Results of LAT and NK Cells Post LIT

Here are the results of my LAT and NK Cells after 2 LIT sessions using 2 donors each.

LAT after 2 LIT sessions using 2 donors

My LAT has improved! Thank God! :) From 10% and 5%, it has gone up to 76% and 41% with reaction code of 6 (strong positive) and 4 (positive reaction).    

NK Cells test results after 2 LIT sessions using 2 donors

As for my NK Cells, it is now within normal range.  Cut-off is 12.  From 14.39, it is down to 10.61.  Finally!

Though results are quite good, my immunologist still suggested that we go for another set of LIT using 2 donors to further increase my LAT score and also to lower my NK cells.  This we have done last September 4, 2012.  Hopefully, with this LIT session, my LAT will go as high as 100% and my NK cells will also decrease.  All of these we are doing in preparation for the IVF.  

Hope it works...

Lymphocyte Immuno Therapy (LIT) Session

A typical LIT session starts with the extraction of blood from husband or donor.  As early as 8am, you can go to Manila Endocrine Lab (MEL) to have your husband’s or donor’s blood extracted. 

Before I forget, you must make sure that the donors have their blood screened first to make sure that they don’t have any diseases that could be transferred to you.  The blood screening should be done a few days before the actual blood extraction.  The test should include the following: CBC, malarial smear, RPR, HIV, Hepa B, and Anti-HCV.  You must present the results of the blood test to the med tech at MEL.

12 vials of blood will be extracted from your donor.

  

After this, the laboratory will then process the blood wherein only the lymphocytes or white blood cells will be extracted.  You will be surprised that out of the 12 vials of blood, only a small vial of white blood cell will be extracted and that will be the one to be injected to us.   

Kuya Reggie of MEL will bring the white blood cells to the clinic of Dra. Aleta at Don Santiago Building.  He usually arrives around 12:00noon, so I usually go there around that time also.

Dra. Aleta will then inject the white blood cells under the skin (sort of like allergy test). My husband took a video of the procedure and here it is.  Warning: Not for the faint-hearted.  

I am not allowed to remove the bandage for 48 hours... not allowed to wet the area and exposed it to sunlight also.  Rashes, pain and itchiness in the injection spots are expected.  

Here's a picture of my arms after removing the bandage.  After this, the injection spots will bruise, like insect bites.

LIT can be done weekly, every two weeks or every three weeks depending on your preference or depending on your need.  You can either use one donor or two donors. The donor can be your husband or other people not related to you.  

Before, I used my husband's blood, but after 4 LIT sessions, my LAT still did not go up, so right now we are using donors' blood for my LIT.  For my recent LIT sessions, we used the available donors from MEL.  You just have to pay an additional of Php1000 per donor.  They say that these donors have been tried and tested already. Their blood were already screened as well.  Ate Aw of Mel sent me their blood screening results through email.  You can always request for that if you want.

I'll be having another LIT session this coming Tuesday.  I just hope that all that we are doing will really be worth it... Hoping that my LAT will increase ASAP.

Consultation With My Immunologist

I went to Dr. Lara Theresa Alentajan-Aleta, my immunologist at the Don Santiago Bldg. across PGH in Taft Avenue last July 10, 2012.  I presented to her the results of all the blood tests I’ve done and here was her interpretation.

My LAT was back to negative. 

My KCT was high.

My NK Cells was also high.  (Though it was within normal range, according to Dr. Aleta, the cut-off should be 12.  Mine was 14.39.)

So, my options are the following:

1. LIT – Lymphocyte Immunotherapy Treatment (solution for Category 1 and 5 problem)

2. IVIG – Intravenous Immunoglobulin (solution for Category 1 and 5 problem)

3. Intralipids infusion (solution for Category 5 problem)

4. Take aspirin 80mg once a day (solution for Category 2 problem)

I told Dra. Aleta that we are planning to have IVF in Taiwan by September 2012.  So, we are doing this in preparation for the IVF.  

According to her, we can either have IVIG before going to Taiwan or have LIT. 

