Immune Testing Results & Consult With Dr. Braverman

You guys, have I told you lately that I love you? For real. Your comments on my last post were just beyond. Not to mention my friends in real life that reached out to me as well. Thank you everyone. A million times over.

Last Tuesday I had my Skype consult with Dr. Braverman and found out the results of my immune testing. Basically, all the findings were consistent with endometriosis. This is pretty good news overall – there’s nothing else more sinister lurking on the sidelines.

Warning: I’m about to get very long-winded and detailed. I want to share as much as possible in case I can help anyone on the interwebs searching for information.

What the testing found:

I am genetically predisposed to endometriosis (duh at this point), Grave’s disease, Hashimoto’s thyroiditis, Antiphospholipid Syndrome (this one is no surprise either), Celiac, psoriasis and psoriatic arthritis

This does not mean I have any of these things–it just means I have the genes that would allow them to develop. Or something. I’m disclaimering right now that I barely understand all of this immune biz, so most of the explanations in this post will likely be at least semi-bogus.

Other things that are awry in my immune system:

My white blood cell counts are a little low. This is consistent with endometriosis, but I forget why.

My anti-cardiolipins are still testing as highly positive.

My natural killer cells and CD8+ T-cell levels are through the roof. Both are in the 98th percentile. Meaning, of all of Dr. Braverman’s patients, 2% of them have higher natural killer cells and CD8+T-cells than me. Whoa.

So why is this significant? Basically, both of these types of cells are totally normal. Everyone has them in their bodies. They fight off cancer, viruses and the like. But if they are too active, they see an embryo as a foreign body and kick it out.

To sum it up: I have endometriosis. This negatively impacts egg quality for a variety of reasons, two of the main ones being that it creates inflammation in the reproductive organs and also messes up the mitochondria in my eggs. This makes it really hard to produce eggs that actually turn into babies. Then, on the off chance that I do make a healthy embryo, the anticardiolipins, natural killer cells and CD8+T-cells kill it. On many levels, my reproductive system is – no, was – screwed! Was. It’s a whole new world now.

What Dr. Braverman suggests:

Luckily, everything that he found is straightforward to treat! Huzzah.

The first step is to remove the endometriosis, which I have already done.

Next, we wait two cycles in order for the inflammation to die down. I’m a little less than halfway through this.

Then he recommends another IVF cycle. As some of you know, I have an embryo still frozen at my old clinic. He said it’s not impossible, but very unlikely given what we know, that this embryo is genetically normal. So he recommended holding off on transferring that one for now.

After the IVF cycle we’ll freeze all embryos, ideally on day five. Apparently, the drugs from the IVF will make my immune response worse, so no fresh transfers for me. He then wants to do something called mitochondrial testing on the embryos. This is apparently a brand-new test. Instead of genetically screening the embryos, it tests only the mitochondria, which is apparently the most important factor for endometriosis patients. I’m not sure if we’ll do this yet. I need to look into it. He does not recommend traditional genetic screening.

Finally, we’ll do a frozen transfer, using Dr. Braverman’s immune protocol.

The immune protocol will include:

Lovenox (a blood thinner)

Steroids (reduces inflammation)

Intralipid IV infusions (this is, like, straight-up fat, I think. I don’t even remember what it does, but it sounds like some mad scientist hootenanny. Sign me up!)

All of this will be done at our new clinic, with Dr. Braverman consulting on the frozen transfer. The new clinic is about an hour away from us, which is a major downer, but our old clinic won’t work with outside doctors, and this one does.

Other recommendations from Braverman for patients with endometriosis:

Cut out gluten (I’ve been gluten free for a year or two now, so we’re good there.)

Cut out dairy (I’ve also been dairy free for a while. Dr. B. says a little dairy every so often is fine. It’s not as much of an issue as gluten.)

Eat organic

Take a crapload of supplements.

Here’s the supplement list, if you’re interested:

Pycnogenol and Resveratrol (antioxidants that reduce oxidative stress and lower reactive oxygen species in the follicle, improving egg quality)

Melatonin (an antioxidant — it has been shown in the literature to increase the number of FSH receptors on the follicles in patients with endometriosis. I may not be able to stick with this one, btw, as it appears to be exacerbating my asthma)

VSL#3 probiotics (to lower the level of inflammation by increasing the production of IL10 in the blood. If anyone knows what IL10 is, let me know.)

