Immune Tests and follow ups - where do I start?

[tpid]

Hi,

I just got done with my 2nd fresh IVF cycle. Previously, I have had 2 IUIs, 1 fresh IVF and 1 FET cycle done. All BFN. Not even chemical. HCG detected was 0.6. My diagnosis is unexplained.

I met with my RE today and he basically wished me luck and said that we should seek a second opinion elsewhere. Which I agree with. He mentioned it was due to egg quality issues. I'm not sure I agree or disagree with him since in my 1st IVF I transferred 2 perfect looking blasts. For my FET as well, we used 2 perfect looking blasts. However, for the latest IVF cycle, out of the 15 retrieved, only 2 fertilized on day 1. Another 2 fertilized the next day. They transferred 4 2cell embryos on day 2 and I got a BFN.

I asked him about implanation issues and immunological tests but he dismissed them. He says he's confident its egg quality. Ok .. so he's not a big believer in immunological issues. However, I'm wanting to investigate more on the immunological side esp since I have hashimotos and thalessmia minor.

So, the question is where do I start? I have visited Dr. Beer's website, as well as SIRM. I have also seen references to Dr. Coulam in Chicago and a Dr. Kwik-Kam (spelling?). How did you choose one vs the other? Is it geographical - how close they are to you? Or, is it based on specialties? Or, how do I find an RI or someone who can run the tests for me in NC?

If you've been patients at one or other such clinics or even had a phone consult with them, can you tell me how you started? Did you meet with them, then get them to prescribe some tests and then meet them again to discuss results?

Sorry the questions are a little broad, but I was hoping for a little hand holding while I find my way around RI-land.

Thanks in advance.

[poohbear]

I consulted with SIRM NY who interpreted the tests ran by Millenova where Coulam is the director. I repeated one of the tests a year later. Fortunately I found a RE in my area that will treat me for immune issues so I ditched my current RE and switched. Some of the testing at Beer's website are a little different. I almost went through them. I would say both are fine. Good Luck!

[tpid]

Poohbear,

Thanks for responding. So, how did you determine which tests to run at Millenova? Who prescribed them for you?

Also, you said you found a local RE who believes in immune issues. Can you share how you found it? There are 4 clinics in my town in NC and I looked at all the doctor profiles. so, either I'm not looking for the right specialty or there aren't none.

[sdeut]

I know on Dr. Kwak-Kim's web-site they have a list of doctors that will work with her but my OB who is not on the list also will work with her (she already has). I have not spoken to my RE about seeing her but I figure if my OB will work with her is doesn't matter if my RE will.

I just sent in all my paperwork to Dr. Kwak-Kim. I am lucky because I live in Illinois where Kwak-Kim and Coulam are located. I have heard good things about Dr. Kwak-Kim, Dr. Beers clinic, Dr. Coulam, and SIRM so I agree it is a hard decision. I choose Kwak-Kim because my OB worked with her before.

[tpid]

sdeut,

Thanks for the reply. I will check on Dr. Kwak-Kim's website for details. Also, a great point about the ob working with the RI. I hadn't even thought of that.

Btw, I love your avatar. I love love love collies.

[poohbear]

Tpid,
I just lucked out. My RE is at CNY Fertility based in Syracuse but has a local office as I'm in upstate NY. Most RE's don't believe in immune issues which is the problem. As long as you can find someone to work with your doctor and do the testing it doesn't really matter who you go to (Beer, Coulam, etc.)

[sdeut]

tpid - Thanks about the avitar - He is one of our babies we have 2 of them.

I hope that you find someone you can work with. My OB said she would not discount RI testing because who is she to think she knows everything - that doctors are learning new info everyday to help with fertility and RI might just be the next big thing in infertility treatment.