IVIG is more expensive and it will only stay in my body for a month.  LIT, on the other hand is cheaper (but will need at least 4 sessions or more depending on my body) but once my LAT is up, it could stay in my body for 6 months.  If within 6 months, I don’t get pregnant, I have to have booster shots to maintain the LAT. This, I wasn’t able to do before, that is why my LAT returned to 10% and 5%, which is considered a negative reaction.  So, it is very important to remember this: Booster shots within 6 months if you don’t get pregnant to maintain positive LAT.  If not, you’ll have to do it all over again, just like me.

So, Dra. Aleta and I agreed that we will have LIT since I still have time to do it before going to Taiwan.  So our schedule is this:

July 17 – LIT using 2 donors

July 31 – LIT using 2 donors

August 14 – blood test

Then we will decide from there if I need additional LIT and if I still need to have intralipids infusion.

Another thing I asked Dr. Aleta is how can I increase my LAT naturally.  Her answer: Avoid xenoestrogens.  Avoid processed and canned foods.  Avoid using styro and plastics.  Do not use fabric softeners.  Stop using make-up and lotions that contain paraben.  Avoid eating meat.  It is ok to eat fish, vegetables, fruits, seafood, organic eggs and free range chicken.

She asked me if I am taking any vitamins and I said I was taking Usana Essentials, Calcium, Biomega and Proflavanol.  She asked me to continue taking the vitamins and on top of this, she prescribed Glutathione 500mg, 1 capsule daily.  The brand she prescribed was Cosmo Skin which can be bought at Watson’s for Php45 per capsule or Php1350 per bottle of 30 capsules. 

That's it for my consultation with Dra. Aleta.  

I'll be posting my LIT session soon.

Have a great day ahead!

LAT Result

Here’s my recent LAT result from Manila Endocrine Laboratory (MEL).

I should have gotten the result already last Friday.  However, Ate Aw of MEL called me up and told me that my result was very low and since she knew that I had my LIT sessions done before, she was surprised with my very low result.  So just to be sure that there was no error whatsoever on their part, she wants my blood to be retested again by a different laboratory to verify and confirm the result.  Just so that both of us can have a peace of mind, she had it retested without me paying anything in addition to what I have paid for.

  

The result came out already and here it is…

Both results showed that my LAT is back to negative again.  It’s been more than a year already since I had my LAT checked… If I remember it right, it was last April 2011 when my LAT has increased to 100% but with only a reaction code of 4 (positive reaction).  That was after 9 LIT sessions.  Since then, I haven’t checked my LAT and did not undergo any LIT session.

For those of you who are not familiar with LAT and LIT...

LAT - Leukocyte Antibody Test

- This test is done to measure if you produce blocking antibodies to stop the immune system from attacking and rejecting the fetus.  The problem is when the woman shares the same antibodies with her partner; in other words the couple’s DNA is too similar.  Normally the father’s DNA in the embryo tells the mother’s body to set up a protective reaction around the baby.  But when this blocking effect does not happen, the baby is rejected. 

LIT – Lymphocyte Immunization Therapy

- This is the treatment for those who have negative or low leukocyte antibodies, in which the male partner or donor’s white blood cells are injected into the woman to help her body increase the level of leukocyte antibodies in her blood.

Low levels of leukocyte antibodies have been linked with fertility problems.  Women with lower than normal levels of the antibodies are more likely to experience miscarriage, have stillbirth and have repeated spontaneous abortions.  Those struggling with infertility especially those with unexplained infertility, multiple miscarriages and continued IVF failure can benefit from this test.

Normal result should indicate that you have tested positive for leukocyte antibodies in your bloodstream.  A normal LAT level is above 50%.

Borderline normal results mean that you do have leukocytes antibodies in your blood, but in less than typical quantities. A measurement between 30% and 50% is considered borderline.

Abnormal results indicate very low levels of leukocyte antibodies in the bloodstream. Levels of less than 30% are considered abnormal. (Source:www.sharedjourney.com)

This I think is one of the factors contributing to my infertility.  Though my LAT has increased to 100% already, the reaction was only 4 which meant that it was only a positive reaction and not a strong or very strong positive reaction.  Most likely, my LAT level at that time was just borderline.  I should have continued my LIT sessions then...  Oh well, now I’m back to zero and I have to start all over again...

They say that the leukocytes antibodies from the LIT can stay in your body for 6 months.  That is why once your LAT has increased to 100% and has a very strong positive reaction of 8, you should get pregnant within 6 months.  If not, you have to have booster shots to maintain your LAT.