Fish oil with Omega 3 (didn’t get an explanation for this)

Mitochondrial optimizer (helps to improve mitochondrial function in the egg, which increases the competence of the nucleus. This leads to higher euploid rates and better embryo performance)

Vitamin D3 (to help decrease natural killer cell activity)

Greens formula (didn’t get an explanation for this)

General notes:

He said that, after surgery, I have about a one-year window until the endometriosis comes back.

His official word is that one cup of coffee a day and drinking socially is fine. He’s firmly in the everything-in-moderation camp. So, guess what guys? If I want a friggen glass of wine, I’m having a friggen glass of wine. No more guilt!

He called me young! Well, kinda. When I asked him if I should be taking DHEA, he was all, “That only works for older women, not women who have diminished ovarian reserve for other reasons.” Consider my life made. It’s not often that 38 is classified as a younger woman in the fertility world. I’m taking that and running with it.

Whew! Are you still awake? I am, but only barely. If you’ve read this far, you are a rock star.

And with that, I’m signing off. Must go to bed. Tomorrow we meet the doctor at our new clinic for the first time. I hope we like him (and the clinic) because we really don’t have much choice in the matter.

‘Night, dudes. Sleep tight.

49 thoughts on “Immune Testing Results & Consult With Dr. Braverman

  1. Oh my gosh there is so much awesomeness in this post! Awesome that you have a solid protocol and a plan. Awesome that you finally have a diagnosis. Awesome that you have your youth and Super Awesome that your beautiful Lettie was meant to come to you guys even through all the stuff going on in your body! I am feeling so positive for you. Xo

    1. Thank, MamaJ! I am like 30 years late responding to comments and I have “talked” to you a million times since then, but I still wanted to say that I appreciate your support, as always!

  2. I am so excited for you!!! Okay, now I realize that might be weird to most post people, but having met Dr. Braverman myself, and knowing our prognosis from him, I think your diagnosis is phenomenally optimistic in the world if IF/RPL. I love that you have a plan that has a real possibility of working and is attainable for you! I love that you sound optimistic in your writing today. I love that you are trying a new clinic because honestly I think it’s time.
    And I love more then anything that I understood everything you wrote too! I get it, but only because I’ve literally been there and this means you are not alone, and not being alone always makes me feel better, and I think you too! I know our diagnosis was not identical and we didn’t end up choosing this route, but I know another blogger/in-real-life friend who did and guess when she has her wonderful little baby in her arms today!! In fact, I think her protocol was very similar to yours. (if you don’t follow her its SpiritBabyComeHome – I think you do, but just in case I thought I’d share).
    Honestly, this is just awesome!
    (P.S. I wanted to email you last week and bug you about the results, but I decided to give you space. That said I’ve been thinking of you every single day and I’m so excited you were ready to share today).
    And lastly, I hope you have a wonderful sleep!

    1. I love everything about this comment! Sorry it took me so long to respond to it. I am way behind in everything blog. I do “know” Spirit Baby! You and her are the reasons I went to Dr. B. in the first place. Her story gives me so much hope. And for the record, I wouldn’t have minded at all if you had emailed me about the results!

      1. Haha! I am so behind on some of my past blog post comments too. i hate it, it drives me crazy, but I’ve decided not to stress about it because well, I don’t need to make my ulcer worse. 🙂 And good, next time I will just bug you. 🙂

  3. I am so so happy you’re working with Dr. B. It sounds like you’ve got an excellent plan in place and you sound very good. If you’re the sort that likes company, I have insanely high NK cells too. Jeff told me it’s one of the highest values he’s seen. So, with ya! 🙂

  4. Wow this is all really fascinating and makes me think my clinic is lacking in the endo after care somewhat! I should get back off the gluten and the dairy then *sigh* I don’t have it every day but I do dabble in both. Anyway this is all super interesting info for me to take back to me clinic and ask questions about. Your plan and care sound excellent. I hope everything goes super smoothly for you now xx

      1. No. I thougnt about it when we were last there but decided to just let them do their thing. I take a lot of what is on your list so I’m good with that.

