I am an older mama with two living children and nine babies who grew wings far too soon. My Life Partner (LP) and I began our journey to conceive in 2009 while I was still in my 30s. After two miscarriages I delivered our one success story, whom I liked to call the Miracle Baby (subsequently the Miracle Toddler or MT), in early 2012.
In late 2012 we decided to hop on the rollercoaster ride for a second time. After our third loss in 2013, which ended at almost 11 weeks (after healthy heartbeats) with another D&C, I began this blog.
During that last pregnancy in 2013 (my 6th), I noticed having developed some very strange new allergic reactions (most painful was severe allergic conjunctivitis and excema all around my eyes and on my eyelids and throat swelling when I ate foods with dairy, gluten and certain plant proteins). It was difficult to eat much of anything and I was also having exacerbated reactions with my environmental allergies.
I mentioned this to my doctor after my 6th pregnancy ended and noted that the eye excema (which was very painful and left me resembling a raccoon) flared up during the luteal phase of my menstrual cycle or when I tested positive for pregnancy. My doctor insisted these things were unrelated. I felt blown off but accepted (mistakenly) that she knew better than I did.
Our first IVF cycle began in late 2013 and ended in early 2014 with a biochemical pregnancy (very early miscarriage). Our first IUI with injectable meds also ended almost as soon as it began.
We moved on to anonymous donor eggs, accepting the excuse for our Assisted Reproductive Technology (ART) failures being that my eggs were too old and therefore of poor quality and that any embryos created with my eggs would be prone to aneuploidy or chromosomal abnormalities not compatible with life.
It was difficult to accept that all of my eggs are bad when I clearly had eggs to choose from (we got pregnant every cycle in which we tried in 2013 and also 2014). But I was not an expert so for a long time I accepted the word of those who carry that status.
After all, nothing had shown up in the Recurrent Pregnancy Loss (RPL) blood tests or the karyotype testing the LP and I had done. My doctor referred me to a geneticist who refused to see me saying there was nothing further he could offer us.
Our first donor egg embryo transfer resulted in a pregnancy that failed in exactly the same manner as 4 of the 5 previous losses since we had the Miracle Toddler. The immune reactions flared again, worse than ever, and I went to see my doctor about them and to inform her of everything that had happened.
I waffled over consulting a reproductive immunologist but the cost (which is not insured as we live in Canada) and possibility of being told my case was impossible or impossibly costly to address made me wary. My doctor prescribed Prednisone, which led to a complete abatement in my symptoms at higher doses but as the dose tapered down and after the course of treatment ended, the symptoms returned although they are not as severe as they were in the weeks after the donor-egg pregnancy loss.
My then-RE said we should take advantage of my calmed immune symptoms and try again even though he refused to prescribe steroids, blood thinners or any other immune medications. I was certain the there was more to it and eventually came to my senses.
The LP and I consulted Dr. Jeffrey Braverman (see his website here for more information). I chose to call him after considering various reproductive immunologists in the U.S. because he offered the most comprehensive initial testing/analysis. We spoke by phone and met with Dr. Braverman in Long Island, New York and had a schwack of immune testing conducted through Reprosource.
The comprehensive report from Dr. B’s office analyzing what the results meant when read together indicated:
- I am an AA Haplotype, meaning I have no activating KIR receptors. In lay language, bad news.
- The LP and I have zero to one HLA-C mismatches. In lay terms, more bad news.
- I have a lot of angry cytokines and very exuberant Natural Killer cells. Yes. This news is bad, too.
- More generally, I have “significant systemic inflammation”. You guessed it, bad news.
- Our one successful pregnancy likely created a cell memory that has exacerbated the effects of items 1-4 above.
- I probably have endometriosis even though I no longer suffer incredibly painful menstruation. A diagnosis can only be confirmed through surgery. Endometriosis seriously impacts egg quality and may also be related to my systemic inflammation and immune overactivity. If only I had known this sooner.
- I have a genetic marker associated with celiac disease and I could be reacting to trace levels of gluten in my gluten-free diet. More testing would be required to determine if I just have a propensity or actual celiac disease. I am not going there now.
- I have a genetic marker associated with Hashimoto’s Thyroiditis but have currently tested negative for anti-thyroid antibodies so we are currently in the “good news” camp with this one.
In short, I cannot stay pregnant without drugs and getting pregnant without those drugs will continue to make me sicker and with almost 100% certainty result in further losses. The drugs should help but Dr. Braverman cannot guarantee that we will not have any more miscarriages, even with our donor egg embryos. It could “take a pregnancy”, he said, to figure out the dosing of the medications he has recommended or for my body to react as it is hoped it will to those medications.
Unsurprisingly my Reproductive Endocrinologist with whom we generated our DE embryos kyboshed my request that he work with (take directions from) Dr. Braverman. Dr. Braverman cannot prescribe medications for patients whose primary care is out-of-state.
In July and August 2014 Dr. Braverman and his embryologist told me about how the New York state health department has such rigorous requirements and inefficient/unpredictable procedures for allowing the import of embryos from out-of-state that it could take weeks to months for us to get our embryos from the West Coast to the East Coast. That changed in September, enabling us to have our last two frosties – who I had named Gertrude and Alice (Gert and Al) – shipped out East.
We began an immune protocol FET with Dr. Braverman in late September and my frozen embryo transfer of Gert and Al occurred on October 14, 2014. I believe that both embryos implanted but one dropped off almost immediately (per my prior history). I saw one strong heartbeat at 6 weeks 1 day. And cried.
The road that followed was littered with potholes and pitfalls. Alas, our prayers were answered. A healthy Baby Azulito (our spirit baby) arrived by emergency cesarean while the LP was having emergency eye surgery in 2015.
If you have or suspect you have immune issues affecting your fertility and you play well with others (i.e., you are civil and courteous for the most part), please consider checking out the Facebook page RISKIT – Reproductive Immunology Support and Knowledge.
For more awesome bloggers and other fun or if you would like to make new friends in the blogosphere, please check out the incredible blogroll created and maintained by Mel, author of Stirrup Queens (who self-admittedly clearly missed her calling as a personal organizer).
Finally, if you would like to share a little something in private, please e-mail me at firstname.lastname@example.org – I would love to hear from you!
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