Immunology Testing

[justawaiting- brisbane]

Butterfly warrior -- hope the next couple of days go by fast for you -- we can't wait to hear how it all turns out for you. Getting results can really help relieve alot of stress of the "unknown", eventhough we sometimes don't want to delve into things. Good for you for finding the courage to push forward and get some answers.
Heather

[butterfly_warrior]

Had our appointment yesterday... Pretty much everything clear except that I'm heterozygous for the MTHFR gene, but my homocysteine levels are normal. If Dr S is going to say that's not a problem, I'm going to believe him!

But when it comes to the NK test - Dr S doesn't like to see a level above 18, mine was 13, but I was on 10-15mg of prednisone at the time. I can't remember exactly how much I had taken that day. It's not enough to say it is definitely a problem, but it's also not enough to say that it's definitely NOT a problem.

The plan ahead is that I stick with my 10mg of prednisone and increase to 20mg of prednisone at transfer.

If I have further problems, then Dr S would be interested in doing a uterine biopsy to check out how things are there. If I ever get to the point where I'm not pregnant and not on prednisone, we'll have the NK test repeated.

Still trying to figure out how I feel about all this.

BW

[justawaiting- brisbane]

I'm so glad to hear you are moving along and finding some answers. Soon you will get that BFP and be coming back to this thread to help other women with similar conditions.

Heather

[Keen]

Its great to hear that you are finally seeing some answers and possible causes for all this BW. Hope Dr S continues to help..

[scarlet]

BW - I am so glad your appointment went well. Sounds like Dr S knows what he is doing - if he can't rule out the NK as a problem sounds like staying on the prednisone is a good idea. I am hetero for MTHFR C677T and my homocysteine is the high end of normal. The three docs I have seen so far said that they don't consider it an issue as long as homocysteine is in the normal range.

Thanks for answering my question about Dr. S. Good luck with your FET!

[collo04]

Hi just wanted to add my two cents worth here. I too have been to Gavin Sacks and he is the first doctor to see that My thyroid antibodies may have something to do with our unexplained infertility. My NK ceells came back at 16.9 and he thinks it suggests an immune problem. Hvaing transfer in december and if it fails I will have a uterine biopsy in January to determine how much of a problem it is.

[scarlet]

HI Collo,

That's great that Dr S has recognised that. I have a similar problem. I have elevated ATA on my results (I also have TPO ab but within normal range) but every other doctor keeps saying this is not a problem. I am seeing Dr S on Thursday and very nervous but also hopeful that we will finally get some answers and treatment!

I have read a bit about NK cells - that the blood NK result that you have? I believe NK cells can affect implantation, so you might be on to something there! Good luck with your transfer!

[Tess08]

Hi there,

Can anyone recommend an equivalent to Dr Sacks in Melbourne??????

Very much appreciated if you can!

[Flowerchild]

I don't know of any personally. However, this dotor will do phone consultations to answer some of your questions.
I personally reckon it's a good excuse for a trip to Sydney! Wishing you well on your journey...

[Loula]

I did the trip from Melbourne to Sydney and it was well worth it - had fun with a friend too

GL

[Loujane]

Hi there,
I'm new to this forum and have been reading through threads - I think I need a Repoductive Immunologist too...I've lost count of the number of cycles I've done because I have to do a new one each time because I don't prodce many eggs on drugs (3 is a good result). Even so, we had good success with fertilisation - just implantation is eluding us...

My FS doesn't offer any other solution - just keep on going (perhaps like winning the lotto - you number will come up eventually???).

Any ideas about where to start in Melbourne?

I've also heard about the "colorado protocol" recently - can anyone fill me in?

Loujane

[Tess08]

Hi Loujane,

I am booked into see Lynn Burmeister in Richmond who is a director of Monash IVF next week so I can give you some feedback as to how I found her and what insight she gave me.
I have also had a whole lot of blood tests done via my GP, I took a list to him of what I wanted tested, and are waiting for those results which I will take to Dr Bermeister.
In regards to autoimmune tests, I have had done ANA (anti-nuclear antibodies), Cardiolipin antibodies, beta 2 glycoprotein 1 antibodies (which also help to confirm Anti-phospholipid syndrome), Rheumatoid Factor, CRP to see if there is any immune caused inflammation in the body, Lupus antibodies plus a few other tests to rule out infection as cause of recurrent miscarriage. Had a swab done for chlamydia, mycoplasma and ureaplasma. You can have infections inside the cervix which can be a cause of infertility or miscarriage.
Plus I know I have a genetic blood clotting issue to also deal with!
So wanting to be fully aware of any possible clotting, auto-immune or infection issues before trying to fall pregnant again.
On an alternative front, I highly recommend you see a fertility naturopath as they are great for helping with you producing higher quality eggs. I know Nicole MacFadyen from Botanica Naturopathy in East Bentleigh is excellent. She was told she could never have kids and she now has four!
Plus Bill Wong who does acupuncture for fertility is a bit of a guru and has Monash IVF doctors refer patients to him sometimes. He is in Murrumbeena.
Hope all this helps.

Good Luck!

[Loujane]

Thanks Tess - that's really helpful - I will definitiley check out those immunology tests. Hope goes well with Dr Burmeister - like to get your feedback.

