Dr. Sher was one of the first reproductive endocronologists to explore the area of immune issues within the field of infertility. SIRM works with a laboratory located in Chicago called Millenova Immunology Laboratory. They do a wide range of testing with relation to infertility. These tests are optional and are not usually covered by insurance--because to them it is still considered "experimental" and not necessary. At SIRM they usually recommend these tests for anyone who has had two failed cycles or multiple miscarriages. I'll tell a little about each test, but to be honest I don't believe that I still understand everything fully:) We had these tests run in January 09.
One of the panels I had was an Antiphospholipid Antibodies (APA) panel. The basis--at least my understanding--is that they are associated with clotting factors. People who have issues here usually have trouble with miscarriages because the blood flow is interrupted between the placenta and baby. It can also cause implantation failure due to lack of blood flow. The treatment for this is to use blood thinners such as Heparin or Lovenox during a cycle.
A second panel I had drawn was a Natural Killer Cell (NK) panel. Do you guys remember on Friends when they said Monica had a "hostile environment" in her uterus? This is basically what this is. Each person has a certain amount of Natural Killer Cells, but when they are overactive they can attack the embryos and kill them instead of allowing them to implant in the uterus. If the activity is high, it is treated with an IV infusion called Intralipids. The first infusion takes place while taking the FSH medicines and then again at 5 weeks of pregnancy. Intralipids was just introduced into the field as a result of work done by SIRM. It is replacing a treatment called IVIG--which cost up to $2000 per infusion, where Intralipids only cost about $200. Through research, it was determined that Intralipids was just as effective as IVIG. Thank goodness, because that is a huge price difference!!
The last panel I had done was called Reproductive Immunophenotype (RIP). To be honest, I am still stumped by this one. Apparently it is where eight of the most important white blood cell types are counted. These certain 8 white blood cells apparently help to predict future pregnancy losses. I am not sure how they determine this, but I trust the results! Again if there is anything found here, the treatment for this is also Intralipids.
Tony had to have a Sperm DNA Integrity Test (SDI). This test is also done at Millenova and is not covered by insurance. During this test, they look at the individual sperm to determine if there is any fragmentation in the DNA. Each person has a certain percent that are fragmented, but if the percent is higher than normal, then it often interprets into a lower fertilization rate. So we were going to check into that as well. What the heck--what was a few more hundred dollars at this point?
Who would have thought that all of this research and science went into helping people to have babies! It is crazy how many little things can get in the way--don't you just have to have sex? Apparently it isn't that easy for everyone!