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Discussion Starter · #1 ·
I've had quite a few messages from people asking about Dr Ledee in Paris so I thought I should put the info in a post.
Dr Ledee is both a practising IVF doctor and a researcher in the area of implantation. Of course the whole area is quite new with much disagreement so you might find it disconcerting if she recommends something very different from what an immune doc has recommended. Dr L doesn't believe in the validity of immune testing in the blood as she thinks that is not relevant to the uterine environment. She tests nk cells etc but in the womb. (I've posted this in the immune section of the board because I couldn't seem to post under the general diagnosis heading - it's probably not the best place for it so hopefully the moderator will put it where it belongs).

Her tests - which I understand you can only have with her and are awaiting patents - look at uterine bloodflow and also at the level of inflammation. If there is a problem with the former, she can prescribe a combination of pentoxyfilline and vitamin E, I think. As for uterine inflammation, she believes it can be too high but also too low. So she might recommend a level of steroids higher than you have been taking or she might recommend that you do not take steroids at all. The latter was the case for me, which went against the frequent belief that endo implies immune problems and therefore steroids. She may also recommend that you do a scratch or that you definitely don't do one because you already have high inflammation. This differs from the view of some doctors that scratches / implantation cuts are always a good idea. So, again, you might have to make a judgement on whose advice to follow there.

Dr Ledee has done also research into benefits of GCSF for implantation and I think she generally believes it is a good thing. You might have to ask her about this. I think she might not mention it because it's not permitted to prescribe it for fertility in France anyway.

It usually takes a few months to get an appointment. You'll get a second appointment for the uterine biopsy - at an appropriate time in your cycle - and a prescription for some oestrogen you'll need to take to prepare for the biopsy.
I think it costs a little under 40 euro for appointments. The biopsy and test cost about 400 euro.

Dr Ledee works out of a maternity hospital in Paris called Les Bluets. http://www.bluets.org/ When you get there you have to go round to the right into a big round area where you take a green ticket and wait for your number. This is just to do the administrative paperwork and later you go back there to pay. Then you go down a corridor to wait to see Dr Ledee.

I understand Dr Ledee speaks English. On the other hand, I'm pretty sure the secretaries don't. If you don't speak French, here's a template for an email you could send them to set up your appointment. ([email protected] [email protected]).
Madame Holey, Madame Matos,
Je vous écris pour organiser un rendez-vous avec le docteur Ledée.
Voilà mes co-ordonnées:
Nom: INSERT YOUR SURNAME
Prénom: INSERT YOUR FIRST NAME
Date de naissance: INSERT YOUR DATE OF BIRTH
Je vous remercie.
Bien à vous,
YOUR NAME

Moderator Comment: New contact details can be found here http://www.fertilityfriends.co.uk/forum/index.php?topic=332131.msg6501922#msg6501922
 

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Just a comment, I think when you go to wait to see Dr Lédée, you go into the assisted reproduction section ("PMA" in French) rather than right next to the check-in area which is pregnancy stuff. It can be confusing...and possibly upsetting...

Dr Lédée's research is into how embryos that work actually contain GCSF, among other things, and when the lining biopsies are done you will actually get your levels of GCSF in the lining measured, which I found pretty interesting.

She also does research into all sorts of other stuff, including how pentoxifylline (Trental) works.

I was also somebody with not enough inflammation.

Great post, lady!
 

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So interesting. Especially the stuff about GSCF. And so useful. Thank you.
Purplepeak - did you take steroids at all? I had a NK uterine Biopsy with Professor Quenby and she said to me as I didn't have much inflammation not to take them.

But my clinic insists on steroids - even if only 10 mg.

She was also very positive about neupogen for implantation.
 

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Discussion Starter · #4 ·
Yes, Theodora is right. When you go into the central bit to do the administrative side of things there will be pregnant women also there, then for the appointment you go to the assisted reproduction department (PMA). If I remember correctly (but I have a bad sense of direction), if the admin desks are behind you, you either go out the exit at the back right and then take the first left; or you go out the exit on the left (the one you came in) and then take a right. But anyway there should be signs to the PMA. When you get to the PMA for the first time you need to tell the secretary (look for the names on teh doors of hte people you emailed) you're there as she will prepare a folder for you, then a few doors down you wait for Dr L. You'll see her name on her door as well.

LuckyE, I didn't take steroids at all this cycle. I specifically queried with Dr L whether she meant that steroids were simply unnecessary for me or whether she meant that they could harm my chances. She said it was the latter: some uterine inflammation is necessary for implantation to occur so if you have low inflammation and then take steroids you may well make your inflammation too low and thus make implantation less likely. Btw I've just noticed that you're at Serum. I was there as well and Penny did not insist on steroids when I explained why I did not want them, although she seemed a little doubtful. She gave me pred tablets and also some steroid injections to take, after consultation with her, in the event of symptoms of an immune reaction (this did not occur). I myself was nervous about not taking steroids in case Dr Ledee was wrong but, in addition to the confidence Dr L inspired, I also took some comfort from the fact that I understand some immune docs (Braverman, I think) would not prescribe steroids as well as GCSF anyway, and I was on GCSF.
 

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Hi
Re NKa cytotoxitity immune work up and Biopsy:
Is the biopsy carried out under anaestheic? Can we go home the same day or do we stick around for a couple of days. Sorry - about all the questions. Do you guys recommend anywhere to stay? Will be going from the UK.

