# serum v Dr gorgy...and hidden infections v immune issues... what order ??? help



## ustoget (Mar 6, 2014)

Sorry for long post but i have my scan booked for Tuesday for my next cycle and we are going crazy not knowing what to do...any/as many comments would be appreciated.....xxx

Short version
Fresh cycles in april - isci  5 day blasycyst embryo glue Bfp miss miscarriage 8.5 weeks
single transfer 5 day blastcsyt no glue (already hatching) sept bfn 
2 embryo transfer day 6 no glue another bfn

3 more goes left next natural fet due next week, then fresh and next frozen if we get any... Need more answers!!

Yesterday I went to the fertility show and spoke to Penny at serum and Dr Gorgy and liked them both. Their recommendation were different though.

serum.
penny said it was defo sperm problem (12% morphology day of egg collection) and even though our embryos looked good his sperm is not so the quality of them is no good. she said to put him on antibiotics now without testing, continue with our next transfer of our last 2 frosty as we can't change the quality of those and then get me tested for th hidden infections if unsuccessful and have a hysteroscopy and get ready for our next fresh in dec/jan. this sounded great and I liked the plan 
then i meet with Dr gorgy 15 mins later...
He suggested that it could be immune problems and that he would charge approx 3.5k to do all test inc hysteroscopy & hidden infections testing.He only mentioned hidden infections after i mentioned them though?? and seems like alot of money straight off?? He said you shouldn't give antibiotics without finding an infection but also suggested going ahead with the next cycle and then go for all the test if unsuccessful.

we want to make sure we use our goes the best we can. Penny's plan seems good but if its immune issues then we are just wasting this go and our embryo quality could be fine?? But then again maybe it was just chromosomes and one of the last ones could be a our miracle??

If penny's finds the hidden infection how will we know that's all it was?
why not get dr gorgy to do the hidden infections and hysteroscopy here in London (im in london)
dh did have funny colour sperm a couple of years ago and got antibiotics for it but i also got a sore throat the day after and day after that after transfer on both fets so that suggests immune issues.

also i had a d&c so does is that not the same as hysterscopy, surely they would of seen any adhesive  etc..it was nhs hospital though

help :-(


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## 3062melissa (Jan 6, 2011)

Sorry to read your journey. I'm 39 with a prem daughter and 5 miscarriages behind me. 
Unfortunately that's the prob that all these consultations have their own theories and I'm afraid to begin with you have to just go with your instinct and try one. 
I've had myself in knots seeing both of those at the same time and another 2 on top!
If I were you I'd try Penys protocol first then dr gorgys but it is very much a personal and financial decision. Whichever you chose if it sadly doesn't work you'll wish your done the other! I feel at the mo I have to try whatever I  can! 
I don't think you will know if it was just hidden infections unless you get s successful pregnancy by doing just that.
It's so hard to pinpoint the problem.
I saw the miscarriage clinic and got diagnosed with high nk cells, put on a plan I thought great and I'd done infection testing and sadly still mc. Prof quenby then said something had flared my uterine nk cells so nothing would survive so again I didn't know what to do so then saw Peny for hysterscopy and dr g for further testing. Now hubby has high sperm DNA frag so he's doing sperm antibiotics, I had scarring from erpc and I also needed lit therapy and neupogen so who knows now I'm awaiting a BFp with possible ivf in march to see if my new plan works.
The hysterscopy with Peny shows more than nhs as they had to cut basically a dividing wall from my uterus!
Unfortunately it's a minefield good luck with what you decide x


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## ustoget (Mar 6, 2014)

Hi 3062melissa.
I'm so sorry about your 5 miscarriages. I've only had one and can easily say it was the worse time of my life so can't imagine what its like for u :-(

I are what your saying and my gut says to go to do like u say but when u compare costs dr gorgy seems cheaper ?? Am I missing something.

Dr gorgy price list shows...
Couple’s Fertility Check (Consultation, Scan, Saline Hysterography, AMH, Semen Analysis & FU Consultation) £800
&
18 microorganisms in menstrual blood including Chlamydia, Mycoplasma and Ureaplasma by pcr test for DNA £500

Penny's Hysterographyis 1550 euros plus the £200 hidden infection test plus at least £500 flights & accomadation. 

Also do u think we should delay this cycle til after tests?