I have yet to consult my immunologist with regards to the result.  I will update you again after my appointment on Tuesday.

Have a happy weekend!

Blood Test at Manila Endocrine Laboratory

I just had my blood tests done here at Manila Endocrine Laboratory this morning. It's been more than a year since I last checked my LAT, APAS and NK Cells.  Since we're planning to go through IVF, we decided to have these rechecked again and see if there are still problems...  At least, we can still work up on the problems before going to Taiwan for the IVF.  Though our doctor in Taiwan do not believe that my immunological problems are the cause of my infertility, we chose to work up on this side as well.  Better safe than sorry.  This is because I have heard some people who have gone through IVF without fixing their immunological problems first, and they got negative results in the end... 

This is the gate of Manila Endocrine Laboratory.

  

Took this picture while inside the car because it was raining this morning when we went there.

Go straight inside and you'll see this clinic.

This is the blood extraction area.

The tourniquet (tight band) has been placed around my upper arm... and now the medical technician is looking for the vein...

After putting alcohol on the skin over the chosen vein, the needle connected to a syringe was then inserted into  my vein. Ouchy!!!

Extracting bbloooooddd....

After extracting the required amount of blood, the needle was removed.  The small wound was pressed on with cotton for a few minutes to stop bleeding and prevent bruising.  My blood was then placed in these vials. (Only 4 vials in front)

Cost of the tests:
Lymphocytes Antibody Test (LAT) - Php3,500
APAS Test - Php5,000
Primary Immuno Deficiency Panel 1 (for NK Cells) - Php5,800

Total: 14,300

Only a few laboratories do these testings and prices vary.  LAT and APAS tests can be done in PGH-Medical Research Laboratory (Contact Number 5548400 Loc. 3232) every Monday to Friday, 8-10am. Results are released every Friday. Prices are Php3,500 and Php6,410 respectively.

For the Primary Immuno Deficiency Panel 1, you can also have it tested at St. Luke's Global (Contact No. 7897700), 2nd floor pathology for Php5292.  Actually, even if you have it checked at the Manila Endocrine Lab, they will send it to St. Luke's Global for the testing because they are only the ones who can do this kind of testing here in the Philippines.  APAS and LAT testings can also be done in St. Lukes, but are more expensive.

Results:

The results of my APAS tests will be sent to me via email tonight. As for the LAT and NK cells, most probably I will get them on Saturday.  

They run the LAT testings every Friday morning and results are out in the afternoon or by Saturday mornings. So if you want to get your results asap, it would be better to have your blood extracted by Thursday of the week.

For the NK cells test, it usually takes about 2-3 days for the results to come out if you do it in St. Luke's.  So here in Manila Endocrine Lab, results are expected around 3-4 days since they have to bring the blood to  St. Lukes.

Note:  Fasting of 4-6 hours is needed if you are going to do the APAS test.

How to go to Manila Endocrine Laboratory:

That's all for today.  I will update you again of the results as soon as I get them. Till then...

Core Strength Vinyasa Yoga with Toinette

http://www.flickr.com/photos/djrome/

Every time I would arrive home after my yoga class, I feel amazingly wonderful.  I felt SO good.  There is a sort of release physically and mentally that makes me feel so relax and calmed.  Everything seems so peaceful.  Moreover, it lifts up my spirit and gives me immense joy.  It is really a total body, mind and soul experience.

I started the practice of yoga just recently, about two months ago.  It happened during the time when I was so depressed because my LAT (Leukocyte Antibody Test) results would not improve even after 6 sessions of LIT (Lymphocyte Immunotherapy).  See My Infertility Story for more information on this.  I asked my immunologist on what lifestyle change I can make to help my body respond better to the immunological workup we were doing.  She suggested four things: 1. Take Conzace three times a day. 2. Yoga. 3. Acupuncture 4. Less stress. 

Very desperate at that time, I did everything!  And that was how I turned into yoga… and loving it.  I believe that with the help of Yoga, my LAT results improved.  From a PRA of 0%, now it is 100% already.  I believe that yoga has reduced my stress level.  It has calmed my nervous system and strengthened my immune system.  Moreover, it has helped replaced my mind with positive thoughts.  It brought balance to my body, mind and spirit.  I’m really very thankful that I was able to practice Yoga.  Thanks to my friend Cherry who brought me to Yoga with Toinette.

