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Fertility / Infertility (Expert Forum)
Immune Testing Results
Questions in the Fertility/Infertility forum are answered by doctors affiliated with USF Health. Topics covered include fertility or infertility issues, egg quality, fertility drugs and side effects, fertility tests, genetic testing, in-vitro fertilization (IVF), ovulation, relationship issues, risk factors, sperm count/quality, and surgery.
Immune Testing Results
by ttc2long!, Aug 27, 2007 12:00AM
I just got back my immune testing results & the only thing that was out of range was my Thyroglobulin AB which was 41.1 the normal range shows <20 ( I am 30 years old). What does this mean? What should I do to follow up on this? I had 3 failed IVF's w/ great embryos, could this be part of the reason?
Also, my Natural Killer Cell (CD16+/-CD56) was 10.8% & the NK Absolute Value was 150 cells/ml.
Would lovenox help for the high thyroglobulin ab? If not, what would? Is this something I need to go to the doctor for or go on medicine before my next IVF?
I can't afford IVIG. Would I need intralipids or any treatment to lower NK level or since it's borderline would it be ok?
Any info would be greatly appreciated!
Also, my Natural Killer Cell (CD16+/-CD56) was 10.8% & the NK Absolute Value was 150 cells/ml.
Would lovenox help for the high thyroglobulin ab? If not, what would? Is this something I need to go to the doctor for or go on medicine before my next IVF?
I can't afford IVIG. Would I need intralipids or any treatment to lower NK level or since it's borderline would it be ok?
Any info would be greatly appreciated!
Doctor's Answer
by Forum-M.D.-SP, Aug 28, 2007 12:00AM
Dear ttc2long-
In my opinion you do not need IVIG, or lovenox, or intralipid therapy. There is no evidence that immune testing, mildly elevated antithyroglobulin antiobodies, and/or IVIG, are in any way related to recurrent IVF failure or are beneficial.
I understand that it is discouraging when three tries have failed, but remember that even the most fertile couples, trying to get pregnant on their own, have at best a 25%-30% chance of getting pregnant every month, and can sometimes take a few months to get pregnant.
At age 30, after three failed tries, your chances for a successful IVF cycle on the 4th try are still in the 25% range.
Has your endometrial cavity been evaluated yet with a saline ultrasound or hysteroscopy? Have there been any difficulties with your embryo transfers? Are your embryo transfers being done using an ultrasound?
I would like to draw your attention to the American Society for Reproductive Medicine website, www.asrm.org. The ASRM Practice Bulletin on IVIG for recurrent spontaneous pregnancy loss, at http://www.asrm.org/membersonly/practice/ivig.pdf, states 'IVIG as a treatment for recurrent pregnancy loss should be evaluated in patients who are informed, consenting participants in an institutional review board approved randomized clinical trial. For the management of recurrent spontaneous pregnancy loss IVIG is an experimental treatment.' This bulletin does not even discuss IVIG as a treatment option after several failed IVF cycles.
I hope things work out, and wish I had some answers for you, but it is important not to take medical therapy with potential side effects, and/or spend unnecessary money simply to try something different, without very solid evidence that what you are about to embark on has a chance of working.
The best option seems to be, try IVF again, but try to optimize every step of the IVF process, and go with that 25% chance of success. My record for trying was 6 IVF cycles before my patient finally conceived a healthy baby. This was in a mandated state, so the financial aspect was less of an issue. Nevertheless, it was no less emotionally trying. Good luck!
In my opinion you do not need IVIG, or lovenox, or intralipid therapy. There is no evidence that immune testing, mildly elevated antithyroglobulin antiobodies, and/or IVIG, are in any way related to recurrent IVF failure or are beneficial.
I understand that it is discouraging when three tries have failed, but remember that even the most fertile couples, trying to get pregnant on their own, have at best a 25%-30% chance of getting pregnant every month, and can sometimes take a few months to get pregnant.
At age 30, after three failed tries, your chances for a successful IVF cycle on the 4th try are still in the 25% range.
Has your endometrial cavity been evaluated yet with a saline ultrasound or hysteroscopy? Have there been any difficulties with your embryo transfers? Are your embryo transfers being done using an ultrasound?
I would like to draw your attention to the American Society for Reproductive Medicine website, www.asrm.org. The ASRM Practice Bulletin on IVIG for recurrent spontaneous pregnancy loss, at http://www.asrm.org/membersonly/practice/ivig.pdf, states 'IVIG as a treatment for recurrent pregnancy loss should be evaluated in patients who are informed, consenting participants in an institutional review board approved randomized clinical trial. For the management of recurrent spontaneous pregnancy loss IVIG is an experimental treatment.' This bulletin does not even discuss IVIG as a treatment option after several failed IVF cycles.
I hope things work out, and wish I had some answers for you, but it is important not to take medical therapy with potential side effects, and/or spend unnecessary money simply to try something different, without very solid evidence that what you are about to embark on has a chance of working.
The best option seems to be, try IVF again, but try to optimize every step of the IVF process, and go with that 25% chance of success. My record for trying was 6 IVF cycles before my patient finally conceived a healthy baby. This was in a mandated state, so the financial aspect was less of an issue. Nevertheless, it was no less emotionally trying. Good luck!
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