Dear Dr.Beer,
I am contacting you from Croatia, and I have a Q about TSH and IVF.
Please register with my clinic to work with me. Go to repro-med.net to do this and call 408-356-9500
Our medical history is:
My husbands diagnosis is OLIGOASTHENOZOOSPERMIA and we're trying with ICSI methods in Zagreb (Croatia). My colleague Professer Daniel Rukavina is Dean of the medical school there and we worked together in the US for two years.
After 9 negative Betas in 9 IVF-s, the decision was made to do immunologic tests, and all of the reports came back negative, except Thyroid test, that lab report level of TSH was all most 20, AMA and ATA were positive.
This tells me you have category 5 immune problems and will need the NK assay and the TH1 TH2 cytokine test to determine the correct treatment for you.
My Dr. suggested therapy with Euthyrox 50 mg, and after 6 week therapy my TSH is normal for our labs, but too high for IVF/ICSI.
The TSH must be in the 1.0 to 2.0 level.
This is the lab report:
T4 125.0 nmol/l (normal referent. 70.0-165.0)
TSH 2.6 mIJ/l (normal referent. 0.40-4.2)
TPO-At 202 IJ/ml (normal referent. < 20 )
TgAt 66.1 IJ/ml (normal referent. < 60.0)
I would recommend IVIG 25 grams cycle day 6, -2 days before transfer and again with a positive pregnancy test and every three weeks during pregnancy until we see a heart beat in the baby and your NK cells are stabilized and normal.
Those markings TPO-at and TgAt are Croation markings, for TSH antibodies, I think that your markings are AMA for TPO-at and ATA for TgAt.
This is true.
Because my TSH level was still too high for IVF, my Dr. suggested change of therapy to Euthyrox 75 mg, and after this therapy my TSH is normal.
I am happy for you.
But the thing that concerns me is positive antibodies (AMA & ATA) and I¨ ve done NK cells test in Peripheral blood, the lab report was:
NK cells CD56 = 18 % (normal range is 10 - 31) - in our labs
I have not see a live born child in any women with CD 56 of 18% without LIT therapy and IVIG therapy preconception. I recommend both.
But I have found out at your pages that all above 12% is positive, and can affect the result of IVF.
Dr.-s in Croatia don't know a thing about this problem, or how to treat it successfully, but it can lead to miscarriage if it isn´t treated on time.
The Q I would like to ask you is:
How can positive antibodies (AMA & ATA) plus positive NK cells affect the result of IVF and wich treatment would you suggest for successfull IVF/ICSI?
These factors inactivate the DNA in the embryo as soon as it is transferred to you.
Any answer is very helpful, because I am preparing for my next IVF/ICSI, and would like to be prepared as much as possible.
Please consider consulting with me and I will send you a written summary of my findings and recommendations and treatment plan.
Thank you in advance for your answer.
Warm Regards
Alan E Beer, MD