Because I gained a lot of benefits from my practice of yoga, I want to share this with you.  Thus, I interviewed my yoga instructor so that you can get to know all about this fantastic activity better and start reaping its benefits as well. 

Toinette Villajin is a yoga teacher, wellness entrepreneur, dog lover, traveler, dreamer, believer, foodie who lives life to the fullest, and touches other people’s lives through her passion.  She is the Yoga Director of Shui Hilot Spa.  She teaches Yoga for High school students of Reedley International School and she has various private group classes in Metro Manila.  She also does yoga and wellness retreats and events.  She partnered with Dr. Gerry C. Sy N.H.P., the leading Naturopathy Health Practicioner in the Phillippines and launched Ki mind.body, a wellness company which aims to share their passion to others --Yoga and naturopathy.  They offer personalized program combining yoga and naturopathy. She is currently working on a yoga clothing line. She has a very positive energy and desires nothing more than to spread it.  Yoga is her passion, wellness is her business. Sharing and inspiring others through yoga and wellness is her life‘s purpose.

So, she is here to share with us some information about the practice of yoga.

Tell us more about yourself.  

I was born August 16, 1982, a Leo and the eldest of three girls.  I spend most of my childhood in Japan.  I have a Bachelor’s Degree in Wholistic Human Development and Management at the Assumption College.

When and how did you get interested in yoga?  

I started practicing yoga in 2005.  In 2007, I experienced a major crossroad in my life. It was during this time that I took yoga practice into a deeper level.  Through yoga, I was able to overcome and move forward.  This experience affirmed my aspiration to teach yoga.  

How did you get into teaching yoga?  

My calling to be a yoga teacher was answered in the spring of 2009.  I met Sadie Nardini in Union Square, New York.  I was trained and certified by Sadie, an Ultimate Wellness and Yoga expert, and is the founder of Core Strength Vinyasa Yoga.

What is yoga?  

The word yoga comes from a Sanskrit word Yuj, it means to center one’s thought, to concentrate on one’s self, to meditate.  It also means to “unite”, “join” and “connect”; a bringing back into balance.  Yoga harmonizes the body, mind and spirit. 

After their first yoga class, people often testify that they have improved their sleeping habits and posture.  Yoga has helped people lose weight, overcome fears, conquer habits like smoking, and develop better concentration.  Others feel they have improved self-awareness, a deeper sense of well-being, developed compassion, and enhanced relationships, greater self-acceptance and a sensation of being at peace.

What type of yoga do you practice?  How is it different from other types of yoga?  What in your opinion are the greatest health benefits of doing this kind of yoga?

Core Strength Vinyasa Yoga by founder: Sadie Nardini:

I prefer to call Core Strength Vinyasa Yoga a “perspective” on all yoga, rather than just its own style.  I created it after years of training and study where I was seeing a lack of either understanding or focus on the core of our yoga poses on all levels: physical, mental, emotional, spiritual and energetic.

Along the way, I was fortunate to meet one of my formative teachers, Leslie Kaminoff of The Breathing Project in NYC, and author of the bestselling Yoga Anatomy.  Under his expertise in yoga, philosophy, anatomy and pranayama, I continue to evolve my understanding of the multi-faceted core. 

Out of my journey into deep Center came my Core Principles, ways to clarify what the core is, exactly how to instruct it and activate the core within the yoga practice. 

To help students experience their Center, I created my Core Poses, specific movements, postures and sequences that bring the student into more core-generated alignment, improving safety and stability while causing a more efficient total body/mind transformation. 

Together, my Principles and Poses simplify how to access, comprehend and use the “core” most efficiently to gain the maximum yoga benefits (calorie burn, strength, flexibility, focus, self-awareness, confidence…) in the least amount of time. 

Because of its multi-level actions, and focus on constant core connection, Core Strength Vinyasa Yoga is one of the most effective yoga practices for sparking major changes both inside and out. 

In my view, the “Core” is too often seen as only the superficial abdominal muscles.  They are important, but there is a whole world of muscles, actions, energy and philosophy contained within the core of the body and spirit complex.  I teach it all to you so you can demystify what’s at your core and how you can make it work for you instead of against you both on and off the mat.

