Three failed rounds of IVF and time to talk to the doctor

[Anonymous]

Anonymous wrote:PP with Hashis and had success with Abbasi--before I get into immune issues: I got to Dr. Ahmed as well. She didn't want to medicate me but Abbasi said she would touch me unless I was on synthroid. I was given the smallest dose for my cycle.

As for immune issues: your Mother had too many autoimmune diseases and clotting issues for you not to be tested! I realize you probably had clotting done, but go see Abbasi and get the Beers tests. Basically if you have one autoimmune disorder (like Hashis), you are likely to have other (like your mother). The idea is that certain immune responses attack the embie, either preventing implantation or causing a miscarriage. These immune responses are from natural killer cells, APA and ANA antibodies, cytokines, and HLA matches. Basically it can be as simple as you got a virus that triggered these immune responses. The treatment is often baby aspiring, IVIg or interlipids, and/or a steriod along with an antibiotic.
There is more to this...I feel like I am forgetting something. I will post whhen I remember it!

Sorry I meant Abbasi would NOT touch me.

Also, I am the pp with Hashis who went to Abbasi...sorry if I didn't completely articulate that!

[Anonymous]

What was done to treat Hashis? As far as I understand it, you can't do much if you have the antibodies. You can only keep you levels in check with meds.

[Anonymous]

I have hashis and antibodies and just took synthroid and watched my levels very closely.

[Anonymous]

Anonymous wrote:PP with Hashis and had success with Abbasi--before I get into immune issues: I got to Dr. Ahmed as well. She didn't want to medicate me but Abbasi said she would touch me unless I was on synthroid. I was given the smallest dose for my cycle.

As for immune issues: your Mother had too many autoimmune diseases and clotting issues for you not to be tested! I realize you probably had clotting done, but go see Abbasi and get the Beers tests. Basically if you have one autoimmune disorder (like Hashis), you are likely to have other (like your mother). The idea is that certain immune responses attack the embie, either preventing implantation or causing a miscarriage. These immune responses are from natural killer cells, APA and ANA antibodies, cytokines, and HLA matches. Basically it can be as simple as you got a virus that triggered these immune responses. The treatment is often baby aspiring, IVIg or interlipids, and/or a steriod along with an antibiotic.
There is more to this...I feel like I am forgetting something. I will post whhen I remember it!

Thanks. I've made an appointment with Dr. Abbasi and we'll see what she says. It's reassuring that Dr. Ahmed was willing to medicate you on Dr. Abbasi's say-so. Dr. Ahmed didn't want to medicate me either and hasn't responded to my message regarding the miscarriage and whether I should be medicated, but I have an appointment scheduled to see her in June so if Dr. Abbasi says to medicate, hopefully she will agree. Having just had a miscarriage we won't be trying again before June anyway since it will take at least that long for my period to return, if past experience is any guide.

Have you found that diet makes any difference for you? Dr. Ahmed did recommend that I keep carbs to 90 grams or so because I'm having a hard time losing weight. For me this essentially means cutting way down on sugar (always a good thing) and eating veggies, fruit, and maybe some polenta or spelt rather than rice or bread or pasta. I like eating this way and I feel much better -- healthier, stronger, sleeping better. It makes me wonder if there is some sort of fertility effect too. I also wonder if eating lots of sugar could be affecting my cycle, which is long and irregular. I guess the only way to find out is to keep eating this way and see if my cycles shorten.

[Anonymous]

Anonymous wrote:

Anonymous wrote:PP with Hashis and had success with Abbasi--before I get into immune issues: I got to Dr. Ahmed as well. She didn't want to medicate me but Abbasi said she would touch me unless I was on synthroid. I was given the smallest dose for my cycle.

As for immune issues: your Mother had too many autoimmune diseases and clotting issues for you not to be tested! I realize you probably had clotting done, but go see Abbasi and get the Beers tests. Basically if you have one autoimmune disorder (like Hashis), you are likely to have other (like your mother). The idea is that certain immune responses attack the embie, either preventing implantation or causing a miscarriage. These immune responses are from natural killer cells, APA and ANA antibodies, cytokines, and HLA matches. Basically it can be as simple as you got a virus that triggered these immune responses. The treatment is often baby aspiring,
IVIg or interlipids, and/or a steriod along with an antibiotic.
There is more to this...I feel like I am forgetting something. I will post whhen I remember it!

Thanks. I've made an appointment with Dr. Abbasi and we'll see what she says. It's reassuring that Dr. Ahmed was willing to medicate you on Dr. Abbasi's say-so. Dr. Ahmed didn't want to medicate me either and hasn't responded to my message regarding the miscarriage and whether I should be medicated, but I have an appointment scheduled to see her in June so if Dr. Abbasi says to medicate, hopefully she will agree. Having just had a miscarriage we won't be trying again before June anyway since it will take at least that long for my period to return, if past experience is any guide.

