pregnancy/loss history

#1: M/C (different partner)- 2001- 7 weeks (birth control fail)

*****Daughter-(different partner) born- 2002 (another BC fail- LONG story)*****


*********************************************************************************

GOT married to my HUSBAND 

Started ATTC July 2005

#2: M/C-2005- 5-6 weeks

***Son -born- 2006*** (This pregnancy/birth triggered the HY restricting HLA antibodies that attack pregnancies)

#3: M/C 2007 ( on the IUD, so no periods- sac looked to be around 8 weeks)- IUD removed-

Started ATTC sept 2007-

#4: 19 week loss -Aug 5th- 2008 

RPL panel done- and testing on baby- all came back "normal"

***Daughter- concieved 3 months post 19 week loss- born-2009***

Tubal ligation-2009  :(
 ( got tied for fear of having another late term loss, and was bullied into it by in-laws and OBGYN) 

****Tubal reversal- at Chapel Hill tubal reversal center- 2011 ***

*******started ATTC ASAP-******

#5: July/August 2011- M/C @5w (good doubling betas)

Started prometrium after O with every cycle

**HSG done- showed clear tubes- good fill and spill**

#6: Oct/Nov 2011- M/C@5w3d ( good doubling betas)

#7: Feb/march 2012- - femaras, HCG trigger, prometrium and estrace post trigger-  M/C@ 5w5d (great, trippling betas, saw sac on u/s)

#8: May 2012- Ectopic pregnancy- (treated with methotrexate)

#9: Sept-2012 (Femara, HCG trigger, intralipids and prednisone used) -Ectopic- (treated with mtx)

-HSG repeated, along with SIS and hystroscopy - all clear- along with another RPL panel- and various hormone testing- also, "normal"

#10: Dec- 2012- (Femara, HCG trigger, intralipids, lovenox and prednisone) -m/c 4.5 weeks- low betas- 

#11: Feb- 2013- Beta never went higher than 10- 

***Went for immune testing with DR Braverman through reprosource- 36 vials of blood later....we got a DX- Auto and allo immune issues- our worst fear and most complicated to treat-  (info on DX at bottom of page) ****

#12: May 2013-- **Braverman immune cycle** ( used femara, follstim, estrace, HCG trigger, PIO, prometrium vaginally, prednisone 40 mgs a day , Lovenox for hashis antibodies, and neupogen for HLA antibody issues-
 cycle resulted in another ectopic- FINALLY resolved at 11 weeks after 2 rounds of mtx injects**

***STOPPED ATTC- we were out of money and tired of losses***

August 2013- Surprise BFP- after several up and down beta's and a ultrasound, it revealed we had a 4th ectopic pregnancy. I had a  2 cm  mass on my right tube, I was rushed into surgery, and they  removed my right tube along with the baby in it...I was 5w5d

That makes....

#13.....13 DOCUMENTED losses...

we also  many, many chemicals mixed in there that were not documented- some with immune meds, some without

we are done trying for now-

Below is the diagnosis info from BRAVERMAN about our losses- 

Hi Megan , here is a summary of our findings and our plan for treatment

1.       You have a high level of antibodies against your husbands HLA genes and these are complement fixing so we know they cause damage to the pregnancy and may explain your 19 week loss.

2.       You have a HY restricting allele the DRB3 and this causes you to make antibodies against any male pregnancy and if fact when the immune rejection for the male becomes strong enough most of your pregnancies will be rejected , all of this starts usually after a full term male pregnancy has occurred.

3.       You have a combination of HLA genes that predisposes the embryo  to making low levels of HLA G , a molecule the embryo must make to HELP create immune tolerance for your husbands genetics which obviously is not working

4.       You have significant uterine artery flow issues

5.       You do not have enough differences with your husband on certain HLA genes that are necessary to create immune tolerance toward all of his genetics.

To treat this we recommend

1.       Prednisone to decrease the production of the anti HLA antibodies that you have (you should start at 40mg , 20mg twice per day) we discussed IVIG beeing much needed as well but this is very expensive , however we will try and order it to see if it is covered but I would doubt it.

2.       Neupogen for the HLA matching issues and to help develop tolerance toward your husband genetics. It is important to have sexual relations as often as you can while on the neupogen.

3.       Lovenox to improve the uterine artery blood flow and to prevent the activation of complement caused to your complement fixing HLA antibodies that is the root of the problem with these types of antibodies.

The nurses will call you to go over injection teaching.

You must reorder the HLA antibodies and Treg cells with each pregnancy test as well as an heparin anti XA level that we will be sure you get scripts for , you need a CBC with each pregnancy test as well.

Regards,

Jeffrey Braverman MD FACOG

Medical Director

Braverman Reproductive Immunology