is that I've been ttc for 2 years and never gotten a BFP. Here's what the different RES are saying:
Shady grove= old eggs/DOR Dominion=DOR Cornell=unexplained but no DOR GW=agrees with Cornell Abassi=immune issues What should I think about these different diagnoses? I feel like I don't know what treatment to pursue now. |
Anonymous
| How old are you? What's your AMR and FSH? Resting follicle count? Is Abassi just guessing or did she actually run immune tests? |
Anonymous
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OP here. Age 38. Amh= .3. Fsh= 7. Afc= 12
This is why the RES have different opinions. Abassi said my Fsh is good so my egg quality is probably good. Shady grove says my Amh and age are the key numbers and that I have old eggs. Cornell says I do not have do because of my Fsh and Afc numbers |
Anonymous
OK, but did Abassi run the immune tests? What was the result? |
Anonymous
| Yes a bassi ran the immune tests. They showed significant abnormalities |
Anonymous
You need to address the immune stuff. Follow Abassi's protocol or go to another doctor (e.g. Braverman, SIRM, etc.) who offers similar treatment. You may have some degree of DOR as well but with significant immune issues you're wasting the few good eggs you have left on a uterine environment that's incompatible with pregnancy. |
Anonymous
| OP here. I guess I just don't know what to think. 4/5 RE's do not think I have immune issues/believe in immune issues. I do have low AMH so fit the DOR category in that respect but I haven't had a single BFP in 2 years, and Dr. Abassi believes I have "repeat implantation failure." I'm just not sure whether or not I believe the immune issues theories right now or not. |
Anonymous
| Did you pursue any treatments? |
Anonymous
Agreed. I'd at least try the immune protocols. I took a "try everything" approach, and did indeed get pregnant after a couple of years. Better to try the immune stuff now and at least give that approach a try. |
Anonymous
You won't know until you try. But this board is big on immune issues, and I include myself in that category, since I had success with Abbasi and immune issues when I never did on my own or with Shady Grove. Shady Grove also "doesn't believe in" thyroid issues and ran the minimum thyroid and clotting tests. Went to a regular endo on my own to get a second opinion and found out I have Hashimoto's. Also saw a hematologist (because I'd had a blood clot after my first child was born) and I have a clotting issue too. Abbasi's tests turned up both of those same findings plus others. Shady Grove kept telling me I'd eventually have success because my AMH was great. Well, I didn't, until I went to Abbasi. If you are seeing REs who don't believe in immune issues, you will never get an answer from them that points to any. It would be different if you saw an RE who did believe in them and instead found you didn't have them. I'm not saying immune stuff is definitely your problem, but if it is, you are unlikely to have success with any other protocol -- so like PP said, you will be wasting your eggs. Whereas with Abbasi or another immune doc you can do the same treatments you'd do with another RE, plus support the immune stuff. If I were you, that is what I would try first. |
Anonymous
| have you had any fertility treatments in the past two years? is this two years of no BFPs with timed intercourse or have you done several IUIs/IVFs? your response to IVF may help determine whether you are DOR or not. Also at 38 your age is likely playing a role. When I went throguh IVF several years ago not all REs believed in immune issues. Personally, I think that suggesting something where the science is as shaky as immune issues to someone over age 35 as a first diagnosis seems a bit odd given that age is more likely to be the reason. Don't they say in med school "when you hear hoofbeats think horses not zebras" |
Anonymous
| I think you have to just pick one. You will get more information only by trying. I know it's stressful, because it's so expensive. |
Anonymous
There are not that many options for treatment. Usually you do a couple of IUIs then IVF. There are different protocols but you need to starts to see what works. It's difficult to predict before you start stimulation. |
Anonymous
This is key. I'd go with this route. |
Anonymous
| Have you tried IVF yet? |