Auto-Immune Mommies and The Emperor's New Clothes

We invented the "Implantation Blastocyst Rescue (IBR)" to monitor the little life every 2-7 days during the most fragile initial stage of embryo after implantation.. If growth retardation, it will be rescued immediately. So far, the survival rate is as high as 50%...
Consultation
2023-03-10
Author: Dr. Hsing-Hua Lai, MD
Translator: Dorothy

Do you believe in the existence of "Auto-Immune Mommies"? Before one of our patients- Zhao Xiaoqiao gave birth to a daughter, 90% of reproductive doctors in Taiwan do not believe in auto-immune in infertility, even rejected immunologists!

Strangely, a small number of physicians who have successfully studied reproductive immunity have a lot of patients. These clients are repeatedly implanted with failure and come to the clinic for help. Why do the reproductive physicians "deny" it? Interesting! What is the unspeakable secret between reproductive physicians and those who repeatedly failed in implantation?

iVie No.45-The protagonist of the cover story—Miss L

At the age of 30, Miss L tried to conceive for three years but failed. Additionally she failed three times in IVF. She had been to many fertility centers and finally came to Stork Fertility Center for Personal-Precise IVF. However, the result of the first embryo transfer is shallow implantation. It was strange! It is said that 80% of people at this age who have regular intercourse and do not intentionally use contraception can become mothers within a year. She failed three times in IVF by using the same methods, and she should have succeeded by implanting the good embryo at the right time for the fourth time. Why did she still fail? Every patient  should have the courage to ask their doctor: "Why?" If the answer is "probability", please leave without hesitation, and don't make things difficult for yourself.

"Shallow implantation '' is usually caused by "immune attack". The outermost layer TE cells of the blastocyst are also called trophoblast cells. The mother's uterus does not recognize them, so the implantation will face the possibility of being wiped out immediately. If without protection, the auto-immune mommy doing repeated implantations are all in vain. Even if you spend all your wealth, it is a waste of work.

Stork Fertility Center began to get involved in reproductive immunology in 2008.

After 14 years, we finally figured out 90% of the body of the "elephant", so we can handle cases that are as difficult as Xiaoqiao. After the news was exposed, a few doctors began to show a positive attitude with reproductive immunity. However, they mistakenly thought that it is done to transfer those who failed in pregnancy to an immune doctor. The actions caused troubles for the immunologists. To be clearer,  it is just an escape.

"Screening Criteria" and "Implantation Strategies"

Talking about auto-immune mommies, you must first establish a "screening criteria" with an immunologist. Those who have tried to conceive for two years, miscarried twice, or failed in two IVF implantations are all candidates of our criteria. After the candidates are confirmed, they will do the preliminary and advanced auto-immune screening. We usually do not spend a lot of money on biological therapy. The main task is to do the "dynamic three-collection" to find out "accomplices" that appear in different timelines. This is called "sacrifice hit" or "exploring the way". Don't think that a sacrifice hit will not succeed. In fact, more than 50% of patients graduated this time, which means that 50% of patients who gave expensive biological agents without "accurate diagnosis" are waste of money.

If "first transfer" fails and is diagnosed as an immune mommy, "second transfer" will use biological agents. Usually, more than 80% of patients can look forward to the baby shower. The last 10% need to adjust strategies repeatedly to achieve success. We Stork invented "Implantation Blastocyst Rescue" to accompany the embryo. Monitoring the little life every 2-7 days during the most vulnerable initial stage of life. If "growth retardation" is found, they will be rescued immediately. So far, the survival rate is as high as 50%, and they will be accompanied by at least for the first three months of pregnancy before they can "graduate".

We Stork has long been positioned by patients as "the last stop for having a baby". The reason is that we always "take our patients as teachers" and stand on the "same side" with them. We believe that the more successful patients are, the more successful we will be. This is not an easy task. However, it is full of a sense of accomplishment and joy, which is also the daily persistence of the team.

Differences between "Stork" and "Non-Stork"

People often ask me how many reproductive centers there are in Taiwan. I said two, “Stork" and "Non-Stork". The difference between the two is "whether to continue to learn across fields and keep pace with the times?", and will always provide the best solution which is "not yet written in the book". More specifically, all members have a common vision and mission. The goal is to have a pregnancy rate of 90% and a live birth rate of 80%. Every link must be accurate and "well-evident-based". If failed in IVF, we can review and improve. We will never use "probability" to fool our patients. Therefore, we keep progressing every year and will never stop. It may be hard to tell the secret that cannot be said, but the uniqueness of Stork is very clear. "We love to take the difficult road" and "the road that others dare not take. Making success fast and happily is our values.

These values lead us to the further destination.

*This article only reflects the treatment status at the time of writing, and the actual situation should be discussed with the doctor.

Comment

Stork Fertility Center
Stork Fertility Center

1. Miss L did egg retrieval twice as below

Egg retrieval First time Second time
Egg number

#16

#11

MII(Mature egg)

#15

#11

2PN(Fertilized egg)

#12

#8

Blastocyst number

#8

#6

PGS results

Euploid#1/Mosaic#1/Aneuploid#2

Euploid#1/Mosaic#3/Aneuploid#1

2. Miss L did transfer twice as below

transfer First time Second time
PGS Blastocyst Euploid #1

Euploid# 1+Mosaic #1

Immunosuppressive drugs Plaquenil / ARIXTRA / low-dose IVIG

ARIXTRA / Humira / high-dose IVIG

Day 7 B-HCG

88.93

122.5

Day 14 B-HCG

29.13

3673

result Shallow implantation  live birth
murderer Antiphospholipid syndrome
others The baby was mosaic blastocyst according to PGS result.

3. Shallow Implantation: Miss L was given low-dose IVIG. It is suspected that the dose is not enough so ended up abortion.

4. Reproductive Immunology: It began to be taken seriously in about 2006. In Taiwan, it started with Professor Xie Songzhou of National Taiwan University and his two colleagues, Dr. Quan and Dr. Du. Different from the traditional rheumatoid immunology department, they are one of the few trustworthy "immuno-reproductive physicians".

5. Reproductive immunity is the "last mile" of IVF. If you don't achieve "full marks" in the first 99 miles, you will definitely spend a lot of money and be heartbroken. Frankly speaking! If you don't do third-generation Plus or a reproductive center with poor grades, you are not qualified to talk about reproductive immunity.

6. Songziniao 2022 further invented "implantation first aid". If time goes back to 2021, Ms. L's "Yizhi" found that the embryo was attacked (shallow implantation) in the second week, and we are now sure to rescue him.