Qus & Ans: Immune System Dysfunctions

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I was wondering if you could answer a question for me. I have been through 7 IUI's and 2 IVF's, which have all failed. My AF has come early each time. During the IUI's.....I experienced a raised lymph node behind my ear at 8 or 9 days past the IUI. In the IVF's we used baby aspirin, and subsequently had no raised L.N. until after baby aspirin was stopped. In those cases the node raised a day or 2 past AF. During a break cycle I experimented with robitussin and baby aspirin and had light cramping and red spotting at 9dpo (apx), but no raised node. Does this raised lymph node send up any red flags to you? My RE seems to not feel it means anything.....but my gut tells me something is going on here. We are doing a hsyteroscopy to map out my bent cervix/uterus better for our next ICSI.....but I feel I need to check this node out before I waste more time and $ on another cycle. What kind of testing should I talk to my RE about regarding this node? Thank you for your input! I am at a loss for what to do next!

Dear patient:

Although I don't have a complete history, I can address your catamenial ("cyclical") lymph node swelling behind your ear.

Your immune system is modulated by sex hormones including progesterone. Thus, many patients will describe changes in their lymph nodes, including swelling or tenderness, in the postovulatory phase. Some patients could manifest similar symptoms during pregnancy when the placenta will produce a large amount of the same sex hormones.

Nobody has proven though that your lymph node swelling will decrease your success rate through an IVF-ICSI cycle. Your multiple treatment cycles raise questions about the effectiveness of the therapy you have and may undergo. In our program the ratio of treatment cycles per birth is approximately 1.2 per birth, including all patients up to age 44, inclusive.

If you would like to send a copy of your medical records followed by a telephone conference, I'll be glad to review your records. Our fax number is 615-321-8877; our address is 326 21st Ave North, Nashville, TN 37203.

Sincerely,

Jaime Vasquez, M.D.
Voice: (615) 321-8899 ~ FAX: (615) 321-8877

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