The IVF Club

A Personal Blog About IVF Treatment & Infertility

Natural Killer Cells

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Sheesh – I just found out I have tested positive for natural killer cells. It seems my body kills embryos.  Now that might explain why I have have 13 IVF failures.  I wish I saw my new Doctor sooner. Now we just have to worry about my husbands sperm, my natural killer cells and our age – well my age!

From what I can gather the next step in the process is steroids and medication to suppress my immune system.  Goody – I wonder if this means I am more likely to get sick. I have been disgustingly healthy – I think I had all my illnesses as a child.  However, if they suppress my immune system I guess I am now more likely to catch various illnesses.  I don’t like being sick and I don’t make a good patient.

Do how does one get tested for natural killer cells.  Well basically you have to book your appointment for day 21 of your cycle. Your fertility specialist will then dig into your uterus and take a specimen for testing. This is not a pleasant test. It hurts for 10 seconds it takes for the specialist to get the speciman as well as afterwards.

My next step is to see the good doctor when he returns from his conference to get the low down on the treatment. Now this is going to be interesting. It seems the more you do IVF, the more drugs get pumped into your body. Anyways, my fertility specialist seems to think that 60% of women get pregnant after being treated for natural killer cells.

New Doctor, New Outlook

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Yesterday, I finally had an appointment with a new IVF doctor.  I chose him because he does thing differently to other IVF doctors. After 13 cycles with no positive result, I decided it was about time to try something new.  Some of you may recall that I had decided to stick with my current doctor since he finally changed my treatment protocol and that I had seen another doctor at another clinic who also didn’t seem to have any other ideas.

I suppose I could have given up, but I made a third appointment with yet another doctor. The wait was long and arduous but well worth it.  My now new doctor asked me a whole stack of questions that had never been raised before:

  • Have you had a biopsy on day 21 to test for natural killer cells
  • Have you have blood tests for x, y & z ? Did you fast for the thyroid test that you had?
  • Has your husband had a blood test on his chromosomes?
  • Has your husband had the SCSA sperm test?

My answers were mostly negative.  So we are now all set for a fresh round of tests.  The SCSA test that my husband has to do is a test for sperm DNA fragmentation. I read somewhere that if sperm fragmentation is over 30% then the likelihood of getting pregnant is 1%.  If this is the case, then we may need to consider other options like a sperm donor.  the cost of $500 but I think it is money well spent given I have now spent over $50k on IVF.  It would have been better to assess this earlier – maybe I could have saved time and money. I guess I will soon find out.  Personally, I feel this could be our major issue. We have lost a lot of embryos due to fragmentation and there is some possibility that the antibodies in my husband sperm have had an impact on this. I feel sure that these things are connected in some way.

The biopsy that I have to do is a test to see if I have any natural killer cells that try and destroy my embryos. Charming.  There is heaps of information about this on the web but I recommend not reading the information unless you have a good understanding of biology. For me, reading about this stuff bores me to tears – it is far to technical for my liking.   The main point of interest about natural killer cells,  is the fact that my new doctor has helped 60% of women found with natural killer cells become pregnant.  Apparently the treatment is simple – just some medication to fix the issue.

The other tests are also important and essentially will help the doctor determine the right protocol for me – particularly if the there are no other likely issues revealed by the other tests.  So my next test is 2-3 weeks away.  Unfortunately we know the full extent of the problem until my Doctor returns back from the European Society of Human Reproduction and Embryology (ESHRE) conference in Italy which is a massive annual event about all the latest findings on IVF.

So it seems my next steps won’t happen until July.  That’s exciting.  I hate the wait but hopefully we might know more than what we did before and be able to make some decisions from this point.  My husband is really annoyed though – he is angry that our other doctor hasn’t done these tests. I can understand that but it does seem that many doctors follow the tried and true path.  My advice for anyone in the same boat is to try different doctors – particularly if you feel you issues are not being investigated thoroughly.

IVF Fertility Specialist Surprises

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I recently went to the effort of booking two appointments with two new fertility specialists in a desperate bid to get a second opinion.  One at a new clinic and the other with a different Doctor at the same clinic I currently attend. I mentioned in a previous post that I had been frustrated that I have not had any success with IVF as yet and that I felt my Doctor had not been proactive in recommending changes in my treatment protocol.