My interest in cutting-edge anatomy (pun intended) led me to study the myofascial meridian work of Tom Myers, as seen in his book Anatomy Trains.  His findings expand our idea of the core from 6 abdominal muscles to multiple head-to-toe interconnecting lines of muscle that make up our innermost support system. 

In classes with me, you’ll learn how to break the habit of moving only from the outer body and loading layers of tension onto yourself.  You will discover how to use your Deep Core Lines along the skeleton to make quick gains in true power, making all your poses more possible as you keep your body healthy for years of yoga to come.

When you go deeper, you balance stability with mobility, strength with freedom, or Sthira-Sukha, and all your yoga benefits will increase.

Can yoga really help infertility?  How can yoga help treat infertility?

The medical community has conducted only a few studies involving the ideal mind-body connection for conception.  The majority of results indicate that many couples simply need to relax.  Practicing yoga postures for infertility, while perhaps not an absolute guarantee of conception, can at the very least promote a refreshed mind and spirit while you restore the body in preparation for its new journey.

Are there any poses or breathing exercises that you can recommend for people dealing with infertility?

--Instead of saying, "I just have to get pregnant!", establish your intention through meditation.

--Repeat a phrase that awakens a peaceful spirit.  This mantra helps you declare your purpose without fear or   negativity.

--Envision yourself holding your healthy newborn. Return to that image if other thoughts invade your session.

--Practice a short meditation at the beginning of the day, and perhaps again before intercourse or fertility treatments.

Is there a healthy yoga routine you can share with us and how often do you suggest practicing it?

Yoga postures for infertility are best described as fertility poses because they spark hormone production, promote full body restoration, and increase circulation to reproductive organs to encourage responsiveness.

Start by stimulating the hormones with poses such as:

Supported Head Stand
Bridge Pose 

Rejuvenate the body through the following postures:
Wide-Angle Seated Forward Bend
Child's Pose
Seated Forward Bend
Bound Angle Pose or Cobbler's Pose

Simultaneously stimulate and relax the abdominal and reproductive areas with these poses:
Reclining Bound Angle Pose
Lotus Pose
Reclining Hero Pose

If some of these postures seem a bit uncomfortable at first, use a bolster, pillow, or folded towel to help you ease into the pose.  These tools are especially effective for the reclining postures.

Yogis familiar with fertility yoga also suggest doing the Legs-Up-The-Wall Pose after coitus for better sperm penetration of the uterus.

What advice do you have for people who have never tried yoga and are interested to?

Start with an open heart and mind.  Do not put any pressure on yourself, enjoy each breathe, each movement.  Keep in mind that yoga is a practice, everything develops through practice.

Yoga classes of Toinette are simple, fun, engaging and open to any levels.  Here is here class schedule: 

Tuesdays 7am Shui Makati / 7pm White Plains Social Hall

Thursday 7am Shui Libis / 7pm White Plains Social Hall

Sunday 7am Shui Makati

She also does Yoga corporate classes, yoga workshops, one-on-one yoga class, private group classes, yoga retreat and other wellness events.  To know more about her, you can visit her website.

Thank you so much Toinette for sharing your expertise, experience and knowledge with us.  I know it will provide a window of help for many to know that we can overcome so much with yoga, whether physically, mentally, spiritually or emotionally.

You can also give Yoga a try!  You have nothing to lose except some tension and stress!  Happy Yoga!

My Infertility Case Exposed

My husband and I were married on May 1, 2005… that was 6 years ago.  We were not in a hurry to have a baby then as we were still enjoying our lives as a couple.   I was just only 24 years old then.  Most of my friends were not even married yet.  I have a regular 28-day cycle.  So I thought everything was normal and getting pregnant will come naturally.  There were no pressure, no rush, no worries… we were just enjoying and taking our time…  Little did we know that getting pregnant isn’t as easy as it seems to be for others…

See  An Infertility Specialist After a Year:

After a year, that was when we started getting a little worried.  Is there something wrong with us?  Do we have any infertility problem?  Why am I not getting pregnant yet?  I think it is time to see a fertility doctor…

True enough… once you have been trying to conceive for more than a year without success, it is time to make an appointment with a fertility specialist for evaluation.  Infertility is defined as the inability of a couple to successfully get pregnant after a year of unprotected, well-timed intercourse. 

