tag:blogger.com,1999:blog-7052836858232611779.post7103266079245323436..comments2024-03-08T02:51:53.512-08:00Comments on Eat Love Procreate: Reproductive Immunology ConsultEmilyhttp://www.blogger.com/profile/07415140299306373048noreply@blogger.comBlogger30125tag:blogger.com,1999:blog-7052836858232611779.post-83457270815982772082014-04-03T04:01:08.293-07:002014-04-03T04:01:08.293-07:00Yeah, definitely not impressed with their customer...Yeah, definitely not impressed with their customer service or methods. I got my bill VERY late in relation to the actual testing. I knew full well it may not be covered, even though the ordering doc and the lab all try to tell you "We run this with immunology coding so as it get it covered." Well, I knew that wouldn't happen and knew it would end up being $450 for the tests so not a huge deal since I expected it. What I really do NOT like is the crap they write on the bills once you receive them about how they are a superior infertility lab, even when testing regular stuff like AMH or whatever. Um no, not buying that. They put such a big push on using them over another lab, and it's just a red flag to me...like they are constantly trying to sell you on the need for their services.Emilyhttps://www.blogger.com/profile/07415140299306373048noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-61486272271873589042014-04-02T19:00:30.409-07:002014-04-02T19:00:30.409-07:00Be wary of Reprosource. That is all I am going to ...Be wary of Reprosource. That is all I am going to say.Janhttps://www.blogger.com/profile/03469446147426159902noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-19525212206984522372013-10-13T11:01:06.630-07:002013-10-13T11:01:06.630-07:00Oh, very interesting indeed. I did make Reprosourc...Oh, very interesting indeed. I did make Reprosource email me in writing with the "self pay" price of the tests I'm doing ahead of time just in case insurance doesn't cover them. Mine will be $453 if my insurance covers nothing and I paid an additional $50 for someone to come draw my blood at my house. <br /><br />Of course, I asked a bunch of questions about all of this ahead of time because I didn't want some "surprise" in the thousands of dollars range ya know! In my Skype consult Sher flat out said, "The tests will be covered by insurance." Even then, I was thinking "Um, how do you know? Are you familiar with my insurance plan?" Sher's office also told me when they called me later, "Your insurance is in-network with Reprosource and we do not code anything for infertility." I am not stupid though...I know the tests they are running are not standard, so I anticipate the possibility of insurance covering nothing. It will be verrrry interesting to see if it plays out like you said...with insurance covering nothing and a "self pay" bill to me in the end anyway. <br /><br />If that's the case, it will be one more red flag against pursuing anything he suggests...esp. because of the way they try to scoot you through the hoops in their "process." If that happens, it will definitely prove to me they are shady! We shall see. <br /><br />To be honest, I don't have any strong intentions of using Sher anyways. I was just really curious what my NK cell testing would show, and my RE doesn't look at anything immune related. In a way, I guess I was just using him to get the test done out of curiosity. I do think there is something to RI, but I don't trust Sher based on my first impression & intuition alone.<br /><br />I really appreciate your input on your experience. I will wait for the phone call! haha!Emilyhttps://www.blogger.com/profile/07415140299306373048noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-51615302790930620832013-10-13T07:20:23.371-07:002013-10-13T07:20:23.371-07:00Thanks lady! So, even though Sher coded my tests a...Thanks lady! So, even though Sher coded my tests as "immune issues", reprosource called me up and said they're offering me a "deal". The tests would cost something like $6000, and my insurance would (supposedly) require me to pay $1000, BUT reprosource would only charge me $650, regardless of how much my insurance paid/didn't pay! Sher's office f*ing knew that reprosource was going to call me 3-5 days after both my blood tests & request upwards of $600, and said nothing about it either time. Rude? Weird? Sketchy. Wait for the phone call...XOAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-86865461716320477682013-10-13T03:24:39.794-07:002013-10-13T03:24:39.794-07:00Thank you so much for your feedback. So far I have...Thank you so much for your feedback. So far I haven't gotten a warm fuzzy "good" feeling from Sher. I do not doubt anything you've said about your experience. <br /><br />I am giving blood on Monday for the initial testing. I notice that Reprosource does outsource the NK testing to a lab in CA but that they'll perform the expanded APA panel themselves. Thought that was