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Discussion Starter · #1 ·
Hi!

I am a 29 year old female from Sweden who finally, after 8 years of actively trying to get pregnant and 3 failed IVFs with own eggs 1 IVF+1 FET with donated eggs, have convinced my gynecologist (actually had to change gyn to get anywhere) to check if immunological factors might be causing the infertility.

I should also add that I am since teenage years diagnosed with 2 auto-immune disorders; Crohn's Disease and Primary Schlerosing Cholangitis.

As the interpretation of test results seem to differ between different countries I'd really appreciate your help in letting me know what your experience/knowledge of my test results is when it comes to impacting fertility!

- AMH 0,54 mikrog/L, below reference value indicating that I have a very low egg reserve
- TSH 2,3 mE/L (slightly higher than it should be according to my gyn)
- TPO-ak 258 kE/L (should be below 34 according to my gyn indicating that I have latent hypothyroidism)
- TNF-alfa 8,5 pg/mL (within new reference value range (<=12) but above old reference value (<=4))
- T4 10 pmol/L (within range)
- ANA no value (haven't had a chance to ask my gyn yet whether that is due to error or that it's because there was no presence of ANA in the blood)
- S-25-OH Vitamin D 41 nmol/L (very low)

I also have a lot more test results but these are the ones I have heard about that might impact fertility.
After receiving these results, my gyn has put me on Vitamin D supplements and Levaxin (think it's called Thyroxine in English speaking countries).

/Sandra
 

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Discussion Starter · #2 ·
I should also add that my FSH level was at 15 2 years ago and at 17 a couple of months ago
 

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Discussion Starter · #3 ·
No one who can suggest what kind of indications these results might have? Any follow-up tests or medications that would be advisable?
 

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[- AMH 0,54 mikrog/L, below reference value indicating that I have a very low egg reserve - as you know (and especially combined with your FSH results) it means you might find it hard to get pg with your own eggs
- TSH 2,3 mE/L (slightly higher than it should be according to my gyn) - as you know, this is slightly high and means it might be hard to get/stay pregnant without treatment with thyroxine
- TPO-ak 258 kE/L (should be below 34 according to my gyn indicating that I have latent hypothyroidism) - this means you have anti-thyroid antibodies - this is an autoimmune issue that attacks your thyroid gland - for fertility, it means that your chances of getting/staying pregnant are much higher if you have treatment with steroids and clexane (and possibly aspirin), as you are likely to have elevated natural killer cells - have a look in the FAQ under T for thyroid and N for natural killer cells
- TNF-alfa 8,5 pg/mL (within new reference value range (<=12) but above old reference value (<=4)) - I am not familiar with the references ranges, but generally, for fertility, the reference ranges tend to be a lot lower than for your general health.  Again, steroid treatment may help your chances of getting/staying pregnant - but some immune fertility docs use treatments like ivig, intralipids and humira as well - see the FAQ.  These treatments can also help with Crohn's
- T4 10 pmol/L (within range)
- ANA no value (haven't had a chance to ask my gyn yet whether that is due to error or that it's because there was no presence of ANA in the blood) - this is a test for autoimmune indicators - it may just mean its normal?
- S-25-OH Vitamin D 41 nmol/L (very low) - low vitamin D is very unhelpful for fertility immune issues - have a look under S for supplements in the FAQ - you need to get this into the high-normal range both for your health and for your chances of pregnancy

hope this helps
 

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Discussion Starter · #5 ·
Thanks agate!!

So the suggestion is to add steroids and Clexane. I did use Prednisone (only 5 mg though) and Baby-aspirin (75 mg) on the last treatment (FET with 3 donated eggs) but only after I had pushed my Spanish doctor (treated at a Spanish clinic as there is a 3 year waiting line to get ED treatment where I live) to include it in my protocol.

How do you test if you have NK cells? Only through biopsy or is there a blood test? 
 

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have a look at the faq under N for natural killer cells and T for thyroid.  also maybe look under C for corticosteroids and clexane
 
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