Thirty Nine Months, Second Child, Twelve Doctors discussed on Beat Infertility
So many medications to dampen their immune system it does make me wonder you know if the basic science tells us that crow inflammation helps with implantation putting people on steroids and everything else just. We just don't have a lot of science that shows that it works. And obviously there are a lot of respect for a lot of the reproductive immunologists out there but i think that throwing medicine at people without science behind it has the potential for harm and maybe not helping people. But you know. I think people when they're in the setting of recurrent implantation failure in recurrent law sometimes are so of course upset that they're willing to do anything necessary but the problem is is that it's hard to always know what the right answer is in terms of science. What would help you most. Obviously this is an area that we're really learning a lot about and when i have patients who have recurrent miscarriage and recurrent implantations failure which could probably do whole episodes. And we have opposites on them. There's a pretty extensive evaluation. I do to try to figure out is it. The embryo is the uterus. I have just one question about recurrent implantation failure. The one of the listener questions said that they've been trying for their second child for thirty nine months. Would you consider that patient to be having recurrent implantation failure for those thirty nine months or something only related to ivf. It certainly could be but we don't know that there's even embryo there right like since it's all happening in her body because it's possible she's not she has the sperm aren't getting to the egg that getting into the fact that the embryos not being transported to the uterus that it's not able to attach so it's really hard to know where in that bond process of things things are not going right obviously with ivf when we literally police an embryo in the uterus and we know a healthy embryo was inside the uterus. That of course is more what we're talking about in terms of recurrent implantation failure. Do you have anything else to add about implantation. Before we move onto the next topic just from a practical perspective this is of course one of the most frustrating things one of the patient questions more or less said like. I don't want to keep doing the same thing. That's not working. Don't keep doing the same thing. That's not working just in general especially with this age of telemedicine. It's always okay to get a second opinion. If feel like you're not getting anywhere or things aren't happening the way they expect you to. I mean i encourage my patients to get other opinions. I often will present my patients at our meeting. So you can get twelve doctors opinions on things at one time but this is something you should and could do if you're not having success and it's okay if you get a second opinion and stay with your doctor. My patients do all the time or it's also okay. If you decide to get a second opinion and try a different avenue remember. Sometimes you know. it's the lab. Sometimes doing more exploration in the body. I really say that there are so many doctors out. There were really good doctors but puts so much weight on success on the embryo being healthy or not. And don't get me wrong. It's a big part of it. Is that i'm real healthy or not. But the other half of it is the uterus healthy. And i think there's a lot of doctors out there who have been trained in a time where they didn't really have the science and they didn't really look at the uterus like we have science now to help tests now to help us dig deeper and fear out. Is there an issue with the uterus. And i think that it's really important to be able to get the opinions of doctors who are thinking about the whole picture not missing out on half of it. So it's important. Obviously if you are listening to this you are already advocating for yourself about your body and that makes me an heather so happy because obviously that's our mission here right is to make sure that you're educated. About what the options are the science behind. What's happening in your body. Obviously a huge passion of mine. I think there's a lot of doctors who sort of pooh pooh some of the test. Which tests are a little out there. I'll say but not all of them. And i think that ignoring the half of the picture which is the uterus which is a huge role in getting pregnant of course is a mistake speaking of this science behind all of this if listeners. If you thought that we were scienc- before were about to really do a deep dive disci- we're going to be talking about integrants next. What is the definition and role of integrion specifically beta three. We know that there are certain molecules that are used by the lining that are important for cell to cell recognition and these are produced in response to progesterone and these are really sort of the key players in hejin of the embryo to the uterus. And we think about integral part of these cam molecules These glycoprotein and help with cell to cell adhesion and they are really expressed during that window of implantation and it's important to realize there's a lot of things that can affect be production of beta three integrity. And i think like they're still so much to learn like there's not just like a medicine i can give you to make more beta three integrants in. It's still very early in our understanding of beta three integrants. We sort of known about them for a while. Her started becoming really a thing to be studied and understood about about fifteen years ago. And i think our knowledge about them hasn't even fifteen years. Seems like a long time in the fertility world. But we're still in the process of really trying to understand but they're mainly of molecule that sits in the lining of the uterus in the end. dmitri that's helpful for it's like the stickiness factor. It's like helps to be the glue that the embryo to the lining. Why do some women not produce beta three integrants and what happens as a result so we think about inflammation processes. So meet me. Someone who has maybe a phase defect. How 'bout endometriosis is one of these that are thought to cause this hydrogel pinks in 'cause women not to produce enough beta three integrants with these are all sort of not infectious chronic inflammation and chronic try to infectious inflammatory. And all of those things can really cause inflammation in the lining and then. There's a decrease in beta three integrants. Then because there's less speed three integrants there's less chance that the uterus is receptive and then there's a lower chance of implementation so it's sort of like Cascade event where the inflammation causes all these things downstream to not work appropriately would or the testing options where the pros and cons. And how reliable are they. So the only real test. I know of that tests for this is receptivity acts which also test for basile six and it sort of looks at both of them. As much as i do this test. I will do this test. Because it's really the only one we have available for women who are having recurrent implantation failure to see. If there's some potential inflammation like dimitrios is that we haven't picked up or potentially a hundred things that we haven't picked up really likely. I will do this test. And it looks at both a molecule kobe. Y'all six as well.