Chlamydia in Recurring Miscarriages & Spontaneous Abortions

CASE HISTORY:

 

Stanley and Rosemary

 

 

R: I met Stanley when I was 23 and had just moved to New York. At the time we both had good careers and were doing a lot of traveling. His father, who was 51, died of heart attack about a year and a half after we met. 

Q: Did any of yours or his parents pressure you to settle down and have children?

R: Well we are from the Midwest. My parents had 4 children and we all did well. Nobody pressured us to have children. I had no health problems at all.

Q: When did you finally decide that it was time to settle down and have a family?

R: Well, were dating for 9 years before he popped the question.

Q: And then you were still not quite ready for a baby correct?

R: Well, my career was going really well, I was the director of a small advertising group responsible for half a dozen magazines. I had quite a lot of responsibility in my job, I was making a lot of money and everything was going really well. In New York people don’t start having a family until their mid- thirties and I was only 33, so I didn’t feel a rush. I didn’t really think about it and when I actually got pregnant, it was an accident.

Q: It just happened?

R: Yes, it just happened.

Q: Shall we talk about this pregnancy? 

R: Well, I do think that the whole thing was just so awful that I did block out a lot but you know… the years go by so fast and I think people are right in the sense that time is a great healer  - with passing time, it hurts less and less.

I was pregnant in December of 2002 and the baby was due at the end of August of 2003. Everything was fine in the beginning; I had a perfect 12-week scan and everything looked good. I was only 35 at the time so I did not feel the need for amniocentesis. And then while I was working one day, I suddenly thought that I just didn’t feel right.

I was about 30 weeks when I went to the emergency room where the nurse who saw me said that my blood pressure was high. I think it was around 140/95, and she said I should call my OB-GYN immediately. So I did that and phoned Stanley as well. My doctor told me to stay in the ER and he arranged my admission to the hospital. So when I got to the floor they said that my blood pressure was extremely high and that the baby was way behind in growth. I did not understand it; I had been feeling very well and I had been eating right and resting and since I had never been in the hospital before, the whole thing was a huge shock. I was kept on bed rest. They told me I had preeclampsia. I was there for 3 weeks and my blood pressure was going up and up and up and the situation was just deteriorating. I was constantly monitored and in the end I was on REALLY high doses of beta-blockers. They could see the baby wasn’t doing well, so they quickly delivered me through cesarean section before 30 weeks. The baby boy was 6 pounds 4 ounces. He was significantly growth restricted. 

Q: And what was the cause of death of that little boy?

R: Initially, everything seemed to go well. They were feeding him through a tube. After 4 days in the incubator, both Stanley and I thought everything was going to be okay and we would be taking him home soon. Flowers and presents were arriving, and then I went in one morning and they looked at his chart and said the doctor wants to see you. Suddenly it was a blur, the doctor said there was a huge problem and they needed to resuscitate him, and then he was rushed off to another hospital and he never came out. The next day they turned off his life support; it was terrible. One day we were parents and the next day we weren’t. It was the worst time in my life. It was terrible; I still don’t know how we recovered from that. They suspected, there was a problem with his stomach and bowels.

Q: Was there blood in his bowels?

R: “Yes, the stomach and the bowels. They were full of blood. He was just not right, you know?” (Pregnancy #1)

Q: How long did it take you to recover from that loss?

R: Physically?

Q: Emotionally.

R: I just felt like I was a total failure, I think I honestly didn’t recover from it until Christina was born. You expect a baby and you are getting ready for a new life and then suddenly it’s gone. I think the worst thing is, you realize just then that you are so ready to be parents, and then it is just taken away from you. So many of our friends were already parents and then suddenly this nightmare took place. It was hard to understand because I was the healthiest of our entire group of friends. I just felt that the loss was extremely unjust. The problem is, you want to feel really happy for your friends but you can’t get over the injustice that had been served to you… I kept thinking what have Stanley and I done to deserve this awful misfortune? We new we would have to pick ourselves up and try again. 

Q: What was the name of the hospital you were in at the time of the first delivery? 