It is but normal to feel uneasy, and worried of what you will find out through the series of fertility tests you are about to undergo.  Just think of it this way, if you find out what is wrong with you, you can do something about it.  

Fertility Testings for Men

So, we went to a fertility specialist and had our initial fertility tests with her.  She requested for a semen analysis from my husband.  This is usually requested to rule out the problem from the husband.  Results showed that his sperm count (the number of sperm per millimeter) was sufficient but the morphology (the percentage of abnormal sperm) was high.  So the diagnosis was Teratozoospermia or high levels of abnormal sperm.  But normally, OBs do not worry too much on this.  As one of my OBs told us, “As long as there are sperms available, there is no problem.  We only need ONE” 

Being a paranoid, I persuaded my husband to see a urologist, a doctor who has specialized knowledge and skill regarding problems of the male and female urinary tract and the male reproductive organs.  Further blood tests and ultrasound were requested.  It came out that he has varicocele.  This condition is similar to varicose veins but involves enlarged veins around the testes which can inhibit sperm production and affects the quantity and quality of sperm produced.  Varicocele can overheat the testes, thus causing problems with fertility.  However, treating this problem by surgery was not recommended to us by the urologist.  According to him, the surgery will not increase our chances of conception significantly.  He advised us to just proceed with artificial insemination instead.     

Fertility Testings for Women

Now, it is my turn.  There are far more fertility tests to be done for women than men.  Oh, life is really like that… So, here are what I have done so far.  I divided it into four groups so that it would be easier for you to understand it.

1.     Hormone testing – Blood tests are usually done on Day 2 or 3 of your cycle to check for hormonal imbalances or disorders that might be preventing pregnancy.  I was asked to check for the following:

a.      FSH (Follicle-Stimulating Hormone) – this hormone stimulates the growth and development of the follicles on the ovary during the follicular phase or first half of the menstrual cycle; high FSH level show fewer eggs left and poor egg quality; mine is normal

b.    LH (Luteinising hormone) – released by the pituitary gland to stimulate ovulation; mine is low; if you have high LH, you may have PCOS or polycystic ovary syndrome.

c.     Prolactin – this hormone is released by the pituitary gland and high levels can stop ovulation and menstruation; mine is a little bit high probably because of stress

d.    TSH (Thyroid hormones) – responsible for controlling thyroid function; mine is also normal

2.   Monitored Cycle –  This is done monthly to know your fertility status and know what plan of action to take next; Depending on your OB, you are usually asked to go to the clinic on the Day 2 or 3 of your cycle for check up.  Then ultrasound follicle monitoring on Day 6-8 to check if there is an egg and also to check the endometrial lining.  Abnormalities such as polyps and myoma can also be seen during this time.  Another ultrasound for follicle monitoring on Day 10-14 to check on the size of the ovarian follicles, and check on the thickness of the lining of the uterus to help predict the time ovulation. Then, you’ll be given a “schedule” as to when you are to have intercourse.  This is called timed intercourse.  Some OBs also give fertility drugs like Clomiphene Citrate or Femara.  This is for ovulation induction and is taken for 5 days starting from Day 2.  

Through the monitoring done by transvaginal ultrasound, I found out that I do ovulate and I have endometrial polyps and myoma.  Most of the time, OBs will not ask you to have the polyps and myoma removed at once because there are many people who also have those but get pregnant also.  In my case, I had my polyps removed last December 2010.  OB did not remove the myoma or uterine fibroid because according to her, in my case it is not the culprit to my infertility.

3. Tubal and uterine investigations to see if there are any structural (anatomical) problems of the reproductive system that causes infertility; usually done on the first part of menstrual cycle to ensure you are not pregnant

a.     Hysterosalpingogram (HSG) – This is a test where a dye is passed through the fallopian tubes to check for blockages that could be stopping the egg or sperm progressing.  This is done in a hospital, but out-patient.  I had mine done in Chinese General Hospital last 2006.  A small catheter is inserted into the cervix through which liquid dye is injected.  X-rays are taken as the dye passes through to see if there are any obstructions.  I felt heavy cramping during and for several hours following this procedure.  But this just means that my fallopian tubes are not blocked.  According to the technician, no pain, no gain.  Expect vaginal discharge as the dye is expelled from the uterus so do bring a pad or panty liner with you.  After the procedure, the OB gave me antibiotics to take to guard against possible infection.  Result: No blockages in the fallopian tube and I have a normal uterus.      