interesting. So far, they're telling me the tests will be coded as "immune disorder" and not infertility so that everything's covered under insurance. We shall see. I will not be surprised one bit if our NK cell testing comes back as elevated and "further testing is required." It's at that point that I'll either decide to take my NK cell testing somewhere else and at least use the results as justification to at just add prednisone or dexa into my protocol (since my current RE doesn't typically use them). If Sher recommends DQ Alpha and all that other jazz, I'm not sure I will pursue it whatsoever. <br /><br />Thank you so much for your feedback! I've added you to my blog list and will be following your journey as well. :)Emilyhttps://www.blogger.com/profile/07415140299306373048noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-67206343770639825352013-10-12T23:21:07.913-07:002013-10-12T23:21:07.913-07:00Um, I saw Dr. Sher and another associate from one ...Um, I saw Dr. Sher and another associate from one of his clinics. They immediately started running these expensive, obscure tests to (IMHO) "stampede" me into IVF by building on my fear that my autoimmune disease was a factor (even though I have been preggo unassisted & at the time only had one miscarriage). He had me do DQ Alpha matching too--beware, his associate left the practice & informed me Dr. Sher nearly always uses DQ Alpha + HLA matches to insinuate you need IVIG, etc. And here's my biggest qualm--I think he's getting a back-end from Reprosource. Yep. They are a middle-man & OUTSOURCE most of these tests to other (often cheaper) labs. I believe in RI and since you're already doing IVF, SIRM may be a good place for you. But they were shady to me and wasted my money on reprosource for both NK cells/ATA's and DQ Alpha matching...without ever doing so much as an ultrasound or HSG...because he knew if he could convince me I'd never get pregnant or carry to term without IVF, then he'd get his $$$. So yeah, free consult but watch out for those reprosource bills.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-19922599199539780012013-10-07T13:03:01.341-07:002013-10-07T13:03:01.341-07:00I have read about Neupogen, although I don't k...I have read about Neupogen, although I don't know a lot about it. I had no idea it also assisted with a healthier lining either. I do know it's used on a very limited basis....was actually surprised to read about your docs using it, since I'd only heard it mentioned with Braverman's name in the past. Supposedly, Sher's office will code any of the tests I take as "immune testing" so it's covered? We shall see what the outcome on coverage is. Emilyhttps://www.blogger.com/profile/07415140299306373048noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-9704855207322129332013-10-05T10:26:53.421-07:002013-10-05T10:26:53.421-07:00I'm wondering if you've read about Neupoge...I'm wondering if you've read about Neupogen. I've mentioned it briefly on my blog, and we'll begin using it soon if the next cycle or two doesn't work. Because all of my issues were "small" and are now resolved, the only thing my doctor feels is left to suspect is egg quality (which she's treating me for with Femara and supplements) or an immune issue. She said she can have me tested for immune issues, but that they don't always give a full picture, and with my insurance, it's likely, I'd end up paying a ton to have certain tests done. So, she recommended Neupogen. It's an injection, but there are some studies that show it's ability to create a very healthy lining (which I know is something you have mentioned struggling with) and helps with implantation that would otherwise be prevented by immune issues. I know Braverman uses it, but it's fairly new, so I haven't heard of many others using it yet. Just wanted to give you the info in case that is something you'd want to discuss with an RI. Farrahttps://www.blogger.com/profile/01562761855454975575noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-61774272389176046192013-10-05T07:20:50.412-07:002013-10-05T07:20:50.412-07:00Using this couch time to catch up in blogs. While ...Using this couch time to catch up in blogs. While my mind is too spent to wrap my head around this, I'm going to pick your brain about recurrent loss and testing/questions to ask for. As soon as I get the strength. You should be an advocate. I've said it before but you having an amazing depth of infertility knowledge. Heidihttps://www.blogger.com/profile/13213799827326314663noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-36525982331303244332013-10-04T12:24:19.125-07:002013-10-04T12:24:19.125-07:00Oh, and P.S. I went through Sher's St. Louis c...Oh, and P.S. I went through Sher's St. Louis clinic when calling for the consult. Not sure if you called Las Vegas, but I wonder if that makes a difference? He practices in both, but his last round of IVF in St. Louis will be in