R: I better not say. It was a university hospital but they just didn’t really offer any explanation as to why such a terrible thing could have happened to such a healthy person. No one was thinking, no one was testing, no one was doing anything… they just said I had preeclampsia.

I was left to go on the Internet. Back in 2003 there wasn’t a great deal on the Internet. It isn’t like now, there were only a few really rubbish web sites. I read one about a woman saying, if you eat eggs and protein you probably won’t get preeclampsia, and someone sent me to an herbalist and she said, well, preeclampsia happens to stressed women with pressurized jobs. I was just left feeling that I had done something wrong myself, it was something that we had done, and the whole thing was very disappointing and very depressing. No one was able to say, it is because of this or that, and it is not your fault.

Q: Did anybody tell you what you should do, how to go forward? Any suggestions?

R: Nothing, just try it… it was, well you’ve had a c-section so in 6 months you should try again. That was it.

Q: Did they tell you that you might have preeclampsia again?

R: Yes, they said since you have had it once you are at risk for having it happen again. I got in touch with a preeclampsia charity and they had a befriending service so again it was someone who lost a baby as well and she had decided to go ahead and have another one, but she did get preeclampsia with the second one. She was really sweet and supportive but there was no medical insight or thinking or any relevant testing at all. It was just a very bad situation. The hospital did a few tests. Borderline elevation of anti-cardiolipin antibodies was reported witch normalized by the time it was repeated. I was reassured that chance for a repeat preeclampsia is remote. I should take aspirin and high doses of vitamin C and try again. 

Q: So you decided to risk it again?

R: Yes, definitely, we felt that it was really bad luck, but we wanted to try again. So 6 months later we tried again and I was pregnant right away, and this time we didn’t tell anyone and I went for a scan at 12 weeks again, and they said there was a bit of a nuchal fold. They told me to wait until 16 weeks and have an amniocentesis. I went to this well-known Park Avenue doctor specializing in high-risk pregnancies. He was a really good guy, who runs a private clinic there, and you could go in and pay and have really good blood tests and ultrasounds performed. When the blood tests were back, he said the numbers weren’t looking very good. I could either wait for an amniocentesis or have a CVS. So I had a CVS that he did himself. Subsequently, I was called in and he said, “I’m really sorry, but your baby has Down syndrome.”

Q: Do you know which chromosome was affected?

R: I can’t remember exactly. Could have been 21, I think.

Q: They advised you to terminate the pregnancy?

R: Yes.

Q: So they performed a D and E at 14 weeks (Pregnancy #2)… Was there any complication?

R: No…we just really wanted a healthy baby; again we were just really devastated again.

Q: How was that recovery? Did you return physically to your activities?

R: The damage was all emotional. I returned to all my previous physical activities, running, etc., Then about a month later we were told we were moving to the West Coast for Stanley’s work and I was excited for the change because I felt as if everything else was going wrong. Then just as we were moving I felt pregnant, so I moved out to San Francisco with a new pregnancy. I think the baby would have been born around middle of February, so I stopped work and I went to a university-affiliated hospital in Oakland. A scan at 9 weeks showed that I had a twin pregnancy but one was a blighted ovum. I was given high doses of Progesterone until the 12th week. Then I had an amnio at 16th week that was perfect. The baby was in the 50th percentile. The blood pressure looked good and I was expecting to stay in San Francisco and keep things really quiet and have the baby.  Then around the 20th week, they noticed I had very low amniotic fluid, and they told me it might be because of the heat, because I was not used to the warmer climate, so they sent me home to drink loads of water. I had a late scan at 22 weeks that showed diminished amniotic fluid and the cord had a single artery. The baby was now in the 25th percentile. I was told to go home and drink a lot of fluid and rest. Then at 23 weeks, one night I became aware that the baby wasn’t moving. The next day I had an induced delivery of a stillborn baby boy…this was November 11th 2004.

I had a D&C a week later to remove retained placental tissue. (Pregnancy #3)

 

It was just awful, another boy, and we had to go through the whole delivery knowing that our baby was dead.

