Questions on Immune Testing

wantababy786 · 06-05-2009, 08:49 AM

Hi Ladies,

I am new to this forum. I am 26 years old and have mild pcos and have slighty elevated high fsh of 12.5. I have been through 4 medicated cycles, 3 with clmid and one with gonal-f that have been successful for ovulation but no BFP. I am moving on to IVF but I was thinking about getting some immune testing done beforehand.

I was thinking about getting the natural killer test done to see if I have elevated ones, and also my doc did an ANA with reflex? what does that test for? Any other tests that are important?

my doc wont do them unless there's a reason like recurrent miscarriages..however there is a website called www.privatemdlabs.com where you can order them on your own but insurance won't cover it..i rather spend the money before spending so much $$$ on IVF first you know?

Any thoughts are appreciated

Thanks!

poohbear · 06-05-2009, 10:15 AM

Wantababy,
The ANA can be + if you have lupus and then they do further testing. The natural killer cell test on this website does not look complete. There are many many tests that a doctor can order. You can go to Millenova Labs and do a more comprehensive test for less money. Dr. Coulam is the director of that lab I believe and reviews the testing. I ordered them from there and had another dr. interpret or you can set up a consult and she will review. If you are in IL, the Rinehart Center, Dr. Coulam specializes in reproductive immunology and she does do phone consults if you can't travel. There are other doctors and labs who do the testing but I wouldn't risk doing the wrong tests on your own. Good luck!

wantababy786 · 06-05-2009, 12:34 PM

thanks, i emailed them asking them which one can test for elevated NK cells for fertility and they said this one:

Natural Killer Cell and Activated T-Cell Profile/IL-2r

Description: Assess changes in T-lymphocyte surface markers that may
indicate immune stimulation.

Includes: Percentage CD3+; absolute CD3+; percentage CD3+CD25+ (IL-2
receptor); absolute CD3+CD25+; percentage CD3-CD56+ (NK); total CD3-CD56+
(NK); CBC with differential; total lymphocyte count.

Categories: Infectious Diseases

All I need to check if it is elevated right? Shouldnt this be enough? Also, any other tests that should be done? what tests for hashimitos thyroiditis and stuff? what is apa?

poohbear · 06-05-2009, 07:17 PM

You should find out if they have a test that does the same as this one does.
http://www.millenova.com/tests/nkassay.cfm. This one is really important and should be done because they show suppression with IVIG and intralipid if there is an elevation.

APA is anti-phospholipid anti-bodies and there is usually a panel they can do. APA's can cause clotting problems and m/c. Also anti-thyroid antibodies if you have thyroid issues. There are many more. Millenova has a recurrent pg. loss panel. Good luck!

lw962 · 06-05-2009, 07:30 PM

Want- I would also suggest getting tested for genetic clotting factors too thru a hemotologist. The can also affect pg and implantation. Good luck.

wantababy786 · 06-05-2009, 08:37 PM

thanks so much!

poohbear- with millenova can i just go through the doc you said or will she want my RE to order it? I dont want my RE involved in this. She's not into all this testing especially since I havent even had an IVF cycle but i would rather have it all tested and know now if there's an issue or later.

thanks!

poohbear · 06-06-2009, 06:59 PM

Last I knew you can order on your own. I had my results faxed to me. If they won't do that, you can have Dr. Coulam interpret. LW is right. You should also do the thrombophilia panel as well to make sure it is all covered. I bypassed my first RE and then got 2 other opinions. I ended up switching to a RE that will treat me for all of the immune issues.

sdeut · 06-11-2009, 06:24 AM

Want - I know you from another board. There is also another Reproductive immunologist in Illinois. Dr. Kwak-Kim http://www.rosalindfranklin.edu/DNN/...1/Default.aspx
That is who I am going to go through. I just sent off paperwork and labs to her. I know you have to go see her for your 1st consult (in vernon hills) and people say she talks and listens for a long time. Then when the labs come back she likes to see you a 2nd time to go over them at least that is what people tell me. My OBGYN says she has had patients who were successful with her so we will see.

I don't know if my RE will work with her but I know my OB will. Though it sounds like I can go to her also or have blood drawn at Quest and sent to her.

It is so confusing and I hope we get some answers.

christina_s · 06-11-2009, 03:32 PM

Hi everyone,

My RI is Dr Kwak and I am very satisfied with them. Moreover they code Immune Diagnosis for the tests and we were covered from our isurance company for the blood work. So far I am 26 weeks and this has been our first successful pregnancy so far.

Hope this helps

I am praying everyone finds his answers soon

wantababy786 · 06-15-2009, 08:48 AM

So, I set-up a phone consult with Dr.Coulam which costs $350. The good thing is she can do them over the phone, then prescribe the tests hopefully, and then the final consult where she goes over the results is $250 as well. It's on July 10th. Lets see what happens.

06-05-2009, 08:49 AM	#1 (permalink)
wantababy786 200-299 post 4 of hearts Join Date: Mar 2009 Location: illinois Posts: 223	Questions on Immune Testing Hi Ladies, I am new to this forum. I am 26 years old and have mild pcos and have slighty elevated high fsh of 12.5. I have been through 4 medicated cycles, 3 with clmid and one with gonal-f that have been successful for ovulation but no BFP. I am moving on to IVF but I was thinking about getting some immune testing done beforehand. I was thinking about getting the natural killer test done to see if I have elevated ones, and also my doc did an ANA with reflex? what does that test for? Any other tests that are important? my doc wont do them unless there's a reason like recurrent miscarriages..however there is a website called www.privatemdlabs.com where you can order them on your own but insurance won't cover it..i rather spend the money before spending so much $$$ on IVF first you know? Any thoughts are appreciated Thanks!