Nov. so he's still taking consults through their practice right now. Emilyhttps://www.blogger.com/profile/07415140299306373048noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-34683924986223575922013-10-04T12:17:55.490-07:002013-10-04T12:17:55.490-07:00It's quite possible that is the case Jessah, a...It's quite possible that is the case Jessah, and that is what my RE's hypothesis is. We did not have a need to do PGD (looking for a specific genetic disease) but we definitely could have done PGS (complete chromosomal screening) and just chose not to. When we did our fresh IVF, my RE said, "Not necessary to do PGS" but now that we've had a few transfers fail, he recommends doing it if/when another retrieval is needed. Kind of annoys me, because we would probably would have done it to begin with had he encouraged us strongly to do so right out of the gate. Yet again, an instance of his more conservative approach where he sees so many people get pregnant just fine WITHOUT the PGS, so why recommend it for every single IVF patient? I get it, but at the same time I am getting tired of trying and need to make sure we're checking all the boxes, even if it costs more and requires more effort and $. I did have a bit of a moral dilemma doing the PGS as well. You can read about that in my reply to Lindsey Lu above ^^Emilyhttps://www.blogger.com/profile/07415140299306373048noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-75756892322685150572013-10-04T12:11:08.929-07:002013-10-04T12:11:08.929-07:00Congrats Lindsey! We discussed doing PGS testing o...Congrats Lindsey! We discussed doing PGS testing of our embryos but ultimately decided against it. First reason, we were told we didn't really need it with our first try, would be like $5000-$7000 extra and that it's not 100% accurate ultimately. Of course we kind of wish we'd done it now, even if it cost extra $. We thought for sure IVF would just work for us. I guess we have one more try to find out if any of our 7 will work!<br /><br />Another reason we decided against doing PGS was that I've struggled with the idea of discarding aneuploid embryos. Reason being, we actually did chromosome testing on both hubby and I and were shocked to find out he himself has an abnormal karyotype (aneuploidy). You would never even know looking at him, and he's perfect in every way! Out of 50 of his cells tested, most had XY, but some of them were missing Y's. So aneuploidies do occur without anything actually being wrong with the person/embryo. What if my hubby's mom had done IVF w/PGS? They could have considered him "aneuploidy" and just discarded him! I would hate to do that with any potential children. <br /><br />However, I know we'd ultimately have the decision on what to do with each embryo, even after the PGS testing is done. It's my understanding that if you do the testing on Day 5 blasts, they test quite a few more cells from each embryo, and so the testing is more accurate, and less chance to discard an embryo based on abnormal testing from just one single cell (as is done with Day 3 PGS testing). For this reason, it's not completely out of the question if we do end up needing another retrieval. Guess we'll cross that bridge IF we have to go there. <br /><br />Thank you for the wonderful info. on HRC as well! I really appreciate you passing that along and will def check it out!Emilyhttps://www.blogger.com/profile/07415140299306373048noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-56956012350093701242013-10-04T11:58:20.725-07:002013-10-04T11:58:20.725-07:00I think it is smart to look into all possibilities...I think it is smart to look into all possibilities and I'm a huge proponent of getting second opinions. One question I was wondering...you said that you had 5 seemlingly normal embryos transferred. Did you have PGD done to ensure that they are normal (euploid) embryos? <br /><br />If not, is is possible that you are just transferring genetically abnormal embryos and that is resulting in the failure to implant or miscarry? Just a thought. Jessah @ Dreaming of Dimpleshttps://www.blogger.com/profile/02945119397487785737noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-45704029807428095092013-10-04T08:25:59.594-07:002013-10-04T08:25:59.594-07:00Hi Emily:
I have been checking in on your blog for...Hi Emily:<br />I have been checking in on your blog for quite some time. I can't remember, when you had your initial retrieval, did you have your embryos biopsied and tested before transfer? I only ask because that could be a really simple (maybe too simple) answer to your issues so far with IVF not working. We recently went through IVF, and THANKFULLY it worked. I really account our success to our doctor! We were only able to retrieve 10 eggs, 7 mature and all 7 fertilized using ISCI (did I get that acronym correct...???) Out of the 7, 6 made it to biopsy. From all accounts they looked like strong healthy embryos, however only 2 were "normal! My hubby and I are both early 30's (32 and 33), and in general in good health. We had NO REASON to suspect that we would have any abnormal embryos. But to our surprise more than half were! I can't imagine now NOT testing. We could have been trying and trying to transfer and could have been potentially transferring the abnormal ones! If you ever want to think about coming out to Southern California for a second opinion, I HIGHLY recommend my doctor's clinic, HRC Fertility. They have one of the highest success rates in CA (so I was told, I didn't really research it). We came into contact with them because my husband's cousin used them. They have 3 beautiful boys (a singleton and twins) all from IVF and HRC! I am wishing you all the best in your endeavors to become pregnant and ultimately a mother! I will keep you and your hubby in my thoughts and prayers! <br />Best!<br />Lindsey Lindsey*Luhttps://www.blogger.com/profile/16540280211427743869noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-19599841699437100562013-10-04T07:31:55.591-07:002013-10-04T07:31:55.591-07:00Although I do believe that immunological factors c...Although I do believe that immunological factors can play a huge role in fertility (my husband has an autoimmune disease and I often wonder if that is what is also causing his infertility) like you said, it would be hard to jump into any form of treatment if it has not been thoroughly tested and proven to work. I think you are doing the right thing by trusting your RE while also doing everything you can do naturally through your diet to decrease the risk of an immune response.<br /><br />I am wishing you all the best! xoGypsy Mamahttps://www.blogger.com/profile/13026496787029080243noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-42880011695065190802013-10-04T06:35:01.194-07:002013-10-04T06:35:01.194-07:00Hmmm something else to think about. Thank you for ...Hmmm something else to think about. Thank you for sharing this, Emily. It's always so hard to know whether or not to "open another can of worms." Personally, I'm pretty confident my issue is my eggs ... At this point, I almost want that to be my issue in a way so I don't have to do more digging. :/ Something else to ask my doctor about today!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-43513305572543346402013-10-04T06:34:56.654-07:002013-10-04T06:34:56.654-07:00Yeah, not sure what we'll do with our results ...Yeah, not sure what we'll do with our results either. Guess we'll cross that bridge when we come to it, depending on what the first test says. I'm definitely treading lightly into the immunology waters, but I do think there is something to it that's worth exploring with my history.<br /><br />I hope your insurance will cover some things for you! I am still waiting on the call to set up my blood draw. It's been 2 days since Sher's office said Reprosource would be contacting me. I'm not going to hunt them down, so we'll see how long it takes them to call me. Emilyhttps://www.blogger.com/profile/07415140299306373048noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-83523643032363001222013-10-03T19:48:22.337-07:002013-10-03T19:48:22.337-07:00Are we living the same life?? I have been thinking...Are we living the same life?? I have been thinking about looking further into the immunology and actually spoke to an immunologist today. I still need to discuss it with my husband (there's too much going on), but it makes sense to at least test. What I choose to do with the results potentially could be another whole issue, but as I explained to the immunologist some of the drugs and protocols the doctor has tried on me, she described it as just trial and error rather than really knowing if I need it or if it will help me (and whatever all my issues are). <br />I will be contacting reprosource probably tomorrow to see if my insurance will cover the blood tests... <br /><br />Thank you for this post. Lots to think about... I hate having to decide what to do or what not to do, and I hate even more wondering if someone is just trying to make money off of you or truly has your best interest at heart! <br /><br />I will be interested to hear more of what you learn!Anonymoushttps://www.blogger.com/profile/02776159795284248871noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-85747608845747910612013-10-03T17:30:50.679-07:002013-10-03T17:30:50.679-07:00See, now that is what irks me...the fact that Brav...See, now that is what irks me...the fact that Braverman would make a blanket statement about ALL those tests. My RE happens to agree with him on the Beta integrin test not being very valid, but c'mon....HSG and hysteroscopy having no benefit? I don't buy that one bit. So, are you doing any testing at all then for curiosity sake, or no? Emilyhttps://www.blogger.com/profile/07415140299306373048noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-58051986745538552482013-10-03T17:28:30.029-07:002013-10-03T17:28:30.029-07:00Well that's some crap you didn't get your ...Well that's some crap you didn't get your free consult! What gives? It seems that most of the RI's are replacing IVIg therapy with Intralipid therapy these days, although some still recommend IVIg. I am really hoping for no activated natural killer cells so I will never have to even be given the recommendation for either of these. We shall see.