Q: How long did you suffer through the delivery?

R: A whole day, it was just awful.

Q: They delivered you, and then they let you go home…. There was no discussion about what could have been the problem?

R: The only answer I got was just to try again, and they said we have done your testing and it looks like… we will TRY you on Aspirin first, and if that doesn’t work then we will TRY you on Heparin. I think my grandfather’s Hungarian temper came out and I said I am not going to have any more pregnancies until I know what is going wrong. I just got really angry about the whole thing, if I just got really angry and pissed off about all of this then I think I stand a better chance… and no one was the least bit interested in thinking it through or helping, Stanley and I really had to do it on our own. I found myself in San Francisco, I didn’t have my fancy job anymore, I wasn’t working, and without a baby, and none of the pregnancy yoga classes anymore, I had nothing to do… so I went on the Internet to do some research and read and read and read.  I went back to my doctor and demanded more testing. The first thing they did was testing me for antibodies, and diagnosed Anti-phospholipid Syndrome, with raised anticardiolipins. I was reassured that with proper therapy my chance to have a full-term delivery is 80%. So I looked at that and realized that it is frequently seen in women with pregnancy losses. They often have raised anticardiolipins… So then I found a board of women who were having pregnancy losses and several of them had late losses… and they had all been given heparin and aspirin, and I followed this board for several months (you know one of those patient help blogs)… and I just noticed that these women were getting no where, they were not having much success and a lot of them were getting worse, they were getting miscarriages earlier and earlier… and I remember sitting there and thinking, they were really nice and a great support, but these ladies had 5 or 6 miscarriages and Heparin and Aspirin was just not helping them. And then I was reading some more about antibodies and learned that they are an immune response… and I thought about anticardiolipins some more. Well, if Heparin is any part of it then what else do I need to do? … And then I found Dr. Beer’s web site. So I started looking at that and thought this is good because I can take everything into my own hands, I didn’t have to trust any more doctors… And then I registered with Doctor Beer’ office. It was a very empowering thing because for the first time I thought that I could do this on my own and I didn’t have to listen to anybody, I didn’t have to wait for an opinion… I could go speak to somebody. Dr Beer’s office is on the West Coast. Send some blood work off on my own and get a response… I was told by several doctors at the hospital “people are doing work on that but it’s controversial and we don’t really approve of that”, and I just said look, if it is an immune problem then I could use something like IVIG.. I had been reading the boards about different treatment and they just said “Yeah, it’s controversial and we don’t approve of it…” so again it was like hitting my head against the wall, so I sent my records and bloods to Dr. Beer and then I had a phone consult with him. Dr. Beer said that we have a D/Q alpha match and the reason we lost this little boy, Daniel is because my immune system had reacted very badly to this D/Q Alpha match, that we produced a baby that was so similar to myself and my immune system had treated it like it was a cancer, like an altered cell and that was the reason. I recall, in addition there were some MTHFR and elevated NK cell problems also.

Indeed in January and February I had very strong pregnancy symptoms, still no pregnancy. I was convinced that my immune system after two late losses is working overtime, preventing spontaneous pregnancy.

Therefore, I needed leukocyte immune treatment “LIT” and IVIG, Heparin, and Aspirin, and that was what we did. To be honest, no one else had given me any kind of explanation, so at least we felt better just being given an explanation. It turned out to be the wrong answer but it was the first answer anyone had given us…you know? It felt like someone was actually listening and thinking and actually interested, so I was very grateful to have someone on our side, so I went off to Mexico and had LIT. They did this to sort of boost what he called blocking antibodies, and then I had IVIG and I kept doing repeat tests and when it looked like my immune system was nice and calm and I thought I had covered everything, we tried for another pregnancy.  This time around, when I got pregnant there was basically…. there was no heartbeat at all. (Pregnancy #4)

Q: Tell me, did you have issues with hair loss and with a changing period pattern?