The first doctor I saw told me my chances of getting pregnant were very low but that he would treat me. There was no variation in the treatment in what I had done previously. The only major change was the change from transferring at Day 2 instead of Day 5. The benefit of going to him was that I would have the same Doctor treating me. The downside was that the clinic’s location was more difficult for me to attend and that I would have to go through the process of getting lots of paperwork transferred from one clinic to the next. I walked out of that office quite upset and depressed for the rest of the day.

The next doctor I was intending to see was not available until the end of May works at the same clinic as my current Doctor!   I therefore decided to maintain my appointment with my current Fertility Specialist.  I am stunned. He spent more time with me than normal, reviewed my files and recommended two major changes to what I had before. The first was:

  1. Embryo biopsy to see if there is any reason why I haven’t gotten pregnant
  2. Trying the Colorado Treatment protocol

I am stunned. Just when I was getting frustrated with my lack of success and made appointments to see other specialists, my own makes a change!  Its a big clinic but I wonder if somehow he found out that I wanted to change or whether he knows from experience that women on a mission to get pregnant will stop at nothing.

The IVF Colorado Protocol

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I recently learnt about a technique called the Colorado Technique which is geared towards older women and those women with multiple failures. It is used to improve the lining of the uterus to aid implantation of the embryo.

Sounds like this technique was made for me. I am older, have had multiple failures and implantation seems to have been an issue. In fact, a work colleague who did IVF swears by it.  Using this technique helped her conceive her baby boy at age 43!

The protocol varies by stage and individual Doctors may vary it slightly but in the general protocol works something like this:

STAGE ONE
1. Commence Baby Asprin (Astrix, Cartia, Cardiprin) when you commence Syneral / Lucrin.

STAGE TWO
2. Your husband commences Doryx 100mg twice a day for 7 days when you commence Gonal F / Puregon.
3. You stop Asprin on the day of your first ultrasound.

STAGE THREE: The day after the Trigger Injection (Pregnyl)
4. Commence Prednisolone 25mg at night for 5 nights.
5. Commence Augmentin 500mg orally twice a day for 5 days.

STAGE FOUR: The day after egg pick up.
6. Crinone (Progresterone gel) one application each morning.
7. Apply two Estraderm mx patches 100mcgm to the buttock (one on each buttock). Change alternative days.
8. Recommence Baby Asprin.
9. Have intercourse the night before embryo transfer.

OTHER

  • Continue Asprin, Crinone/Estraderm Patches until the pregnancy test.
  • If the test is positive, treatment continues to 6 weeks.
  • If the ultrasound shows a viable pregnancy, continue all tyreatments until 13 weeks are completed.
  • The Asprin continues to the 34th week of the pregnancy.

I can’t guarantee the accuracy but this seems to be the general idea. I guess I will find out more when I see my new Fertility Specialist next week.

IVF Cycle #11

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Well another day, another transfer. I am now up to cycle number 11. I thought it would never happen to me but it has. I can’t believe I am up in the double digits now. I don’t have a good feeling about this one either.

I have a feeling that I ovulated a day later than what my clinic thinks I did.  I noticed a stronger LH surge on my ovulation test strip a day after my blood test at the clinic.  Which means I think the clinic has put a Day 5 embryo, four days after ovulation instead of 5. Somehow I do not think this is a good thing. Next time I am going to insist on having a trigger injection so at least the clinic can be sure of when I am ovulating.

On top of that when I went to the clinic and spoke to the Embryologist, the scientist told me that the Embryo survived the thaw but was only 80% okay.  Apparently this is not a bad thing as the cells are amazing in rejuvenating themselves and the clinic sets a limit on what is and isn’t acceptable.  After 10 cycles, it was the first I had heard of it.

My next piece of evidence is that I don’t think the clinic tests the lining of my uterus.  They must evaluate when they do they transfer but I can’t say I have ever seen them measuring the lining.  In talking with a friend of mine who got pregnant after her second attempt at IVF, she tells me that she had a different protocol. They measure her lining before they proceed with the transfer and they don’t give her a blood test! All I ever seem to have are blood tests. The clinician at my last test was unable to find a decent vein (mine have gone into hising now) and left me in the seat while she went for help to find it. Trouble is she left me with with a strap on my arm for nearly 10 minutes – apparently that is not a good thing and makes the veins even harder to find.

And don’t let me get started about the blood test I had before that.  This was just a simple little test for lupus etc which I have had before but they thought they might just do again.  I think they extracted eight vials of blood that day and I recently received a letter informing me that they were unable to get any results from my blood and I have to go in again so they can redo the test.

One might think after reading this blog that I am over IVF.  I think I nearly am. I think I might do one more stimulated cycle before giving myself a well deserved break.