Have you found that diet makes any difference for you? Dr. Ahmed did recommend that I keep carbs to 90 grams or so because I'm having a hard time losing weight. For me this essentially means cutting way down on sugar (always a good thing) and eating veggies, fruit, and maybe some polenta or spelt rather than rice or bread or pasta. I like eating this way and I feel much better -- healthier, stronger, sleeping better. It makes me wonder if there is some sort of fertility effect too. I also wonder if eating lots of sugar could be affecting my cycle, which is long and irregular. I guess the only way to find out is to keep eating this way and see if my cycles shorten.

PP w/ Hashis here: the timeline with the June appt sounds good actually! It gives time for you to get tests done etc.

As for diet a few things. I was lactose intolerant for almost 10 years before going through IF. I started to have issues abt the time they discovered my Hashis. Now, my Hashis is a yo-yo but I almost always stay in range--.33 goes up to 3 and down to 1 and then to 2.5. As I got older, my digestive issues got worse. I read that people with Hashis usually have other autoimmune disorders and that gluten was terrible for a Hashis person. I decided to go whole hog my last cycle. I actually did the Paleo Autoimmune protocol starting a month before my cycle and stay gluten and diary free during my pregnancy and

[Anonymous]

Doh hit send too soon!

And I went back on everything after and don't have GI issues anymore! When I got back for another FET, I will prep doing paleo autoimmune and go gluten and diary free again. I think it helped. The first two weeks were hard--I ate a lot of sweet green for lunch and then meat and veggie for dinner. Breakfast was tough. Good luck OP! Keep us all updated via this thread!!

[Anonymous]

Anonymous wrote:Doh hit send too soon!

And I went back on everything after and don't have GI issues anymore! When I got back for another FET, I will prep doing paleo autoimmune and go gluten and diary free again. I think it helped. The first two weeks were hard--I ate a lot of sweet green for lunch and then meat and veggie for dinner. Breakfast was tough. Good luck OP! Keep us all updated via this thread!!

Thanks. I love Sweetgreen (discovered it during my first pregnancy and I ate it every day during the last trimester) so maybe that won't be so bad! I don't think I can go totally gluten or dairy free unless I'm absolutely ordered to do so, but I can definitely cut back. At this point my dairy consumption is limited to maybe 1 oz of cheese on most days and a teaspoon of heavy cream if I drink tea. And I don't eat bread or pasta or cereal on a regular basis anyway.

I'm actually not OP though, just a PP who kind of hijacked the thread. Sorry to the OP and good luck to everyone.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Doh hit send too soon!

And I went back on everything after and don't have GI issues anymore! When I got back for another FET, I will prep doing paleo autoimmune and go gluten and diary free again. I think it helped. The first two weeks were hard--I ate a lot of sweet green for lunch and then meat and veggie for dinner. Breakfast was tough. Good luck OP! Keep us all updated via this thread!!

Thanks. I love Sweetgreen (discovered it during my first pregnancy and I ate it every day during the last trimester) so maybe that won't be so bad! I don't think I can go totally gluten or dairy free unless I'm absolutely ordered to do so, but I can definitely cut back. At this point my dairy consumption is limited to maybe 1 oz of cheese on most days and a teaspoon of heavy cream if I drink tea. And I don't eat bread or pasta or cereal on a regular basis anyway.

I'm actually not OP though, just a PP who kind of hijacked the thread. Sorry to the OP and good luck to everyone.

LOL! I wish you well PP! Rooting for you and OP both!

[Anonymous]

I just want to post that I have Hashimoto's and did not cut gluten or dairy for my successful pregnancy. That said, I do eat healthy in general.

[Anonymous]

OP here, I don't mind the thread being highjacked, haha.

I am planning to see Dr. Abbasi as soon as I can get my medical records from SG. Apparently that can take a few weeks...

At this point our issues are MFI and repeated implantation failure. We are moving forward with the ERA at Shady Grove (why not), but what else should I ask Abbasi about? Immune issues, it sounds like. Is she a big believer in dietary changes? SG has never suggested anything to me about weight or diet, although I could certainly stand to lose some weight.

I had a hysteroscopy in October 2014 to remove some polyps that showed up on the HSG. Should I ask for another HSG or saline sonogram at this point? (SG didn't seem to think it would help.)

[Anonymous]

bump for updates.

[Anonymous]

Well, hello there.

My updates: I met with Abbasi and she was pretty brusque, seemed okay, but obviously her big thing is immunology and I haven't decided what I think about that. (I bought a book but haven't read it yet.) A couple people at my support group are adamant that I DO NOT go to CFA. They hated it. I also met with Dr. Humm at GW and LOVED HER. I've never felt on the same wavelength as an RE before, it was kind of crazy to have someone sit with me, be empathetic, and explain everything in as much detail as I wanted. She thought I was on the right track with what I'm doing now at SG (ERA, endo scratch for FETs) and suggested adding a couple things for my next FET (prednisone and baby aspirin) that my SG RE is willing to go with those. The emotional part of me wants to get the hell out of SG and go work with her, but considering she wouldn't really be offering anything different in treatment/testing, what's the point? I guess if SG pisses me off enough...