R: Right around that time I just noticed that my periods were going to pieces… and I had been like clockwork, it was just a brown color and would go on for days, it would be bright red flow and then just stop, and then for 5 days it would be brown nasty stuff, it just didn’t look healthy, and I started to have bleeding when I ovulated and my ovulation would normally be very regular and again it was all over, and then I had hair loss, it ended up being changing hormone levels that were flying around with unpredictable mood swings. Dr. Beer said if you got this then you might need some extra hormones, but looking back I was really grateful to him for showing an interest and having an idea, even though they were the wrong ideas… and I think sometimes his idea was: you just need more IVIG and more of this stuff…

Q: He usually gives people Humira and IVIG? That was the heparin, yes?

R: I had a pregnancy and I knew my immune system was calm, but there wasn’t a heartbeat so he said maybe your immune system is just really jumpy, I want you on Humira for the next one, so I then tried Humira and I ended up seeking out the opinion of a rheumatologist in San Francisco who turned into a really great friend. He was working in a small hospital.  He said, I wont give you Humira, but I will give you Enbrel, which I think is better, its not as permanent, it just goes after the bad guys, it will suppress your immune system but not block it, he said I’ve never treated a patient in pregnancy before with immune problems and I’m very interested in learning about this, and so he gave me Enbrel. Again, I went back to Mexico and had some more LIT.  In the meantime C.S., a former patient of Dr Toth had emailed me and she said “You know Rosemary I have been reading your posts and I hope you don’t mind me emailing you but I think you have an infection, everything that happened to you sounds like you have an infection, I went to Dr. Toth and found an infection…” and I said thank you for the email but I really think with Enbrel we have this thing nailed and we are going to try again, but if things go wrong then I promise I will give you a call…

Q: Did C.S. deliver a baby?

R: Yes, she did, she said “you should really think about this because I think you have an infection and its either you or your husband and if you continue to take immune suppressants it isn’t going to help and its actually making your periods and everything worse…it is aggravating the infection and you are just going to make it worse” I mentally stored what she said and thought if something goes wrong with the next I will call her…

Q: Did someone give you Doxycycline at any time during all of this?

R: Yes, I think I had a test and it showed Strep B, Dr. Beer gave me a ten-day course of Doxicycline… and that was why I think I got pregnant…

Q: What year was that?…2004… 2005?

R: Good point, I am really loosing track. I really thought I had done everything and that it had to work, but then we got there and I was pregnant immediately but the scan showed no heartbeat, and the woman asked me “isn’t this your 5th pregnancy now?”… So I remember emailing C.S. and she responded to me right away and emailed me as much as she could and answered my questions. So I sat down with Stanley and read your web site, and I said that if it is an infection, it makes sense, but my immune system is flared, and the more immune suppressants I use and the more pregnancies I have the worse the infection is getting, and now I cant even get pregnant without IVIG and all this stuff… and then I sat down with Stanley and told him “you do understand don’t you”… At this point I had done all this treatment in LA with Dr. Beer and then I even had dragged him to San Francisco. So then I said to Stanley, now I think we have to go to New York... and he said I have looked at the flights and we will fly Saturday… and then at this time I had this pregnancy that was going nowhere…It was really a chemical pregnancy. (Pregnancy#6) 

I lost it in the form of a heavy blood clot after four days delay of the period.    

 

Q: So you were pregnant with #6 when you made your reservation for the plane to see me? 

R: Yes! Six documented pregnancies. There were however at least a half a dozen occasions when I was sure I was pregnant but the period arrived before I had the chance to do the test. We came over to see you; it was a blizzard (laughing)… I didn’t care I was going to get there… 

Q: Rosemary, on that day everyone cancelled, you were the only one who kept the appointment (laughing).

R: When we got to you we thought to ourselves, what else do we have to lose? We’ve already lost everything… I told my rheumatologist and he said, “I really don’t think you have an infection. I think it is a long way to go to find out you don’t have one…” And then I talked to you and you told me “I think I know what’s wrong with you before you are even here”

Q: “I said that?” (Laughing)

R: Yes you did, and you said “you need to come, plan for a week or 10 days, ideally 10 days, and I think without you even coming I know what your problem is…”

Q: What was your impression of the first office visit?