b.    Hysteroscopy - a thin viewing tool called hysteroscope (a light and camera is hooked to it so that the doctor can see the endometrium on a video screen) is inserted via the cervix into the uterus to check for irregularities or scar tissues.  It is also used to remove fibroids or polyps.

c.  Laparoscopy –is a surgical procedure that involves insertion of a narrow telescope-like instrument through a small incision in the belly button. This allows visualization of the abdominal and pelvic organs including the area of the uterus, fallopian tubes and ovaries.  It also checks for scar tissues, endometriosis and fibroids.  Done under general anaesthesia.

I had hysteroscopy and laparoscopy done at the same time last December 2010 at the Philippine General Hospital to remove my endometrial polyps and also to check if I have endometriosis.  My OB found that I have some implants at the back of the uterus so these were cauterized. According to OB, it will be better to get pregnant within 6 months since there is a possibility that the implants might recur.

     

4.   Immunological testing – This is also done through blood tests to check for reproductive immunological factors.  This is normally done if you have a history of miscarriage, IUI and IVF failures, or an unexplained infertility like me.   The tests can be divided into 5 categories.  Below is a description of each category and its corresponding treatment.

 

Category 1 – Leukocyte Antibody Test (LAT) or Lack of Blocking Antibodies

Some women may fail to produce blocking antibodies to stop the immune system from attacking and rejecting the fetus.  The problem is when the woman shares the same antibodies with her partner; in other words the couple’s DNA is too similar.  Normally the father’s DNA in the embryo tells the mother’s body to set up a protective reaction around the baby.  But when this blocking effect does not happen, the baby is rejected.  Treatment for this is lymphocyte immunization therapy (LIT) in which the male partner or donor’s blood is injected into the woman.

Category 2 – Antiphospholipid antibodies (APAs)

Antiphospholipid antibodies are the most common kind of abnormal immune system problem.  APAs can prevent implantation thus preventing pregnancy in the first place.  Phospholipids are a sort of glue needed in early pregnancy.  Some women, however, produce APA blood-clotting antibodies which attack cells that build the placenta and increase the risk of miscarriage.  Anticoagulants like low-dose aspirin and heparin (a blood thinner) are often prescribed.

Category 3 – Antinuclear antibodies (ANAs)

Antinuclear antibodies are directed against structures within the cell nucleus and can attack the fertilized egg and the cells in the womb.  This can prevent implantation and increase the risk of miscarriage.  This is often treated with steroids like prednisone to suppress the inflammatory process.

Category 4 – Antisperm antibodies

Antisperm antibodies can cause agglutination or even prevent fertilization because they stop the sperm being able to penetrate through the cervical mucus.  It can be produced after an infection.  Treatment for this is usually steroids.

Category 5 – Elevated Natural Killer Cells (NK cells)

Natural killer cells are important.  They make up 50% of all white blood cells and are needed to control rapidly dividing cells like cancer.  The theory is that some women produce too many natural killer cells which will aggressively attack any cells that grow and divide, offering protection against cancer but making pregnancy impossible.  Treatment possibilities for high NK cells are LIT, intravenous immunoglobulins, steroids or rheumatoid arthritis drugs.  The natural solution for this is to take fish oil, specifically EPA, to decrease NK killer cell activities.    

Fertility Treatments

Unfortunately for us, I am positive for Category 1, 2, and 5.  We were advised to see an immunologist and had immunological work-up.  So far, from a LAT of 0%, I am now 100%.  That is after 9 LIT sessions, 4 with husband as donor and 5 from blood donors.  I take Aspirin every day for almost 2 years now.

I have experienced 3 failed IUI (artificial insemination).  2 consecutive IUI last 2007, without any immunological work-up.  And right now, after my LAT has increase last April 2011, we tried for another IUI this May 2011, but unfortunately it wasn’t successful.

Whew, so there goes my long story on my infertility case.  I tried to explain it as clear as possible so that you would better understand my condition.  Many people have been asking me about it, so here it is… If you have other questions, please feel free to ask me.  I’d be more than willing to share with you my experiences.   Happy reading!