Speaking of, I had my first ERA biopsy on 6/8. Found out nine days later the sample was unusable for unknown reasons (might have been contaminated or something happened in shipping, who knows). So that's six weeks down the drain and I'm starting the whole thing over. I'm on BCP right now, then back to the estrogen and PIO shots, and another biopsy on 7/25. My life is just super fun. I guess I can't blame SG for the fuck up, but they sure don't seem to care one bit. Par for the course.

I did another saline sonogram last week, uterus looks fine (no polyps or anything). Oh, and it cost me about $50 to get my records from SG and they were kind of a pain in the ass about, but what else would you expect?

[Anonymous]

I'm in the same boat as you PP. Just started cycling for mock cycle ERA. My biopsy is scheduled for 7/11. My nurse from SG just called me today to tell me the blood test I took for thyroid antibodies shows higher (on the low end of high) results for TPO. I asked if this was significant to SG or if it indicated why we've had implantation failure with PGS embryos, and she said that my RE didn't think so. They're telling me to go on Synthroid, 25mg every other day. Ok, fine. We're still waiting for the blood test results for the thrombophilia tests and I can't wait to see what SG says if there is something of of the ordinary. Good luck to you. Hoping they get their act together for you.

[Anonymous]

Anonymous wrote:Well, hello there.

My updates: I met with Abbasi and she was pretty brusque, seemed okay, but obviously her big thing is immunology and I haven't decided what I think about that. (I bought a book but haven't read it yet.) A couple people at my support group are adamant that I DO NOT go to CFA. They hated it. I also met with Dr. Humm at GW and LOVED HER. I've never felt on the same wavelength as an RE before, it was kind of crazy to have someone sit with me, be empathetic, and explain everything in as much detail as I wanted. She thought I was on the right track with what I'm doing now at SG (ERA, endo scratch for FETs) and suggested adding a couple things for my next FET (prednisone and baby aspirin) that my SG RE is willing to go with those. The emotional part of me wants to get the hell out of SG and go work with her, but considering she wouldn't really be offering anything different in treatment/testing, what's the point? I guess if SG pisses me off enough...

Speaking of, I had my first ERA biopsy on 6/8. Found out nine days later the sample was unusable for unknown reasons (might have been contaminated or something happened in shipping, who knows). So that's six weeks down the drain and I'm starting the whole thing over. I'm on BCP right now, then back to the estrogen and PIO shots, and another biopsy on 7/25. My life is just super fun. I guess I can't blame SG for the fuck up, but they sure don't seem to care one bit. Par for the course.

I did another saline sonogram last week, uterus looks fine (no polyps or anything). Oh, and it cost me about $50 to get my records from SG and they were kind of a pain in the ass about, but what else would you expect?

I'm the "hijack" PP from earlier. I've been posting recently on another thread but I'll update here as I too saw Dr. Abbasi and have decided to switch to her (from SG). I agree she is brusque but I didn't mind that -- different personalities and all. I think I'm on board with the immunology since autoimmune diseases run in my family (mother has lupus and others) and I already knew I have Hashimoto's. My testing came back mildly positive for a few immune problems and positive for a blood clotting factor for which SG did not test me. Dr. Abbasi also seems more interventionist than SG, in that she is recommending metformin for possible PCOS and letrozole for my late/irregular ovulation. SG didn't recommend either; they said since I can figure out when I ovulate, even though it's sometimes as late as day 35 of a cycle, I can just try on my own. But trying on my own has gotten me 3 miscarriages so at this point I want to try a more proactive approach. The other things she recommended for me were prednisone, lovenox, and intralipids. The intralipids are somewhat controversial, I think, but I find it interesting, OP, that you said your RE is on board with prednisone and lovenox. Dr. Abbasi recommended those for the immune issues and the blood clotting. So even though the basis may be different, she and your RE seem to be somewhat on the same page with treatment.

I will say the CFA operation has not impressed me. But Dr. Abbasi has. So I am willing to try it out.

[Anonymous]

20:18 I admire your ability to make the move. I'm 19:46, and I'm thinking I'll get diagnostic tests from SG, see what they say, and if they aren't going to try something different, then I'll transfer with Abassi. The only thing is, we don't have the money or emotional fortitude to do another retrieval. We have 2 embryos from the past cycles left, 1 pgs rated and one not. I'm scared they're not our best options since they're the last ones... But we gotta give them a chance. The thought of going through all of the prep work just to have it fall again really scared me... But what other choice do we have.