Autoimmune related tests?

[luthien]

Hey so we're about to start IVF, had our first appointment in February, and need my TSH to be below 2.5, on meds for that. I have a couple of queries.

I have Endometriosis (been excised in Jan 2021), and my Thyroid Antibodies are sky high. My yearly blood tests show high counts of Eosinophils and Basophils with low MCH (possible anaemia) - GP isn't concerned so hasn't said anything. My physio would like to refer me to a Rheumatologist regarding my lower back muscle aches, tight lower back and blood tests results because she feels that I could have immune responses specifically mentioning Fibromyalgia and Chronic Fatigue Syndrome.

Could the high immune response be why we've had problems TTC for years? I mean nothing has ever happened; no skipped or delayed periods, no positive results even with possible pregnancy symptoms. My husband has had his sperm tested and all is within expected levels.

I haven't had a CRP test, would it be an idea to get this done? I've read about high immune responses and possibly needing NK cells test? But I know nothing about Immune responses.

We are going through IVF privately, do you think they'd want additional tests before starting relating to the above? I don't want failed cycles and then investigations as it would cost a lot.

Any info would be greatly appreciated.

[Marisa32]

Hi, thyroid issues alone can cause infertility. I got pregnant only after bringing TSH down to 1. Endocrinologists like it to be below 2 closer to 1 actually when ttc and during 1st trimester. GPs never seem to be concerned by anything, so I would definitely seek out specialists to assess the remaining conditions you listed. And I would do a DNA fragmentation test on sperm to make sure I'm not missing anything on the other end.

[luthien in reply to Marisa32]

How and where does my husband request the DNA Fragmentation? I've checked the clinic we're looking at and they don't outright say the do it. Is it something we could ask for / push for at our Initial Consultation where they discuss plans and timescales?

[Zebedee1971 in reply to luthien]

Just to add, sometimes the dna fragmentation test is called 'comet' and I also had to have my thyroid level brought down as it was 4.63. When I conceived my level was at 1.

[Marisa32 in reply to luthien]

Not sure how it works in the UK, for some reason clinics there don't do the test automatically. I think you have to request/pay for it privately. Some ladies on here from UK had it done, so they may know more about how to get it.

[Zebedee1971]

My neighbour has lupus and managed to conceive, she was on hydroxychloroquine tablets. When I tested positive for nk cells, I was put on hydroxy too, and we conceived in september (also had Intralipids and steroids). If you have an immune issue then yes, that could be affecting implantation. There are three specialists in England who you might like to see privately: quenby, gorgy or shehata. The latter two are in London and quenby is in Warwick. A private clinic wouldn't be bothered about getting the tests done first as their go to response is always 'most of the time it's the embryo and age of the mothers eggs'!! They always blame chromosomal abnormalities for failed rounds and only recommend testing after 3 failed rounds usually. So if I were you I'd get private testing done, then have the ivf. You're right not to waste the money when you know there could be something that needs looking into first x

[luthien in reply to Zebedee1971]

Thanks for the info.

My first consultation was with Kalpana Reddy, under the Cotswold Fertility Clinic which is a satellite clinic for Oxford Fertility (The Fertility Partnership). I chose her because of my Endometriosis, my private Endometriosis Consultant actually recommended her at one of my post op appointments. She seems quite thorough. Travel to any of the specialists you've mentioned will be difficult with both of us being in a full time jobs and possibly going back into the office, I cycle, my husband drives.

I shall email Reddy's secretary and ask if there's any chance of having the tests you've mentioned prior to starting treatment; it may be on her list of things to have done.