R: I just remember being quite scared about the whole thing, but just feeling in very capable hands, and I think the pair of us were just relieved to get an answer”

Q: “Well I did not have the result of the cultures at the time we started the therapy, but based on your medical history I had a good idea what the cause might be?”

R: I think you did a prostate scan didn’t you?

Q: Yes, I did the prostate scan which was quite revealing… 

R: and then you basically said “AH HA! I think we know what the problem is sir…your prostate is like a gravel pit”… Stanley and I didn’t really care whose fault it was, we were just really concerned to get it right.

Q: Tell me, how much did the therapy take out of you?

R: You know Stanley really suffered the most. We planned on having a lovely Valentines meal and he was just laid up, he could barely move, he was so sick with flu like symptoms, so every night I would go around by myself and try to find pizza and take out food… yeah he had about 2 or 3 days like that…

Q: This is the so-called “Die Off Phenomenon” reaction, more like major flu like symptoms, with high fever, muscle ache, and muscle pain, due to absorbing bacterial proteins from the killed bacteria. Stanley probably could not do much for 48 hours.

R: I did not have any reaction. There were no large pockets of bacteria in my uterus as Stanley had them in his prostate. The monthly periods cyclically depleted the bacteria in my uterus but my immune system was battling it all of the time, yes? I think my immune system was so alert that as soon as a new pregnancy tried to take hold in my uterus it kicked in and rejected it. All failed pregnancies kept putting infection ahead with an ever-increasing immune response. It was just too much. I couldn’t fight it. I am sure I had many more pregnancy losses. Some of these pregnancies were so short; they did not even upset the onset of the next menstrual period. I could feel them…

Q: I’m sure they were pregnancies…Tell me, what was Stanley’s opinion of my therapy? Was he cursing at you?

Stanley gets on the phone-

Q: Stanley, after you left me… the memory… was it a nightmare?

S: First things first-we were in this together, we just wanted to kind of come to a point where we could get answers and figure out what was going on?

The idea of prostate injections is much worse then the actual procedure. 

The three days with the die off event was like a really bad flue. I think my brother looked it up that it was toxic shock, where the Chlamydia cells are being destroyed and they were discharging bacterial proteins… I felt absolutely rubbish in that hotel on 61st street for about 2-3 days…

But listen, all that bad memory stuff, its all gone… 

Q: My last question to you is whether there is any long lasting adverse affect from the therapy?

S: No, I don’t think so DT, there was obviously a period of healing going on after, to be honest the sperm was a little pink a few weeks following the treatment but everything turned back to normal. The psychological complication has nothing to do with your treatment. The whole trying to get an erection to have perfectly prescribed timed sex with Rosemary… um… to try to make another baby, on two occasions I was getting really quite worked up about it.

Q: Well those things are part of the course I would find it abnormal…

S: Well plenty of other people have to do it on a far more frequent basis than I do, but it only happened to me on two occasions where Rosemary was looking at the calendar going “come on Stanley, lets go…” it wasn’t just the whole time of the month thing, I think it was the fact that we had just spent a ton of US dollars on treatment for Rosemary and if it wasn’t the perfect cycle moment it may not work, I MEAN ALL THIS MONEY AND I CAN’T GET AN ERECTION! (Laughing) I can now say that I am completely unaware of anything long term that DT did to me, as far as we are concerned we owe our life to you, you can have as much time with us as you need. 

 

Q: Rosemary, after you arrived in New York, we went through the interview and then the agreement was to start antibiotic therapy without even knowing the result of the bacteria studies. I was almost certain what the underlying culprit was... Yes? Did I make that statement on the basis of the history or did I make it after I performed the ultrasound examination on Stanley?

R: You did the ultrasound first and you gave us a good idea of what it was and you did make it clear that there you wouldn’t really know until the cultures were back

Q: The therapy itself, did it cause any yeast problems later on or other type of vaginal or bladder irritation? How and when did you start feeling that things were turning around in your pelvis?