[wen10]

Hi ladies,
i am new to this site and found it just be chance as i was googling Dr Sacks who does NKcell testing at t Geoorges in London in UK but as i read on here am i to gather he no longer works in he Uk? In the UK we are quite behind as far as NKcell testing goes as the NHS wont test for it but private clinics will at a hefty price!!!

Goodluck to you all and best wishes
wen from cold and wet UK!!!XXX

[Tess08]

Hi LouJane,

Saw Dr Burmeister at Epworth Medical Centre.She didn't much about. Checked for mycoplasma and ureaplasma which are infections you can have in your cervix which are implicated in recurrent miscarriage. I tested positive. didn't have chlamydia but did have these mycoplasmas. She put me on specific antibiotics straight away. Same for my partner.
Next pregnancy I have to inject with a drug called Clexane due to a blood clotting issue I have along with aspirin, plus she wants progesterone pessaries first 12 weeks and weekly ultrasounds from 12 weeks onwards to check for incompetent cervix. She isn't delivering babies herself from about May so you need to find another person to deliver. She did recommend Emily Olive from the Freemasons who apparently has studied extra ultrasound courses and is a more skilled ultrasound technician than a regular OB. So it means you can have skilled ultrasounds as often as you like in her rooms to check on things which is comforting.
I had a few autoimmune thing show in my blood in low levels and she doesn't think these will be an issue but has written me extra blood test requests to have this monitored nonetheless.
I am back seeing my acupuncturist from now on too until I fall pregnant and then to weekly until I am 12 weeks. I cant recommend him high enough - Bill Wong in Murrumbeena Rd Murrumbeena.
Just had my first period since my miscarriage on 14th August at 14 weeks. One more cycle after this and we will try again. Third time lucky I hope!

Cheers,

Tess

[Tess08]

Hi LouJane,

Saw Dr Burmeister at Epworth Medical Centre.She didn't much about. Checked for mycoplasma and ureaplasma which are infections you can have in your cervix which are implicated in recurrent miscarriage. I tested positive. didn't have chlamydia but did have these mycoplasmas. She put me on specific antibiotics straight away. Same for my partner.
Next pregnancy I have to inject with a drug called Clexane due to a blood clotting issue I have along with aspirin, plus she wants progesterone pessaries first 12 weeks and weekly ultrasounds from 12 weeks onwards to check for incompetent cervix. She isn't delivering babies herself from about May so you need to find another person to deliver. She did recommend Emily Olive from the Freemasons who apparently has studied extra ultrasound courses and is a more skilled ultrasound technician than a regular OB. So it means you can have skilled ultrasounds as often as you like in her rooms to check on things which is comforting.
I had a few autoimmune thing show in my blood in low levels and she doesn't think these will be an issue but has written me extra blood test requests to have this monitored nonetheless.
I am back seeing my acupuncturist from now on too until I fall pregnant and then to weekly until I am 12 weeks. I cant recommend him high enough - Bill Wong in Murrumbeena Rd Murrumbeena.
Just had my first period since my miscarriage on 14th August at 14 weeks. One more cycle after this and we will try again. Third time lucky I hope!

Cheers,

Tess

[butterfly_warrior]

Can anyone shed any light on what elevated levels of C reactive protein may mean?

I've got a history of this in blood tests that my rheumy has conducted, and just had my FS send me for his own round of autoimmune testing. He pretty much implied that if any of the tests came back with something we were pretty much screwed... that was one of his tests (I can't even recall if it was one that Dr S tested for), and I tripped over some results today that show it has been a problem in the past.

BW

[Tess08]

Hi Butterfly Warrior,

CRP ( c reactive protein) is normally a measure of inflammation in the body. So if it is elevated, seems like there is too much inflammation going on from whatever cause whether it is autoimmune or another reason.
I had a CRP of 261 when I miscarried at 14 weeks and the reading should be less than 10 normally so something was clearly going on. You will also get a high CRP if there is an infection in your body. Inflammation is part of many processes in the body whether infection, pain, arthritis etc. some doctors even look at CRP for increasing your risk of heart disease if you are very overweight, have high blood pressure, large waist measurement, pre-diabetes or diabetes. It's one of the markers used for assessing heart attack risk.
In your case seems like it would be autoimmune.
I had my CRP re-done and it is now back to normal low levels, was just incredibly high during the miscarriage and I have had some doctors say I had an infection at the time and others say I didn't and it was just how my body reacts during miscarriage. who knows! I will definitely be checking it again next pregnancy regularly to see what is going on.

Let me know what your doctor says about your CRP and it's implications. I did a big search on the internet for CRP and miscarriage / infertility and there wasn't much I could find.

I have Factor V Leiden heterozygous so will inject with Clexane next pregnancy for the first time and take aspirin as there were some very low cardiolipin antibodies showing some low level auto-immune involvement but nothing high enough to put me in a specific auto-immune condition such as lupus or anti-phospholipid syndrome. They dont think I need prednisone at this stage but will keep an eye on the auto-immune aspect with regular blood tests.

I have also ordered Dr Alan Beer's book about infertility and autoimmune problems so looking forward to reading this when it arrives.

Best regards,

Tess