Should I take immune tests? And If yes, what are the steps?

[Dreaming888]

Hello everybody, I am new here and feel lucky to find a support group like this!
I am 34 and DH 35, ttc for 4 years, failed many monitoring cycles, 2 IUIs, 1 IVF converted to IUI (due to low response). Did all necessary tests, hyp, lap, DH did 2 SAs, one DNA tests, everything is normal and Dx as "unexplained" (I really hate this label), I have never ever seen BFP in my life! While I am waiting for my next IVF, I heard one girl I know with exactly same history as me but who failed 3 IVFs with no good explanations dx with elevated NK cells. I immediately thought this could be the hidden reason for my IF too. I went to see my RE and asked to do a full immune check up, (btw, I once had thyroid problem 12 years ago), but she refused to order the tests for me b/c she deosn't believe primary unexplained IF is related with immune issues. She just asked me to go ahead with my IVF.
I still think I should do immune tests before taking an IVF, however with no support from my RE, I don't know how to proceed with myself.
First of all, what tests should I do? I am thinking doing APA, ANA, ATA + NKa, are these good enuf for an initial check up? I saw on MillenOva website they offer "implantation failure panel" with 7 tests (above mentioned 4 + ETA, RIPh, IgGMA), but that panel costs $1353, I am not sure if that is necessary.
I live in Toronto Canada, can any of these tests be done locally? If government pays for any of those, there could be some savings for me.
Does anybody here know a good RI in Toronto area so I can go to? As my RE doesn't support my idea of immune issues, I really need a good doctor who has the knowledge and experience to interprete the test results and if I am positive, to come out a good treatment plan. I checked out Beer Centre as many people talked about them, they seem to be quite expensive, I hope I can get as much help as possible from a local RI (if there is any).
Anyway, at current stage, I just want to get my tests done and am really curious to find out if the hidden cause is NK or some other immune stuff.
Any good suggestions from you guys? Thanks to everyone here and I have learnt a lot from this board already!

[BC-pepper]

I would still push. I believe there are some immunity issues with me as well but so far they are undetected. Ask for a full thyroid panel as well, not just TSH. I just discovered I had an elevated TSH and didn't even know it. According to some doctors/some labs, my TSH from 8 years ago was high as well (3.55) when at the time it was considered normal. It's 5.73 now, not overly high, but 4.0 or 4.5 is the upper normal. Some REs and Reproductive Immunologists believe TSH should be between 1-2. I had a full thyroid panel done to check T3, T4, Anti-thyroid Antibodies, and Anti-Thyroid Globulin Antibodies yesterday. If I am still not pregnant after taking synthroid and getting the TSH under control, I would love to check for all the others, so we'll see.

I have had 1 failed IUI and 3 failed fresh IVF-ICSIs with many immature eggs and fragmented embryos. I have never gotten pregnant from treatment.

[c1311]

I would have it done if I were you. DH and I are also in our mid-30s and have never had a BFP, but I have endo. So after 6 months of charting and no luck we went to an RE. She told us that endo patients had lower success rates with IVF and that IUI would be a waste of time because in endo patients it has not been shown to be any more effective than timed intercourse.

So...I went on a quest to find out why endo patients have lower success rates with IVF and stumbled on the immune connection. DH and I decieded that before we moved forward with IVF that I should be tested. (We are OOP and I'm not one to throw money down the drain if there is a problem that can be identified BEFORE treatment.) RE told us she doesn't believe in an the immune/infertility connection and refused to even order the tests, which is when we realized she was NOT the RE for us. We contacted SIRM in Las Vegas and had APA, ATA , nKa and HLA testing done at RAI in California. According to my RE there are only three or so labs in the US that perform these tests with enough sensitivity to be useful. Not sure whether Canada has one or not. However my RE does treat patients from out of the country and they have a free consult, so at least he could advise you, order and interpret the tests and maybe you could find someone to treat you locally.

I think knowledge is power. If you have an immune abnormality then you at least have a choice about having it treated before doing IVF. Good luck finding an RE who is on board with this. I found that for some reason most seem to ignore compeling evidence to the immune/infertility/endo connection, which is really frustrating.

[Dreaming888]

Thank you ladies! I will see my family doctor in a week to refer me an RI here. I have been thinking of consulting with SIRM in NYC, but getting everything done across the border is a big decision for us. It is really frustrating that a lot of RE just don't believe in immune causes, I hope this situation will change soon.

[barren-bipolar]

Yes, I hope the situation changes soon, too. I think that we, as patients, have a role in bringing change. What if we all wrote letters to our old REs after immune testing with our new REs? What if we were able to prove that we had done 3 failed IVFs and that after immune testing, we immediately became pregnant? If enough of us wrote letters, they would really be foolish to follow the crowd!