<br /><br />Like you, I am pretty hardcore with a healthy diet while cycling, eliminating anything that can remotely cause an inflammatory response; gluten, dairy, alcohol, etc. Just so happens the last two times I've at least gotten a short lived pregnancy, I've been totally gluten free. Last time I was also on Lovenox. My RE is totally against using prednisone, even though I've asked about adding it numerous times. He has finally relented to give me dexamethasone for this "last chance" FET which I'll add to the estrogen, Lovenox, baby aspirin, and progesterone. Who knows, maybe I should just suck it up and use PIO instead of Crinone just to try something different? It's such a crap shoot isn't it? <br /><br />I REALLY hope that you have success this time around. I would love to see you get pregnant despite not using either of those RI's!Emilyhttps://www.blogger.com/profile/07415140299306373048noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-31836109848936046612013-10-03T16:34:26.283-07:002013-10-03T16:34:26.283-07:00Well, this post pissed me off!
Not you, of cours...Well, this post pissed me off! <br /><br />Not you, of course, but Dr. Sher! So after my 2 unexplained losses AFTER hearing a heartbeat both times... and chromosomal testing for my twins (first pregnancy) and everything coming back NORMAL... my RE insisted I see Dr. Braverman. I called. $900 for a consult. No, thank you.<br /><br />Then, I found out that Dr. Sher did free Skype consults, so I called them. The receptionist claimed that he stopped doing them, and now a Skype consult was $450! And this was legit two months ago. So WTF??<br /><br />Right now I'm PUPO after my third IVF, taking a whole lotta things recommended in the book Is Your Body Baby Friendly (PIO shots, baby aspirin, Prednisone, Lovenox). I loved the book, but it also made me freak out more than necessary, I'm sure. Plus, I can't really afford to do IVIg (up to $5,000 per session?) and that seems to be what they recommend for the killer cells. The whole thing is so overwhelming.<br /><br />I'm also doing a hardcore elimination diet, cut out everything but the bare basics. No gluten. That seems to be the one thing that's linked to miscarriage. In my case it seems like diet/allergic reactions are linked somehow. I truly wish there was more established research in this field.<br /><br />I really hope you find your answers. I don't know if I've ever commented on your blog before, but I've been following you for a while. The next time you talk to Sher, tell him I'm so pissed! I want a free consult and pro bono testing! No fair! Haha.Deedahttps://www.blogger.com/profile/02386061097583007160noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-39528020633011466742013-10-03T13:56:09.596-07:002013-10-03T13:56:09.596-07:00You are so wise! So impressed with all your resear...You are so wise! So impressed with all your research! I look forward to hearing how the results come back and what else you find out from the doctor! So glad you got to speak with him!!Caroline @ In Due Timehttps://www.blogger.com/profile/16261569299914107796noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-86335786909097252562013-10-03T13:11:05.541-07:002013-10-03T13:11:05.541-07:00Great job, Emily! I know a lot of people are reall...Great job, Emily! I know a lot of people are really interested in this, and you always explain it all so well! Hopeful that the test will give you an answer and that you will feel confident moving forward after the results!Amandahttps://www.blogger.com/profile/11657607481465480125noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-22686923797125571252013-10-03T11:51:26.519-07:002013-10-03T11:51:26.519-07:00I always wondered if my body rejects pregnancy bec...I always wondered if my body rejects pregnancy because all of our ducks are supposedly in a row. I will request a full work up again when we are starting IVF. I can't wait to hear how it goes for you.Charityhttps://www.blogger.com/profile/12085408470703258088noreply@blogger.comtag:blogger.com,1999:blog-7052836858232611779.post-17396581467779517132013-10-03T11:42:52.341-07:002013-10-03T11:42:52.341-07:00I'm really enjoying learning more about RI thr...I'm really enjoying learning more about RI through your experience. I hope this test leads to more answers rather than more questions. Looking forward to hearing more!dspencehttps://www.blogger.com/profile/03028178955338687090noreply@blogger.com