Hi Dr Sher

I have recently discovered your work and am curious if you think I should pursue an autoimmune protocol for IVF. 

I’m 40 years old and have undergone 2 unsuccessful cycles of IVF this year. I have been pregnant twice before, one at 18 y/o which I chose to terminate, and a pregnancy in March 2022 which ended in miscarriage at 6 weeks gestation. I have low AMH, under-active thyroid which is managed with Levothyroxine and have endometriosis which I have managed via laparoscopic ablation this summer, and adenomyosis in the front wall of the uterus. 

My first cycle of IVF in May 2023 I received just 5 days of stimulation but ovulated spontaneously and so this cycle was abandoned. I then underwent the laporoscopic ablation. In July 2023 my second IVF cycle began, I had one lead follicle which turned out to be ’empty’. I then continued with stimulation and one mature egg was collected. This one egg unfortunately fertilised abnormally as 2 sperm fertilised the egg. The clinic suggested that ICSI should be used going forward. 

I am currently following a medicated protocol with Neo Fertility to optomize my menstrual cycles and prepare for conception. I am taking Naltrexone 3mg every night. I previously took 75mg DHEA daily, but have stopped this recently due to some side effects. My most recent testosterone level was 1.3.

I recently had leucocyte antibody test which came back as low. IgG antibodies were 3.8.

I have also been taking CoQ10 for 4 months and was advised to stop taking for 4 months before taking it again, is there any benefit to stopping and starting antioxidant supplements in this way?

Given my history do you think I should have autoimmune fertility tests carried out before starting another IVF cycle? Which tests should be focused on?

I’m based in the UK but a friend had a consultation with yourself in 2019 and you were able to advise on further tests and give an IVF protocol that she could potentially use with a local clinic. Is this something that you still offer for International patients as I would be keen to have a consultation but am unsure if we could travel to the US for treatment. 

I look forward to hearing your thoughts.