My latest obsession – reproductive immunology

In my hunt for answers I have been reading various articles online and also different books on miscarriage.  There is a doctor in NY that specializes in recurrent miscarriage (Dr. Jonathan Scher), however he doesn’t accept insurance so you have to pay to see him out of pocket.  That is, unfortunately, not an option for us at this juncture, but he also wrote  a book “Preventing Miscarriage” which I read and found to be very interesting.  Especially at the end of the book he detailed a LOT of immunological issues that could cause early losses.  In layperson’s terms, we all have antibodies in our body which are designed to protect our body and tissues from foreign invaders (i.e. bacteria, viruses, etc.)  However, sometimes the antibodies attack the wrong thing.  For example, if you suffer allergies, this is an overreaction by your immune system.  When you get pregnant, the embryo is supposed to release certain chemical markers to tell your antibodies not to attack it – after all, it is 50% foreign material (dad’s DNA).  But sometimes this doesn’t happen.  If my immune system starts attacking this embryo as soon as it fertilizes it, it may be destroying it or making it unable to fully implant.

So, there are a variety of tests to see if this is happening and there is treatment available if these tests come back positive.  I have only been tested for one type of antibodies, but there are MANY other tests available.  I have an appointment on Thursday to discuss these tests with my doctor.  However, it seems that many doctors either don’t believe this is truly a factor or that the studies behind these tests and treatment aren’t strong enough to support doing the treatment.  With my dad’s help I have found a lot of studies and the results are mixed.  Some say that the treatment (IVIG, intravenous immunoglobulin) drastically improved success rates.  Others say the results are negligible.  Here are a few articles I’ve read recently.  You will see that they term miscarriage as “spontaneous abortion” but they are talking about miscarriage, not abortion.

The first two studies above are supportive of immunotherapy.  The last one is not.  So its pretty confusing.  Before I can do anything I have to see if I actually have any of these antibodies or if my husband and I are so genetically similar that my antibodies are attacking his (given our ethnic background, this would really surprise me, but who knows?)

There is a lab in Chicago called Millenova and they have an “Implantation Failure panel” that tests for most of these antibodies, including Anti-phospholipid antibodies (APA), anti-nuclear antibodies (ANA), anti-thyroid antibodies (ATA),immunoglobulin panelembryotoxicity assay (ETA),reproductive immuno-phenotype (RIP), and NK activation assay (NKa).

If my RE will not test for these then I will see if my insurance covers all or part of this.  If not, its $1300 out of pocket, which is kind of expensive, but honestly I just don’t see how I can try again without looking deeper into what is going on, and $1300 isn’t as bad as it could be.

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3 thoughts on “My latest obsession – reproductive immunology

  1. I am so glad you started this blog. As you know, I was also a recurrent early miscarrier, and no one really talks about this problem. I know this blog would have been a huge source of comfort for me when I was going through my losses… thank you for having the strength to talk about this!

  2. Amy says:

    Dr Jeff Braverman! The VERY VERY best Reproductive immunology practice in the world . He’s in NYC and LI NY. And he DOES accept insurance. Brilliant man. Many ppl come after visiting 2, 3, 4, or 5 other Dr’s. Save your self the hassle and see him first!

    • rowanthefrog says:

      Rachel,

      Thank you for the recommendation. Thankfully I went on to have 2 more healthy pregnancies and my family is complete but there are others on this blog who might want to see him.

      A

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