I am so shocked and amazed by Dr. Kwak-Kim’s findings! I’m extremely encouraged and positive about treatment though. She found a lot of stuff wrong with me, but it’s all fixable!!! And it makes so much sense that I’ve been able to get pregnant, but have had failed implantation so many times. She has faith (and so do we) that we will overcome these issues and finally be successful. It’s so hard to believe after all this time, that we will actually achieve our dream! It’s surreal! I almost don’t want to get my hopes up and believe it.
Sorry this is very long!!
We already found out at my initial appointment that I have poor blood flow to my uterus, which we can treat with blood thinning injections (Lovenox). Plus, I’m doing a lot of natural/alternative treatments to hopefully remedy that. I will return at some point to re-check (their u/s machines are more high-tech than anything we have around here).
She found THREE blood clotting disorders that we previously missed! The first one is Factor XIII. I have an increased amount of blood clotting. This would be treated with the above mentioned Lovenox every day of my cycle (which I’m already on). I would need to increase to 2 injections daily after a positive beta.
The next one (you may have heard of this one) is MTHFR. This also causes increased clotting, but it affects other things. It blocks the absorption of Folic Acid and B vitamins, which are essential for a growing baby. It also affects egg quality, since it affects all cell growth. For this, I’ll take a special prescription for Folic Acid and B vitamins that my body will absorb properly. I also must take a baby aspirin (which I already do). The other issue with MTHFR is that is raises the level of Homocysteine in the blood, which is dangerous and can cause cardiac issues. She said my levels are pretty high, so we definitely want to bring that down for my overall health.
The 3rd disorder is an increased level of PAI-1. Having too much of that causes increased clotting, failed implantation, and may cause Gestational Diabetes or even Type II Diabetes. Along with this, she found that my testosterone is a little on the high side, and some of my other labs indicate an atypical form of PCOS. She will treat this with Metformin. I also need to exercise, reduce my daily carbohydrates, and lower my BMI. She said my egg quality will improve as well with this treatment. Obviously, my fertility will get better with this treatment, but we are also concerned about my overall health.
In addition to the blood clotting disorders, she found a positive ANA and positive APA. These are markers for autoimmune problems. However, I tested negative for Rheumatoid Arthritis and other autoimmune disorders. It still shows that I have lot of inflammation in my body though. She found that my Natural Killer Cells were not that high, like Dr. Sher had said. She did find that my inflammatory T Cells are very high. We need to calm the inflammatory response with IV-IG. This is an IV medication used to boost the immune system and reduce inflammation. It would be done early in my cycle, as well as into pregnancy. I have to take steroids daily, too.
The last thing she found was that I’m deficient in IGG and IGA. These are linked to an increased chance of infections – viral and bacterial. It means my immune system is weak. To replenish this, I would need IV-IG. The good thing about that is that it would be considered medically necessary – not just for fertility, but for my health. She said I could probably find a regular Immunologist in the area to treat me.
One thing that I’m really amazed and confused by is that my AMH went UP! I know I still have Diminished Ovarian Reserve, but my AMH went from 0.3 to 1.85!! That is a huge difference! It’s supposed to get worse, not better. That combined with the fact that my FSH has been much better, too makes me wonder. I guess the healthy changes I’ve made have helped??!! Maybe I won’t enter menopause as soon as they guesstimated?? I’m not sure, but I feel great about that!!
So, it’s a lot of information and I’m not thrilled about having more problems….but the fact that all these things have come to light and we can fix them is amazing! Plus, I had no idea that so many of these things would affect my HEALTH…not just my fertility.
Dr. Kwak-Kim said she recently put a lady on a similar protocol. A lady that had been through IVF and many early losses like me. She got pregnant naturally – no fertility drugs or treatments (except these meds I mentioned). She’s now 6 weeks pregnant and doing great! She thinks we have a chance to be successful without any IVF or even IUI!!! I’ll be starting my new medications today! I’m not sure when I can do the IV treatment though. I’m so excited to make some changes! 😀