immunological testing and treatment
3 Replies
hopefully trying - April 9

1)What is your opinion on autoimmune related issues such as natural killer cell and t cell activation as a cause for implantation failure? An MD from another web site has suggested I be tested for this as well as anti-thyroid antibodies do to my and my family's hx of hypothyroidism (both parents and maternal grandmother are/were hypothyroid). I also tested positive for sperm antibodies.

2)what is your opinion on use of IVIG? My RE is willing to do the testing but believes this dx and tx is "on the fringe" of standard of care and will not do the IVIG. Although they have agreed if I wanted to do it they would monitor me if I wanted to go somewhere else for the IVIG.

3)How can I best evaluate the safety issues with IVIG? How high is the risk really?
Thanks in advance

 

Barry Jacobs, M. D. - April 9

There are conflicting data with regards to natural killer cels. From what I have read, the preponderance of data imply that the testing and treatment of them has little value in assisting couples achieve successful proegnancy.

Cautious physicians do not accept statements regarding research dat unlesss more than 1 group of researschers can produce the same results. So far no outside group of investigators ha sbeen able to reproduce the findins of those who claim a beenfit to using IVIG. Since a single treatment requires blood from 750 donors, it is the risk equivalent of 750 transfusions. Since there is no proven benefit ti justify the risk, I do not do it.

Good luck.

 

hopefully trying - April 9

Thank you for your straightforward answer. We decided to go ahead and do the testing but have serious reservations about the treatment for the reasons you mentioned. I'm just trying to look at my situation realistically. While we have 2 more invitros through insurance (our part is still $5,000 which is a hardship financially...my husband has a 10 y o who will be looking at college in 8 years and may need to do private school through middle and high school), I'm wrestling with justifying the expense in light of all this IF our chances are sooo slim to none that I could achieve a viable pregnacy. In addition to my profile info, the only other big thing they've noticed is that my endometrium has remained thin...largest it's grown has been to 5.9

If we (I) test positive, do you think it reasonable to keep trying through invitro with ICSI and PGD?

 

Barry Jacobs, M. D. - April 9

There are a number of reports in the literature that the endometrium has to be greater than 7 mm thick to support a pregnancy. As far as PGD, we do it for women who are near or over 40 years old, to detect chromosome abnormalities of the embryos, or for couples who are carriers for genetic diseases. If you are under 35, with no known risk factors, I do not think PGD is cost effective.
Good luck.

 

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