Immune Testing Doctors

Does anyone know of any other docs that do immune testing besides Braverman on LI? I believe I saw some posts about Kofinas?

Thanks!

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Immune Testing Doctors

It's pretty much Braverman (Reproductive Immunologist) or Kofinas (a perinatologist / MFM, as said above).

In the city, there's also SIRM, but their immune testing is very surface level for just a few basic things like natural killer cells and DQalpha matches.

I've been to all 3 of these practices.

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Thanks. I'm asking for a friend who is at Gold Coast. Looks like she's on her way to her third failed transfer. I mentioned RLP testing and immune testing and she had no clue what I was talking about. She doesn't Google or go on infertility forums. I told her she needs to start.

Any other suggestions for tests to ask for besides RLP and Immune? Her RE does an endo scratch and gives her steroids before each transfer but it still hasn't helped. She hasn't even had a CP. I was also going to suggest an ERA.

She has a failed fresh with 2 embies last year and possibly 2 failed FETS with PGS tested embies this year. Her beta is tomorrow but she's been testing negative. Hoping the tests were wrong.

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I've been to SIRM but it was just some basic testing, Dr. T in in the City. I've recently also seen Dr Kofinas in Garden City which was more detailed.

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Message edited 11/29/2017 9:27:25 AM.

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She seems to be in denial right now that she needs further testing. Her beta was less than 1 today. I'm hoping she will snap out of it but she said he's going to do her last embie transfer with him. I told her to demand RLP and immune testing but something tells me she won't.

As for you, I'm really sorry to hear this. What's the next step?

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Congrats! So what ended up working for you?

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She's in denial that she should have any further testing whatsoever, not just immune testing.

I am not being pushy. I'm trying to help her. I gave her a list of things to ask her doc, including to ask about an ERA and the RLP, at a minimum. The doc apparently told her it could take 6 or 7 transfers before an embryo sticks and she didn't need further testing. She paid 20K out of pocket last year and transferred her only 2 blasts. This year, she had 3 rounds of IVF and only ended up with 3 blasts and has maxed our her IVF insurance. She had 2 failed FETs and only has one left. Why risk her last one without having at least one or two more tests done? She doesn't even want to go to another doctor for a second opinion.

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Thanks for trying to give me advice to back off, but when she told me she didn't need further testing bc the doc told her she should transfer a bunch more embryos first, I mentioned ERA and a receptivity test. She had never heard of these things and was grateful for me suggesting them.. She made a consult with her do to bring them up. This happened after I made the initial post about the immune testing. She said she doesn't like to do research because it scares her, but after talking to me, she started reading up on tests and is glad she has options to talk to the doctor about. I never butted into to her issues. She asked for my opninon in the first place since I am struggling with infertility as well.

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So how does it work with Kofinas since he is not an RE? He will test you for immune issues then what? He can treat you but you just have to find a clinic that will work with him?

My friend is doing her final 4th transfer with Palter in a couple weeks and didn't get any testing done. She said said will find a new doc if this fails. I hope it works out for her and she won't need a new doc, but I want to help her get everything lined up asap.

I found a website of clinics willing to work with a RE that specializes in immune testing and RS of NY was listed on there. Anyone know if this is true?

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Message edited 1/2/2018 9:29:14 AM.

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Hmmmm ok. So, Kofinas really won't be able to help her if he can't treat her during IVF. She will habe to do another round if the next transfer fails.

I'm not sure where to tell her to go. She's relying heavily on me for advice on where to go to next and who does immune testing. Looks like it Braverman or SIRM.

The doc at Gold Coast told her to keep doing IVF and hopefully one of them will stick...no further testing is needed. Ha. She paid 20K out of pocket for her first round, switched insurance and maxed her 3 rounds of IVF this year. Now she will have to pay OOP again. I told her to ask about an ERA bc she wasn't familiar with them til I brought it up. He told her NY State isn't licensed to perform them and she would have to go out of state if she wanted to do it, but she shouldn't bother. She was not happy with his answers and I don't blame her.

Here is where I got the immune clinic info from:

http://www.immunologysupport.com/collaborating-doctors.html

I went to LI IVF for my IUIs and liked the nurses and Dr. Brenner. So you don't think they would work with an immunologist? The office would be close to her for monitoring but I definitely would not see Brenner on board with immune testing.

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Is she interested in getting further testing done? If she is, why doesn't she call Kofinas for an appointment. She will meet him; he will go over history; and he will write a script for bloods. Let him take all the tests on her; and wait for results. He will have a protocol for her. What things to take before, during, after transfer for whichever doctor she prefers to go to.

I would have her wait on the FET; so she can see Kofinas first.

Then once she has all those eggs in a basket sorta speak, she can schedule her FET with Palter. Palter and Kofinas don't really need to talk to each other. Kofinas' nurses who are great by the way..........are the main form of communication. Meaning they will tell her, "hey when you know your transfer date, tell us. Hey, when you know the date of this call us and tell us." From there they tell her what to do in phases. Supplements to start/finish. When to schedule immune treatment (if needed).

Thats what I did. I wasnt going to go crazy trying to find a doctor that was on board because they were few and far between.

Braverman is a fortune; but she can try him if $ is not an issue. SIRM is great if she dont mind the city. So its really her choice in what and who she prefers. All I am saying is she doesnt have to have a DR that is on board with what Kofinas does. They really have no say. And to be honest, half of the things I kept to myself. Kofinas office would tell me what to do, and I did it. I did not tell LIIVF; because at the time; their opinion didnt matter to me nor was going to change my decision in my treatments.

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I agree with you 100% that she should get tested before doing her transfer, but she won't. Her current attitude is "let me just do my last embryo with him then move onto another doc of it doesn't work." I personally would not take the risk, but she's relying on her last consult with Palter where he said "all tests have been exhausted and there is nothing left to test."

This is very helpful. I thought that Kofinas wouldn't be able to treat someone if you are doing IVF under another doctor's care. I wouldn't tell Long Island IVF, either, but I thought Kofinas would he required to reach out to the doc there. Good to know. Anyway, she hates the city and if Braverman is a fortune, sounds like Kofinas is the way to go.

My friend is very paranoid and won't even take supplements like Q10 and fish oil without getting the ok from her doc. Not sure why.

Immune Testing Doctors

I see Dr. Kofinas and go to LIIVF. I am very open with LIIVF and told them that I am seeing Dr. Kofinas. When they ask me what meds I’m on I let them know all the meds including what Dr. Kofinas has me on and what he changes. She has to be her own advocate and in the end all the doctors should be concerned with is getting her pregnant and keeping her pregnant.

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That's good to know you are telling LI IVF. How's your doc there? I was very happy with my care there. I know my friend would definitely not to keep anything from a new RE.

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I love Brenner. I would recommend my friend to him as well. I'm so glad he's fine with you working with another doc.

I'm in VA now on a temp work detail. I don't have insurance for IVF, but they have a shared risk package of 6 rounds of IVF, unlimited transfers, for 28K. You get all your money back if you do a round or 2 and decide you want to go to another clinic. If you have frozen embryos and pull out of the contract, you get 14K back. You can't beat that. Too bad Long Island doesn't have something like that.