Dr. Alan Beer on reproductive immunology basics

19 09 2012

Dr. Alan Beer was one of the pioneers of reproductive immunology.  Here’s a transcript of a Q&A session he had in 2004– full of useful information about immunology, signs and symptoms of immune-related infertility, and discussions about diagnosis and treatment.  If you’ve been told your IVF failures or infertility are “unexplained” or due to just bad luck, keep trying– READ THIS!

Some excerpts:

“The average age of couples I see is 39.6 plus or minus two years of age and they have been
unsuccessful 4.4 plus or minus two times. I used to deal with individuals that have
lost three pregnancies, disgustingly healthy but miscarried every pregnancy. And
now deal with about half of my patient population again disgustingly healthy couples
who make beautiful embryos in the test tube but when they are put back in the
women’s body they all wither on vine.

So the average individual I see has been through IVF three times, they have spend a lot of money — they are angry, they feel that the medical community has let them down, and it has been a real privilege for
me to really learn that this condition actually thought of by many doctors as being
“Nature’s Way”, “God’s Will”, “You are unlucky this time, try again, you will be more
lucky the next time”, is really an immune problem that causes rejection of the embryo
and this immune problem is dangerous to women’s health.

And I would like to tell you at least what I know about this. All of us are born with natural killer cells that
defend us against cancer. These natural killer cells see cancer cells, they spit out a
chemical called tumor necrosis factor alpha and it paralyses the DNA in the cancer
cells so it doesn’t grow and divide, that doesn’t kill the cells but it’s — it’s paralyses the
DNA, so it doesn’t grow and divide.Certain individuals have the ability to make
graduate student natural killer cells that no longer play by the same rules and these
natural killer cells are exactly the same kind that we find in the joints of patients with
Rheumatoid Arthritis and the organs of patients with Lupus, in the balls of the patient
with Crohn’s disease but we find them in the uterus and in the blood of individuals
that I have just described to you, perfectly healthy but indeed have been very
unsuccessful in their reproduction. And Wendy Fisher in whose beautiful home I am
sitting this evening is a classic example of this. She had lost many pregnancies,
[but] came to me [and though] we found her natural killer cells were really on the “Olympic team,”we
were able to suppress them. She got pregnant the first, had Lee, a perfectly normal
pregnancy, beautiful child, got pregnant soon after that, had Andy, a perfectly healthy
normal pregnancy. But now that she is finished with her we are still dealing with the
same immune problem that brought her to me the first time. So, I really understand
what’s happening and patients like all of you and I like to tell you how we make the
diagnosis.”

“Many of the patients that I see come to me with a history of endometriosis. They
have been treated by their doctors, they have had the endometriosis cleared out,
they have been able to take medications for them and the doctors have pronounced
them cured but they go to try again and they have an exceedingly high incidence of
implantation failure and recurrent pregnancy loss. We have found that if we treat the
natural killer cells … the success rate is… in the vicinity of 78 percent success rate
versus..39 percent success rate when the drugs were not used. So there is a
huge difference. Definitely ladies with endometriosis have a problem that continues
even after the endometriosis has been removed and this problem is apparently
immune because when you give them the immune treatments the pregnancies
succeed.”

“15 percent of the patients I see who have activated natural killer cells who are
infertile even if they are treated and successful like Wendy has been, 15 percent will
stop making an enough serotonin. Serotonin is necessary each month to build the
layers of the uterus into three layers or zones and allows blood flow to go into zone
three and when I measure the serotonin level an individuals with this problem where
it should be a 100 to 400, I may find it less than five. And these individuals feel
desperate, they are project oriented, they obsess about things, they put too much on
their plate, they let problems get to them… And there are people awake
early in the morning know that now that sleep there is no longer going to be a part of
their morning, they are project oriented and they get on with their day. And this is
totally due to low serotonin levels which we can treat. There are specific drugs that
will raise the serotonin levels but the most specific thing is taming the natural killer
cells which are so high that they are slowing down the serotonin producing cells from replicating and dividing.

The next organ here is the pancreas, and 15 percent of the women develop adult onset diabetes because their insulin levels get off. And these individuals need to be treated with a glucophage called Metformin to bring the free-insulin level down. Free-insulin in these individuals are very elevated. Free-insulin
doesn’t control the blood sugar, it does only one thing, it makes new fat cells and it
puts them on the thighs, the butt and the hips, and women can jog, women can eat
500 calories a day, they will lose weight in their face, their neck, their breast and their
arms, but the fat on your legs, butts, thighs, and hips, stays, and this is indicating a
chemical imbalance of the insulin.

The third thing that happens is that 15 percent of individuals get underactive in their
thyroid gland. Because we begin making antibodies against for thyroid gland
because individuals need to have their natural killer cells bought down and need to
be treated with the thyroid medications. So, infertility is hazardous to a woman’s
health, and we are only finding that out because we are beginning to take it seriously
as a new disease. Their bodies are really made to have babies when it’s not working
something is wrong. And when it’s not working when you are making beautiful
embryos in the test tube and they put them back in your body and they is still
repudiated, something is wrong. And we are living in a time that we can take care of
this, we can diagnose the problem, we can do something about it.”

