# Appointment this Afternoon - anything I should ask re immune testing?



## Elpida (Feb 11, 2008)

Hi Ladies


I thought I'd once again tap into the wealth of knowledge on here and ask your advice. After the last BFN I'm trying to decide what to do for the best. I'm on the waiting list at Birmingham Women's for donor sperm (expected March 2011) and I'm also considering going to CARE in Nottingham.


I'm concerned that if I wait for my appointment at BWH they will do little more in terms of treatment than the Priory (SP IVF/ICSI) and although I've only had three negative cycles, with admittedly improving egg and embryo quality each time, there may be additional, underlying problems. With the discovery of the pituitary problems, the extremely high thyroid antibodies and history of endometriosis I don't think it's unreasonable to want to investigate as much as I can before investing more financially and emotionally in another cycle (although I've tested negative for Cardiolipins/sticky blood).


I've managed to get a private appointment with Mr Coomarasamy who is a miscarriage expert based at BWH, for this afternoon. I phoned BWH on Friday and spoke with their head of research who confirmed that they don't believe in the extensive immune testing  carried out by CARE and won't go that route. I'm hesitant about the extensive immune testing, partly out of ignorance (I've not investigated it fully yet as I've tried not to get too far ahead of myself) and partly becuase the testing, and associated treatment if positive, would wipe me out financially.


I'm going to ask what BWH will do in terms of embryo screening, so see if they will investigate problems there - anything specific I should ask?


I'm sorry this is a really confused post (hence the request for help!) I suppose what I'm asking you guys is - is there a level if immune tests before the Chicago tests/NK Killer cells stuff that BWH may be able to investigate, along with embryo screening that I can request? Would it be worth me requesting a cycle with steroids as a precaution? I know some clinics will do this and some are reluctant but should I ask and see what his response is?


Sorry for the late, rambling request for advice.


E x


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## ♥JJ1♥ (Feb 11, 2006)

E I can't really help you with immune testing as I had them done I know you asked about testing the embryos and this is where care might be more ahead of the game as they do CGH. I know other women who have blindly had clexane and steroids and then got pregnant so I'd be inclined to try them. 
Good luck x


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## Rose39 (Dec 9, 2007)

Esperanza - good luck this afternoon. I'd suggest looking at the immunes board on FF - there is an overview guide to immune testing which would give you info on the basic tests. There are 2 levels of Chicago tests - level 1 is the basic one, and you've actually done several of the tests already, level 2 is the more advanced level, which includes NK cells. I took steroids and clexane for several cycles, but more thorough immune testing revealed other immune issues such as a high level of inflammatory chemicals (TNF-alpha) which needed treating in other ways (detailed in my profile below).

I'd also suggest posting your question on the immunes board as there are some very knowledgeable ladies on there who would be able to give you advice.

Rose xx


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## Betty-Boo (Oct 14, 2007)

Es - am really sorry  - not much help as haven't explored that route as yet.  Wanted to post to say am thinking of you and wish you all the best this afternoon.  I do hope you get some answers honey x x 

Take care mini x x


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## Elpida (Feb 11, 2008)

Thank you all.

Firstly, what a lovely man! The outcome of the appointment is perfect for me - I'm reassured and will stick with the BWH hospital plan. He suggested prophylactically treating me with steroids before I brought it up and will also put me in the TROPHY trial http://ukpmc.ac.uk/articles/PMC2795733;jsessionid=1B88AF1114D6D382C09C970A4D4B1743.jvm4.

He recommends a short antagonist protocol again and, as I thought, is not a fan of the extensive immune testing offered by CARE et al. I still haven't ruled this out, but I am slightly dubious (mostly out of ignorance and fear of the cost and treatments) and for my next cycle I am reassured enough by him and feel that more is being done. He didn't think that embryo testing was necessary based on my last crop, and on the improvement since the introduction of HRT in quality.

The high TPO anti-thyroid antibodies are linked with increased risk of miscarriage and so you could infer a link with implantation difficulties, but the suggested treatment is 50mcg of thyroxine, which I already take, so that's covered.

He's going to check the donor sperm wait at BWH and update me, as he will also work out of the Priory.

So, a good appointment and I feel more positive.

Thanks for your support.

E x

/links


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## some1 (May 13, 2006)

E - so glad your appointment went well today and that you now have a way forward that you are happy with.  Hope you get good news about the wait for donor sperm at BWH.

Some1

xx


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## 32Flavours (Aug 4, 2010)

Sounds like he was very forward thinking. Glad it went well, good luck with the rest of your treatment .


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## Betty-Boo (Oct 14, 2007)

He sounds fab - its amazing when you get a good consult - I normally come out buzzing!!!  x x


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## suitcase of dreams (Oct 7, 2007)

That's great E, glad it all went so well for you today   
Do make sure he puts you on a decent dose of steroids, no point otherwise - 25mg per day seems to be the dose recommended by the immune experts...
Good luck!
Suitcase
x


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## Elpida (Feb 11, 2008)

Mini -  I know what you mean, just that boost to hope-reserves is so important.


Suity  - thanks for the tip re dosage


Fingers crossed for a slightly shorter wait than anticipated at BWH


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