IVF failure related to immune problems - lifestyle advice

[Cariad82]

I have just had my third failed IVF cycle. The last 2 were chemical pregnancies. All test results so far are normal, infertility unexplained, I've got a good lining, I've had the extra progesterone, asprin etc.

I am now interested in immune issues as a possible explanation as to why the embryo is implanting but not sticking around. I have already pre-paid for 2 more cycles at my current clinic as we bought a multi cycle package, so I am committed to them for another 2 cycles. I am going to push for immune testing/treatment but I've brought it up with them before and it's not something they're keen on. If the next 2 cycles fail I will look at going somewhere more specialised.

In the meantime though, does anyone know of any lifestyle changes I can make that might help any potential immune issues? Or good books I can read on it? I've already read it starts with the egg and adopted their recommendations (natural cleaning / beauty products, organic food, supplements, no BPA's etc). I just want specific advice for immune issues. Might going gluten free help for example?

I won't be doing another cycle for about 3 months and if there's anything I can do that might help the next one I will try it.

Thanks

Hi @Cariad82 - I'm sorry it has been so tough for you; chemical pregnancies are so cruel.

I'm currently 9+2 after my 4th cycle. The difference this time is that my clinic were willing to listen to my insistence that something was affecting development immediately after implantation, so they put me on Inhixa injections (anticoagulants), prednisone (steroid), and aspirin as well as the usual oestrogen and progesterone. I got test results back after the clinic agreed to prescribe these (I had the tests abroad as it was much cheaper) confirming that I have high levels of activated NK cells, but in hindsight I didn't need to pay for the test as my clinic already agreed to prescribe empirically, so that was a waste!

Maybe your clinic might do the same next cycle? Mine took the view that it wouldn't do any harm, but might do some good.

Oh and both times I got pregnant (one current, one chemical) I'd had an endometrial scratch.

Hi @RedPandaFluff - I remember you from previous boards. Congratulations on your pregnancy, that's amazing news. I'm really happy for you.

Thanks for the advice. I really do feel there's something amiss, like you said you felt. I'm going to really push this time. Maybe now I've had a second chemical they will take me more seriously.

For both chemicals, I tested out the trigger then got a very clear positive on the exact same day of embryo development on each cycle. 4 days before my OTD. Then over the next 4 days it faded whilst I had spotting that increased daily. I think it's odd that it's happened in exactly the same way both times. Both embryos looked good on transfer, my lining was good each time, they definitely implanted, so what the hell is happening??

Where abroad did you have the tests done, and was it a fairly easy process?

I've never had a scratch - everything I read say they are unnecessary and painful. Did you find it painful? I'm hesitant to have yet another uncomfortable procedure.

Thank you for the congrats - I don't feel confident that this is it just yet, but it's as far as I've ever got so fingers crossed!

I had all the tests done at the Gennet clinic in Prague - after 3 unsuccessful gos, and a gut feeling that there was something more than the original fertility issue, I wanted to rule out some basics, so I had the following:

Hysteroscopy
Endometrial scratch
Immune testing (including NK cells)
Karyotype
Sperm DNA fragmentation
MTHFR gene testing

It all cost £2.5k but would have cost close to £6k in the UK, and it gave me some peace of mind that the next cycles weren't necessarily doomed to fail because of uterine polyps or bad sperm etc.

The scratch is absolutely fine - I've had two, and it's no worse than embryo transfer or a cervical smear. I did some research and it seems to be one of the more clinically proven add-ons.

I'd push your clinic to prescribe anticoags like clexane/fragmin/Inhixa and prednisone before you shell out for tests, though - I'm glad I did the hysteroscopy and scratch but the rest weren't really necessary, I was just building ammunition I didn't need in the end!

Hi Cariad I'm so sorry to hear you've had so many chemicals that's really hard. After my second ivf failure my consultant couldn't work out what was going on given I had unexplained infertility and everything was fine - hormones, ovulation, lining etc. I had immune testing and came up borderline, so did the intralipid treatment before my third transfer (which stuck). My clinic have done their own trials, small numbers so not robust enough to publish but they've had good results so my consultant is open to immune treatment.

Sorry I can't give you any research to look at, but I would push for testing at least.

Thank you both. This has given me lots to think about and I'm definitely going to put some of these into place for my next cycle. I refuse to just keep doing the same thing and hope for a different result - definition of insanity right?!

If immune issues are the problem then losing weight, drinking more water, taking steroids and having intralipid drips is the treatment option.

Defo the definition of insanity, expensive too! Really hope you can get treatment and it works out for you cariad. Will you keep us posted?

Yes I will definitely keep you posted. It drives me mad when I read a thread looking for an answer to a question and the OP doesn't let you know know how it all turned out!

I am going to do my research, have a thorough chat about all this with my consultant at my existing clinic and see if they will treat immune disorders empirically and if not I will look at a specialist elsewhere. I'm also going to make some lifestyle changes. I have 3 months until I cycle again.

Thank you all taking the time to give me some advice x

Interesting thread. Are there any other symptoms apart from failed cycles that might point towards immune issues?

This is interesting:

theconversation.com/suppressing-the-immune-system-wont-improve-your-chances-of-conceiving-with-ivf-65562

Thanks @AliceAbsolum that is interesting. It's really hard to know what to think isn't it? And I know some doctors don't buy in the the whole immune issue thing, but when there seems to be so much anecdotal evidence it's hard not to want to try.

I guess with the intralipid infusion it can't hurt, it's literally a soy and egg fat solution. I didn't have the steroid drugs they discussed in the article, so can't comment on that. I guess I felt it couldn't hurt, it wasn't painful or that expensive, so worth a try in terms of the risks and potential reward.