“We have found that that the incidence of many individuals I see might have one
live born child and then miscarried after that and then I have outcomes on several
thousand children. One thing I have learned that if the woman is not treated properly
there is a 10 fold increase in hyperactivity, Attention Deficit Disorder, autistic
behavior in these in these children and some of them even have slower than normal
growth. So a problem which we have treated in the mother can be passed on to the
infant and that occurs primarily in individuals that have also made an antibody to their
own serotonin which helps lower the serotonin level just as you can make an
antibody to your thyroid, to your insulin and become adult onset diabetic. These
individuals have antibodies to their own serotonin and that passes to the child and it’s
my feeling that this is in part responsible for the behavior changes that we see. We
see a higher incidence of adult-onset schizophrenia in families of women who have a
history of recurrent pregnancy loss or also implantation failure. So, for the sake of
children yet to be born it’s really important that you know how friendly your body is to
have babies and whether there are any immunities that you have that are affecting
your own systems that could be passed to the unsuspecting child. And in those
individuals that have that problem we treat the mother with good antibody in the form
of Intravenous Gamma Globulin (IVIG).”

[Caller’s question: Now, the IVF world believes that women nearing 40, are over and beyond the hill, it’s
like a done deal, you are downhill from now on and their eggs are not good and as
result your DNA maybe also not good. So, where does immune therapy come in to
change that or to even rectify it that with the immune therapy somebody who is 40
plus, is going to create as healthy of an embryo, as somebody who has not reached
that 40 year mark?]

Beer’s Answer: This patient probably is going in the wrong side of 40 and she is really
wondering about what her chances are because when she goes to IVF centers, they
frown at her and they urge her to do something different. You probably know the
success rate, this is the success rate in individuals and I have seen personally that
had failed three IVF cycles before I see them, come to me for testing diagnosis and
treatment. And in the 40 to 42 year age group, 58 percent of those who return to IVF
deliver a baby. So, the success rate is not two percent, like most of the IVF centers
will tell you, it’s 58 percent and women that are 43 to 46, the success rate is 17
percent and if we use donor eggs in the older individuals it jumps up to 69 percent.
So, I no longer can have long discussions with people like you about their age,
because, to me, as long as you are menstruating and producing eggs, there is a
possibility of a child in your home. And, of course, we worry about the embryo, but in
my experience that if there is DNA damage of an older women’s embryo or egg that
those pregnancies will fail in a matter of two or three days, at the most a week so that
we don’t have to worry about an abnormal baby. In fact the incidence of Down’s
Syndrome and genetic abnormalities in women within the age group is two times less
in the immune treated group than what the life tables predict for people in that age
group. So, what we are doing is not making it more likely for you to keep an abnormal
child.

[Next Caller:] If somebody “has no trouble getting pregnant”, would you recommend going with
fertility treatment in addition to the immune therapy just to boost the chances of
getting pregnant during the immune therapy, or would you recommend trying the
natural way?
[Dr. Beer:] The highest success rate are in those individuals that have failed three IVFs, who,
after the immune treatment, get pregnant on their own. And the peak time of that
happening is 17.4 weeks after the immune treatment is started. So, if the immune
system has caused some damage to the eggs, it appears that it takes at least three
to maybe four months for this to heal, but these are all individuals that had failed IVF
three times, they went back to IVF after treatment, failed again and then again, and I
told them to give up and these are individuals who started showing up pregnant on
their on the average of 17.4 weeks after the treatment was begun. So now the advice
I give to patients, who have high numbers, is to have the treatment, give your body
time to heal and then go for it when we know that you are in a safe window of
opportunity.

“If I had my wishes, all patients with the immune problem would carry twins because
the twin pregnancies do better than singletons as far as the immune system is
concerned. And even if you have a vanishing twin, we have found that the ongoing
pregnancy success rates with the vanishing twin, triplet or quadruplet is 85 percent.
So that a vanishing twin during a cycle or during a pregnancy doesn’t put the other
child in jeopardy. And these are women that are living in terror, they are seeing one
baby dissolve and another baby, they would buy an ultrasound at Wal-Mart if they
could, if they could to scan their baby every morning, say “Good morning baby”,
“Good night baby” because otherwise you are obsessed and worrying about it. But
a vanishing twin doesn’t bother me because it’s not going to prejudice the one that’s
surviving.”

“Yes. The question is stimulated versus the natural cycle. Stimulation results in high
estrogen levels and high estrogen levels stimulate the bone marrow to pour out more
natural killer cells and the success rate of the stimulated versus a natural cycle, it’s
better with the natural cycle. But that’s hard to tell a couple that has spent their life savings on three failed IVF cycles and now see this crazy doctor in California who is telling you to try on your
own for two cycles, but I have learned this from people like yourself.

Caller: Do you have numbers on the percentage of losses that are due to “bad eggs” on the
immune treatments? Does that does that question make sense?

Dr. Alan Beer: Yes. (to audience) The question is do I have any statistics on the quality of the eggs
or bad eggs that are produced, and does this improve with the immune treatment?
The answer is yes, it does improve with the immune treatment, and any cytokine
number above 40 tells me for certain, this a TH-1 TH-2 cytokine assay, it tells me for
certain that your eggs most likely have DNA damage, and I know when that exists, it
takes a minimum of 17.4 weeks for that to heal. And I know this by doing biopsies of
eggs of individuals that go to IVF. And sometimes this is difficult because people like
you go to IVF and a good cycle will be that you will produce three or four eggs, not 17
or 21 so immediately the doctors will say, well, I’m not going to biopsy your eggs
because I might damage them. But I have learned from individuals that have failed
three IVF cycles and then have gotten pregnant on their own that occurs about 17
weeks after the treatment has started, and that’s now this been confirmed by my
program in London, where we are doing egg and embryo biopsies on everyone.”

 

 

 

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2 responses

25 03 2013
Can A Girl Get Pregnant

Timing your sex every second day will give you an opportunityto identify
the appearance of your cervical mucus on the. It is true that sex that is not
within the time of ovulation will not result
in pregnancy. The number of 24 year olds that has had trouble conceiving has almost
doubled in the past several years.

2 04 2013
Georgette

Not really sure this is relevant to anything pertaining to me and my issues, but thanks for contributing 🙂

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