06-11-2009, 06:24 AM	#8 (permalink)
sdeut 1000-4999 post queen of hearts Join Date: Aug 2008 Location: illinois Posts: 2,629	Want - I know you from another board. There is also another Reproductive immunologist in Illinois. Dr. Kwak-Kim http://www.rosalindfranklin.edu/DNN/...1/Default.aspx That is who I am going to go through. I just sent off paperwork and labs to her. I know you have to go see her for your 1st consult (in vernon hills) and people say she talks and listens for a long time. Then when the labs come back she likes to see you a 2nd time to go over them at least that is what people tell me. My OBGYN says she has had patients who were successful with her so we will see. I don't know if my RE will work with her but I know my OB will. Though it sounds like I can go to her also or have blood drawn at Quest and sent to her. It is so confusing and I hope we get some answers. __________________ Me 33 DH 33 Highest FSH 17 2 chemical pg Zachary B 4/22/08 D 6/24/08 (due to SMA) IVF #1 w/PGD - ectopic IVF #2 - m/c 9 weeks

06-11-2009, 03:32 PM	#9 (permalink)
christina_s 0-99 post 2 of hearts Join Date: May 2009 Location: Florida Posts: 22	Dr Kwak pregnancy metioned. Hi everyone, My RI is Dr Kwak and I am very satisfied with them. Moreover they code Immune Diagnosis for the tests and we were covered from our isurance company for the blood work. So far I am 26 weeks and this has been our first successful pregnancy so far. Hope this helps I am praying everyone finds his answers soon

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06-05-2009, 10:15 AM	#2 (permalink)
poohbear 5000-9999 post king of hearts Join Date: Jan 2002 Location: NYS Posts: 6,330	Wantababy, The ANA can be + if you have lupus and then they do further testing. The natural killer cell test on this website does not look complete. There are many many tests that a doctor can order. You can go to Millenova Labs and do a more comprehensive test for less money. Dr. Coulam is the director of that lab I believe and reviews the testing. I ordered them from there and had another dr. interpret or you can set up a consult and she will review. If you are in IL, the Rinehart Center, Dr. Coulam specializes in reproductive immunology and she does do phone consults if you can't travel. There are other doctors and labs who do the testing but I wouldn't risk doing the wrong tests on your own. Good luck!

06-05-2009, 12:34 PM	#3 (permalink)
wantababy786 200-299 post 4 of hearts Join Date: Mar 2009 Location: illinois Posts: 223	thanks, i emailed them asking them which one can test for elevated NK cells for fertility and they said this one: Natural Killer Cell and Activated T-Cell Profile/IL-2r Description: Assess changes in T-lymphocyte surface markers that may indicate immune stimulation. Includes: Percentage CD3+; absolute CD3+; percentage CD3+CD25+ (IL-2 receptor); absolute CD3+CD25+; percentage CD3-CD56+ (NK); total CD3-CD56+ (NK); CBC with differential; total lymphocyte count. Categories: Infectious Diseases All I need to check if it is elevated right? Shouldnt this be enough? Also, any other tests that should be done? what tests for hashimitos thyroiditis and stuff? what is apa?

06-05-2009, 07:17 PM	#4 (permalink)
poohbear 5000-9999 post king of hearts Join Date: Jan 2002 Location: NYS Posts: 6,330	You should find out if they have a test that does the same as this one does. http://www.millenova.com/tests/nkassay.cfm. This one is really important and should be done because they show suppression with IVIG and intralipid if there is an elevation. APA is anti-phospholipid anti-bodies and there is usually a panel they can do. APA's can cause clotting problems and m/c. Also anti-thyroid antibodies if you have thyroid issues. There are many more. Millenova has a recurrent pg. loss panel. Good luck!

06-05-2009, 07:30 PM	#5 (permalink)
lw962 1000-4999 post queen of hearts Join Date: Oct 2007 Location: Miami, FL Posts: 3,763	Want- I would also suggest getting tested for genetic clotting factors too thru a hemotologist. The can also affect pg and implantation. Good luck.

06-05-2009, 08:37 PM	#6 (permalink)
wantababy786 200-299 post 4 of hearts Join Date: Mar 2009 Location: illinois Posts: 223	thanks so much! poohbear- with millenova can i just go through the doc you said or will she want my RE to order it? I dont want my RE involved in this. She's not into all this testing especially since I havent even had an IVF cycle but i would rather have it all tested and know now if there's an issue or later. thanks!

06-06-2009, 06:59 PM	#7 (permalink)
poohbear 5000-9999 post king of hearts Join Date: Jan 2002 Location: NYS Posts: 6,330	Last I knew you can order on your own. I had my results faxed to me. If they won't do that, you can have Dr. Coulam interpret. LW is right. You should also do the thrombophilia panel as well to make sure it is all covered. I bypassed my first RE and then got 2 other opinions. I ended up switching to a RE that will treat me for all of the immune issues.

06-15-2009, 08:48 AM	#10 (permalink)
wantababy786 200-299 post 4 of hearts Join Date: Mar 2009 Location: illinois Posts: 223	So, I set-up a phone consult with Dr.Coulam which costs $350. The good thing is she can do them over the phone, then prescribe the tests hopefully, and then the final consult where she goes over the results is $250 as well. It's on July 10th. Lets see what happens.