  5. First yes you have baffled me with science lol but everything sounds so positive and you have a plan! We like a plan. I am feeling very optimistic for you! xo

      1. Hello stranger! I am okay, I must update but have just felt like I had nothing to say but woe is me ha. I have my follow up appointment at the hospital this month which will probably be more doom and gloom and we need to decide what to do next. How are you? Not checked yet if you have updated. xo

  6. I can feel the relief in your “voice.” You have a plan. Sounds like your doctor is amazing and YOU are an amazing mama who is going to carry it out. Praying for you.

  7. Wow – fantastic results and so much to act on. I did a TON of research and knew how important mitochondria were but didn’t realise that endo affected them. I remember reading about supporting cellular energy (i.e. feeding your mitochondria) in the weeks before ovulation and how important it was. That kind of prompted the juice-fast (nutrient dense) and I tried to eat as cleanly and nutrient-loaded as possible in the weeks before ovulation – the few days before are especially important as the eggs undergo a massive final growth spurt. All the same applies to egg retrieval, but even more mitos to feed so load up on greens!! 38 IS young 🙂 Facing IVF at 40 made me feel like I was basically an old crone (eyeroll). Anyway, all brilliant news and yes have that glass of wine!! Keep on moving forward xxxxx

    1. Mitochondria are no joke, apparently! It sounds like you were doing all the right things! I made it theough my egg retrieval and transfer isn’t for a few weeks so I am celebrating by eating some crappy food and drinking wine. 🙂

  8. This post makes me so happy to read!!! I’m so stoked for you that you have a plan, some answers, and some solutions that seem relatively straight forward! So so so glad you took the leap to try this guy out. I’m cheering from the side lines! Xx

  9. This is so exciting! You’ve got an explanation for what’s been going wrong! And a plan! And you’re young! 🙂 Hooray!!! So glad that you’ve had such a productive consult with Dr. B, and that you’re already halfway through your waiting period of healing after the endometriosis surgery. And what luck that your one little girl was able to fight through your immune system the first time — she really is a little miracle, that kid. 🙂 Love the optimism in this post and can’t wait to hear more!

  10. Hey! I’m running a TTC exchange on my blog if you want to join in, it’s for support & of course a parcel in the post! Remember you are not alone in any of this 😘 xx

  11. Thank you, Thank you, Thank you for posting all of this. I had stage 1V endo that I had surgery on last June and the last few months my cramping throughout my cycle has gotten so much worse and I figured the endo was back but your post just pretty much helped me confirm it. I didn’t know about the rest but it looks like I have some research to do on where to get some of those supplements and how the heck to go gluten free and dairy…well, let’s just say I’m from WI…there’s no way I can cut that out completely. My life would have no meaning, lol. I will try my best to cut way down though. If you have any tips on the gluten thing, I would gladly take them! And definitely re-posting this one. 🙂

  12. Amazing! I think that sounds so promising. Such good news! You know a lot of women wonder about DHEA and taking that, but in some cases it can actually do more harm than good. I have elevated DHEA levels and that’s one of things in PCOS we’re trying to fight. So, I always recommend against taking it unless levels are low. Also, I’ve been living by the the cup of coffee and glass of wine if I want it. I can’t keep living scared to do anything. Good luck to you friend! I can’t wait to follow your journey! ❤

  13. A plan is a beautiful thing and this is a seriously comprehensive one! I love it 🙂 Good luck with the clinic. I didn’t realize we’re the same age – yup, I’ve had the “young” comment a couple of times too – it always makes me laugh. xoxo

  14. Wow that’s a lot of information. This Dr. B sounds great and very very thorough. But it all sounds very promising and I have a lot of hope that with this new protocol you will be on the right track!

  15. I’m so glad to see that not only did you finally post, but you sound super encouraged and hopeful (you young woman, you)! I’m very interested in the mitochondria testing and how that works, so keep us posted. So glad you have a plan too, I sincerely hope it goes awesomely for ya 🙂

  16. How is everything coming along? I start birth control in a few weeks to keep my endo at bey. Then onto seeing what my body does with all those drugs and IVF!

    1. Thanks for checking in — I need to update soon. It’s just been so busy with work and summer trips and blah blah blah. Anyway, I’m plodding along with stims right now. I go back on Monday to check and see how things are going. That’s very exciting that you are getting the ball rolling on IVF!

      1. I’ve been feeling ok! My doc is having me take Clomid on top of the Menopur and Follistim, so that part is actually a little rough. I did not miss Clomid, not one bit.

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