Is her protocol the same as the chicago test carried out by Serum?
Thanks in advance. xx
 

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Thanks for this post Purplepeak.

I have requested a 'rendez-vous' with Dr Ledee. Sounds more like a date rather than a medical appointment.  ;D

I have a few questions.....
Do I need to have someone with me who can speak French?
Can you do it as a day trip or do i need to stay over?
What prep is needed beforehand?

Oh and more widely, how does this vary from the Prof Quenby's uterine biopsy?

Thanks,
Tigger xx
 

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You can do this as a day trip. I tended to wait a bit for the doctor, & the appt takes a bit, so don't plan trips back to the UK too tightly....

The biopsy is not done with anesthetic, & since you are measuring inflammation, best not to take anything beforehand, altho be ready with painkillers/ibuprofen for right afterwards maybe!! While in France, hop over to any pharmacy & get a box or two of Spasfon, it's great for period pain, anything to do with stomach, etc -- it's an antispasmodic with no side effects I've ever noticed.

Dr Lédée apparently speaks quite fine English altho we always spoke in French.
 

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Discussion Starter · #8 ·
Concerning the questions about similarity to chicago tests and to Prof Quenby, I haven't got experience of those. But I think the chicago tests are a set of immune tests on a blood sample (not from the womb) so quite different. I know Prof Quenby does some kind of biopsy on the actual womb so that may be aiming to do a similar thing although I don't think it can be the same as I understand Dr Ledee's tests are ones she's developed herself.

I think Theodora answered the other questions.

Good luck!  ^hugme^
 

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Thanks for the tips ladies!!

I seem to have managed to organise a 'rendez-vous' with Dr Ledee in early March. My pigeon French was somewhat supplemented by Google translate on the various emails back and forth but I seem to have got there somehow!!  ::)

I'm now looking at eurostar timings / fares etc and will book it all as a day trip I think! Hope I can navigate this trip with my very basic French!


 

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Discussion Starter · #10 ·
Good luck Tigger! X
 

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Thanks purplepeak. I'm off next week so will let you know how it goes. Do you recall how long it is between first appointment and the second where they do the testing? What results would I get? What treatment advise would she give? How long does the results take to come through. DH desperate to start ttc again so want to give him a timeframe.
 

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Discussion Starter · #12 ·
It was all quite slow, I'm afraid, as it's not easy to get an appointment with her. I think I had the first appointment in May, then the second appointment and biopsy was July. The results took about 5 weeks, however that was over August when most of France goes on holiday so maybe it is usually faster. They can be emailed to you, however you'll need another appointment if you want to discuss them further with her, which I'd recommend as that was def useful to me. Treatment advice varies a lot. In the case of one lady I have spoken to, the diagnosis was serious over-inflammation, and the treatment for that (pentoxyfylline and vit E) takes some time to work given a bad problem so that lady delayed her further treatment for quite a few months (I think she was glad she did as she felt that it had helped). But I am guessing that's quite unusual. In my case, I was able to go ahead with treatment straight away (after scratch / cuts since I had low inflammation). Good luck!
 

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Unfortunately the results always take at least 4 weeks, & you are in trouble if you do it around vacation times... which are often in France!!
 

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Hi girls and congrats to some of you, it's great to see positive results.  I've just had five oe Ivf failures and a de failure in Greece.  I have booked dr Ledee and have my first consult in march but am overcome with nerves about the biopsy as will be travelling alone. I can bear a smear, transfer and light scratch but due to all this treatment have become terrified of new procedures.  Is the biopsy very bad?  Can you take Valium before it? I'm sorry for the question I just feel overwhelmed at the moment and don't know if I can face another onslaught of painful tests :(
 

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The biopsy is done just like a PAP smear or other such procedure using a speculum. The biopsy itself takes a few seconds. It does hurt quite a bit, but it is better not to take painkillers or anti-inflammatory stuff beforehand since you want to see the inflammation levels in the lining -- altho maybe it is not instantaneous?? I'd take all your meds with you & then pop the pills as soon as she is done! The procedure is nothing to worry about in terms of what it is & how it will go, but it does hurt that day. I never had pain afterwards though, just on the day it is done.
 

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Thanks Theodora for the reply.  I am living in dread of it but hoping it will be worth it for a few seconds.  Does she explain what she is doing in English I like to be pre warned!  Thanks again for the help
 

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I think her English is quite good, altho better read/written than spoken. She is quite nice, a real researcher!

If you are traveling from outside France, I must tell you about a medicine you can buy over the counter here (for about 3 euros??) called Spasfon. They are pills for cramping (uterine or belly or even back a bit), with no side effects I've ever seen. I'd recommend getting some & use them right afterwards & throughout that day & you should feel much much better! (Note, get the pink pills, not the powder kind called "Spasfon Lyoc".)
 

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I'm seeing Dr Ledee at2:30 pm today. How long in advance of this time should I get there?

I'll get some spasfon too. Thanks for the tip!!
 

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Discussion Starter · #20 ·
I'd get there half an hour in advance to be on the safe side, as you have to wait to do the admin bit then go to her secretary's office for more paperwork, then wait for your apptmt. And you might be slow in finding your way around if French is a challenge. Good luck!
 
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