R: I just knew. As soon as the therapy started I could feel that something good was happening…

Q: So after we finished the therapy here, as a routine, I always put patients on oral antibiotic therapy for at least a month, correct?

R: Yes

Q: By then I probably had, at least a partial idea of the culture results.

R: Yes, you were pretty sure that Stanley and I had Chlamydia, and you said that was what you expected, and the whole thing made sense, suddenly everything made sense because I couldn’t ever understand why I was so healthy but had all these problems and then suddenly it made sense; it felt good to understand the problem. It was a really big step for us, because the immune treatment had been really difficult. This helped us understand why the immune treatment didn’t work; we had been trying to fix the symptoms when we really needed to go after underlying problem, which was the infection. Once we started doing that, then a lot of these other problems would go away

Q: Now Rosemary, as I recall, you told me that before you came to New York, there were already appreciable signs of certain changes in your menstrual flow, in your overall well being, and your pelvic function, correct?

R: Yes, I had by this time 6 pregnancies. Yes, my cycles were pretty messed up, and my menstrual flow was brown and nasty.

Q: Do you remember how the menstruation changed after the therapy?

R: C.S. had told me that I would be amazed because my menstruation would be back to being normal right away, and it was. She was absolutely right, and I just felt much healthier. It was a significant, immediate change.

Q: Now I do not have any records of what happened over the next few months?

R: Well, you told us to go home, to go diving, no babies, and we waited 3 months, you said that every month as my immune system was recovering, our chances to get pregnant would improve. So we tried in the 3rd month and I had Enbrel in my refrigerator still so what I decided to do was combine the Enbrel with Heparin and Aspirin, and again that month I felt like I was pregnant but there was nothing there, so for the next month I went and had an online discussion with another lady who said not to do Embryl or Humira. She had combined Dr. Beer’s treatment with your treatment, and had felt that her immune system had been really flared up, and it just wasn’t going to calm down. I tried that month without the IVIG and it didn’t work, she said don’t do Embryl, it will suppress the immune system too much and it will allow any left over infection to take hold, but she did tell me to go with IVIG. So the next month I discussed this with you and I took Zithromax, I think for the first 10 days.

Q: Correct, that is the protocol

A: So, Stanley and I did, and then I didn’t take anymore Embryl. I had IVIG and then I got pregnant with Christina.

As soon as I was pregnant I spent 10 hours of trying to find somebody to start the intravenous antibiotics. 

Q: I remember vividly those 24 hours when you were frantically searching for a doctor to give you IV Clindamycin…

R: Yes and thank god I was in San Francisco, because I knew this rheumatologist in the hospital and he said if it was an emergency that they would try to help. I got a letter from you, but all these doctors weren’t sure, fortunately there was one Indian doctor who was on duty and he said, I think this is actually what is needed for this infection and I do not see the harm in it, so he helped me. I was lucky that he was there. I had the IV for 10 days and then I had a scan at 4 weeks and they heard the heartbeat. Then I had a scan at 9 weeks and everything looked perfect. Just about that time Stanley was transferred back to New York where I found a new OB doctor. I had a nuchal fold check and everything was perfect; it was absolutely perfect and yet I was still terrified, I came back with the numbers of a 21 year old. 

Q: Did they suggest amniocentesis? Or a CVS?

R:  No! They said your numbers are so good we are not suggesting anything; there is absolutely no chance of anything being wrong

Q: So as the pregnancy proceeded, did your anxiety grow with the size of the pregnancy?

R: You know I was just still worried, I did IVIG until 4 months I just kept testing I think I had 2 or 3 more IVIG’s, my NK cells were checked repeatedly and I took antibiotics repeatedly…remember?

Q: Oh yes! I remember I always gave you oral antibiotics…

R: I took Clindamycin and Zithromax, so we did 3 oral doses, after that if my NK cells were elevated a little bit then I would know, it was time to do more oral antibiotics… so in the end I sort of calmed down and I was more confident that the antibiotics alone were doing the job, I still continue to do the immune tests then I knew for sure that everything was okay and I had scans every 4 weeks, the whole thing was quite a challenge…

Q: How close to the due date were you with Christina?