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## agate (Nov 14, 2008)

Its impossible to know...buy you are seeing the typical approaches of 2 clinics.

Serum tend to do antibiotics and concentrate on sperm issues because if that works its quite a cheap fix and it works in a high proportion of cases.  If they do find infection then they add immune meds on the assumption that if you harbour long term infection that will probably have upset your immunes but they don't tend to suggest a lot of immune tests because of the expense.

Gorgy has a typical list of quite expensive tests which he suggests as first step to all patients, then immune programs that are basically quite similar to each other and to serum regardless of what the tests show.

So serum would say that spending money on the tests isn't worth it but maybe Gorgy would say that doing the tests filters out the very small proportion of infertility patients that show no immune probs and that he doesn't give immune meds to.

In the end you can't know if the problem is egg or sperm, infection or immunes or uterine...so its a case of picking one thing to try and treat first then see if that works.

Good luck


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## agate (Nov 14, 2008)

ustoget said:


> Hi 3062melissa.
> I'm so sorry about your 5 miscarriages. I've only had one and can easily say it was the worse time of my life so can't imagine what its like for u :-(
> 
> I are what your saying and my gut says to go to do like u say but when u compare costs dr gorgy seems cheaper ?? Am I missing something.
> ...


When you quote gorgys cost its just the initial appointment. You don't get a treatment plan until you've done the set of immune tests and gone back for follow up appt. Tests will usually include nk assay, cytokines, dqa, lad etc...so it adds up


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## ustoget (Mar 6, 2014)

Hi Agate,
Thanks so much for your thoughts... so I see what your saying, Serum treat for immune anyway so that's how it ends up cheaper... although I thought u didn't different drugs for different issues. Are you saying (sorry just need to be clear) that serum will give you the antibiotics to both partners and a general immune treatment and if that doesn't work then go to Dr Gorgy to find out more specific issues?

Do you think its worth holding of my next natural fet until December and doing these tests first? to me is does but the both said to go ahead with it. ahhh need to tell them today as my scan at oxford is book t'mo!!

The first talk I saw at the fertility show was about embryo selection. The embryologist  mentions the stats that 50% of all fertilized embryos are not chromosomal correct which makes me think that maybe one of my last 2 are ok.. or do you think that's clutching at straws?


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## agate (Nov 14, 2008)

Gorgy tends to use mainly the same tx but he often starts with a higher dose of steroids and he uses humira and ivig often which serum dont because of the cost.

Its impossible to know if your frozens are euploid or not.

I started with Gorgy but quickly spent enough to buy a new car (!) and ended up with his standard treatment plan.  So I'd have spent a lot less if I'd have gone to serum from the start.  I'm not saying that the treatment plans aren't helpful but you can do something v similar elsewhere for a lot less cash.

Also bear in mind that Gorgy copies a lot of what serum do (theyd been doing the infection tests for years before he started to offer them)... And vice versa...they started using GCSF after he started to (which of course he copied from braverman)

They just take different approaches to cost/benefit of expensive meds and tests.


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## ustoget (Mar 6, 2014)

ok serum is sold... although I have just been speaking with Melanie brown the nutritionist .. thought I would be a good idea to check I'm doing everything right that's side as well to get ready for my fresh in January (if needed) She knows them both and said Dr gorgy refers his hidden c patients to serum anyway which I didn't know. Said did say she thinks that they serums treatment are sometimes a bit harsh though... but I suppose again its another view !!
She seems to know what she's talking about from the brief messages and would be unbiased in her referrals... im going to book an appointment with her in 2 weeks to discuss our plan and give her more info.

In the mean time...still need to decide whether to do this natural fet now... everyone is saying to do it but something is holding me back. Maybe its because if it doesn't work im scared how I will feel with only 2 goes left and even more pressure :-(

talking it through out loud, if I have this fet...
it won't delay DH getting his sperm check for hidden infections as can still do that now and get my the antibiotics and I will still be sending my sample  if/when I get my period so that doesn't change times. The hysteroscopy is preferred just after your period so that would be December anyway correct? if he has a dna fragmentation test that's already made and no changing the embryos we have, so again doesn't help to delay.

The only benefit I can see to delay is whether its immune but then wasting this go or whether I have hidden infections that could be causing me to be inhospitable that anti biotic could help if I take for a month first ??

what would you do?? ha ha pressure


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