R: I delivered at 39 weeks. A planned cesarean section; because my first premature delivery was a cesarean section. So my OB said we are not taking any chances, I do not want you to have any problems with the delivery, so we are just going to do a planned cesarean section. 

Do you remember that I wrote an essay on reasons why I wanted to have a cesarean section? I wrote it and had you sign it to give to my OB but she ended up telling me that I needed a c-section anyway… 

Q: I just signed it I guess?

R: Yes

Q: Any complications with the c-section or immediately after Christina’s birth?

R: Absolutely none, it was just the happiest day of my entire life! Because it was so relaxed, I remember Stanley and I sat there and we were just waiting all of these years for a baby and then suddenly they came in with a big smile and said “So Rosemary, do you want to come in and have your baby?” (Laughing) It was a Friday and everyone was relaxed… it was really nice. They wheeled me into the operating room and there were no complications when Christina came out, she was just perfect…

Q: Did they put you to sleep or did you have an epidural?

R: I had an epidural. The whole process felt like a party.

Q: FANTASTIC!

R: We had a camera when she was born and it was really a happy time! Then they discharged me 2 days later…

Q: Did you breastfeed?

R: Yes, until about 8 months

Q: Did you experience postpartum depression/ postpartum blues?

R: No! I did not have any of that… it was just elation

Q: How many months went by before you had this idea of having the second one? 

R: Do you remember we came to see you… Christina was born in March of 2007, and we came to see you in November, 2007.

Q: What did I do? I did 5 days of washes and 5 days of IV Correct? Did I do anything to Stanley?

R: Yes! Stanley had treatment as well 

Q: Then I let you go back home to try without immune therapy just by using antibiotics… 

R: And then I did Zithromax… 

Q: but then you measured your antibodies? And they suddenly went through the roof as soon as you tried…remember? It was an incredible flare… 

R: Well yes. So I did IVIG and managed to get pregnant again.  A couple of weeks later I went for a scan and there was no heartbeat, so we were like oh my god! This is completely ridiculous! 

Q: We had a long discussion and we arrive to the conclusion that you cannot be exposed to the seminal fluid because it just makes you flare! Wasn’t that the final…?

R: I think I said to you that I was going to try at least 2 more times and if this doesn’t work then I am going to do IVF,

Q: Yes, with IVIG of course?...

R: Yes, I said to myself that I’ve just got too many variables here… I know that my immune system flares… I know I need IVIG, Stanley and I need antibiotics, I’m a few years older and I now need a decent egg, so we tried a few more months and nothing was happening, in fact every time we started trying naturally I felt like I was getting flared. It wasn’t even 7-10 days after intercourse. It was the next day! And I would have to like sit there, really fighting it to get rid of it…

Q: Yes…

R: That was the time we realized that we have no other option besides IVF.

Q: Who was the doctor who did your IVF?

A: At that time Stanley had a job assignment in Boston, so we joined up with this private clinic my friend had great experience with and I went for an uneventful IVF cycle with day five transfer of two blasts. 

From then on I had IVIG when I needed it, they gave me progesterone in quite high doses. The HCG determinations showed exactly the same numbers as with Christina, no CVS, no amnio needed, they said that this baby is perfect. Brian was delivered at 39 weeks and he was 7 pounds 12 ounces. 

Q: And in terms of infectious complications with the children, do you recall anything… nasal, tonsils, bronchitis, allergies… any of those things?

R: No, nothing at all, absolutely nothing, neither Christina nor Brian ever had any chest infections, ear infections, nothing.

Q: tell me… your menstrual period resumed perfectly normal again?

R: Yes, it has 

Q: Did you resume your physical activities?

R: Yes, I started running again but now I don’t have the time! (Laughing)

Q: Well I believe it! You have a full time job now

R: I think when Christina starts school is September it will be easier because I will have more time in the day… people will tell me “you are only having 2?” but to me 2 is enough! 

 

Analysis of the case:

Treatment: