Implantation issues - treatments, causes?

[Anonymous]

What about ERA? That's about implantation timing -- maybe you're just off by 48 hours or so? Again, in the grand scheme of things it's a relatively cheap test.

[Anonymous]

OP here. Just wanted to update this thread in consideration of all of your helpful recommendations. We moved forward with both PGS testing on the frozen embryos and the Beers Blood/thrombophilia panels with CFA. 6/9 of the embryos were chromosomally normal, so we now know it's not an egg quality issue, but boy, were you guys right on the money with the immune stuff! Tests came back recently with a MTHFR mutation, Factor XIII mutation, NK cells WAY out of whack...many many reasons for why we're not even seeing implantation. I can't thank you enough for all your suggestions that we get tested. We'll be starting a FET cycle next week with baby asprin, metanx, prednisone, lovenox and intralipid infusions. Obviously have no way of knowing if it'll work, but wouldn't have made it this far without your helpful suggestions.

[Anonymous]

Anonymous wrote:OP here. Just wanted to update this thread in consideration of all of your helpful recommendations. We moved forward with both PGS testing on the frozen embryos and the Beers Blood/thrombophilia panels with CFA. 6/9 of the embryos were chromosomally normal, so we now know it's not an egg quality issue, but boy, were you guys right on the money with the immune stuff! Tests came back recently with a MTHFR mutation, Factor XIII mutation, NK cells WAY out of whack...many many reasons for why we're not even seeing implantation. I can't thank you enough for all your suggestions that we get tested. We'll be starting a FET cycle next week with baby asprin, metanx, prednisone, lovenox and intralipid infusions. Obviously have no way of knowing if it'll work, but wouldn't have made it this far without your helpful suggestions.

I'm glad you got answers, OP. Good luck!

I was one of the earlier PPs. I had a similar protocol to what you describe, minus the metanx. I'm due in a week. Hope you have a similarly happy outcome.

[Anonymous]

Anonymous wrote:OP here. Just wanted to update this thread in consideration of all of your helpful recommendations. We moved forward with both PGS testing on the frozen embryos and the Beers Blood/thrombophilia panels with CFA. 6/9 of the embryos were chromosomally normal, so we now know it's not an egg quality issue, but boy, were you guys right on the money with the immune stuff! Tests came back recently with a MTHFR mutation, Factor XIII mutation, NK cells WAY out of whack...many many reasons for why we're not even seeing implantation. I can't thank you enough for all your suggestions that we get tested. We'll be starting a FET cycle next week with baby asprin, metanx, prednisone, lovenox and intralipid infusions. Obviously have no way of knowing if it'll work, but wouldn't have made it this far without your helpful suggestions.

Ask for Neupogen instead of intralipids. In the big picture of things the increase in cost is very marginal.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here. Just wanted to update this thread in consideration of all of your helpful recommendations. We moved forward with both PGS testing on the frozen embryos and the Beers Blood/thrombophilia panels with CFA. 6/9 of the embryos were chromosomally normal, so we now know it's not an egg quality issue, but boy, were you guys right on the money with the immune stuff! Tests came back recently with a MTHFR mutation, Factor XIII mutation, NK cells WAY out of whack...many many reasons for why we're not even seeing implantation. I can't thank you enough for all your suggestions that we get tested. We'll be starting a FET cycle next week with baby asprin, metanx, prednisone, lovenox and intralipid infusions. Obviously have no way of knowing if it'll work, but wouldn't have made it this far without your helpful suggestions.

Ask for Neupogen instead of intralipids. In the big picture of things the increase in cost is very marginal.

OP here - I'm pretty new to the immune treatments. What would be the benefit of Neupogen over intralipids?

[Anonymous]

I'm also one of the immune PPs in this thread and was on Neupogen and intralipids - but not 7:34. I don't think you should listen to the PP here. They treat different things entirely. Highly doubt I would have had successful pregnancies on one or the other - I definitely needed both. Trust your doctors and stick to the protocol they set for you.

I agree that nothing you wrote looks like Neupogen is necessary - lovenox, prednisone and IL seem like the big ones here and are used to treat the clotting and NKs.

[Anonymous]

Anonymous wrote:I'm also one of the immune PPs in this thread and was on Neupogen and intralipids - but not 7:34. I don't think you should listen to the PP here. They treat different things entirely. Highly doubt I would have had successful pregnancies on one or the other - I definitely needed both. Trust your doctors and stick to the protocol they set for you.

I agree that nothing you wrote looks like Neupogen is necessary - lovenox, prednisone and IL seem like the big ones here and are used to treat the clotting and NKs.

22:08 here and clotting (Factor XIII) and NK issues (though not severe). Lovenox, prednisone, IL, baby aspirin were my protocol. Also metformin and synthroid. Seems like you should start with IL if that's what your RE recommends; you can always "upgrade" to IVig or Neupogen if the IL doesn't work.

Of course, I don't know about Neupogen, but IL are crazy expensive. $500 per treatment for me. Fortunately I only needed 4.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm also one of the immune PPs in this thread and was on Neupogen and intralipids - but not 7:34. I don't think you should listen to the PP here. They treat different things entirely. Highly doubt I would have had successful pregnancies on one or the other - I definitely needed both. Trust your doctors and stick to the protocol they set for you.

I agree that nothing you wrote looks like Neupogen is necessary - lovenox, prednisone and IL seem like the big ones here and are used to treat the clotting and NKs.

22:08 here and clotting (Factor XIII) and NK issues (though not severe). Lovenox, prednisone, IL, baby aspirin were my protocol. Also metformin and synthroid. Seems like you should start with IL if that's what your RE recommends; you can always "upgrade" to IVig or Neupogen if the IL doesn't work.

Of course, I don't know about Neupogen, but IL are crazy expensive. $500 per treatment for me. Fortunately I only needed 4.

I had many many (20 or so) IL treatments over the course of 3 successful pregnancies with immune treatments. All of them except for maybe 1 was covered under my insurance. I think I paid under $50 for each one. My OB and MFM did the prescribing under high risk pregnancy.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'm also one of the immune PPs in this thread and was on Neupogen and intralipids - but not 7:34. I don't think you should listen to the PP here. They treat different things entirely. Highly doubt I would have had successful pregnancies on one or the other - I definitely needed both. Trust your doctors and stick to the protocol they set for you.

I agree that nothing you wrote looks like Neupogen is necessary - lovenox, prednisone and IL seem like the big ones here and are used to treat the clotting and NKs.

22:08 here and clotting (Factor XIII) and NK issues (though not severe). Lovenox, prednisone, IL, baby aspirin were my protocol. Also metformin and synthroid. Seems like you should start with IL if that's what your RE recommends; you can always "upgrade" to IVig or Neupogen if the IL doesn't work.

Of course, I don't know about Neupogen, but IL are crazy expensive. $500 per treatment for me. Fortunately I only needed 4.

I had many many (20 or so) IL treatments over the course of 3 successful pregnancies with immune treatments. All of them except for maybe 1 was covered under my insurance. I think I paid under $50 for each one. My OB and MFM did the prescribing under high risk pregnancy.

You're lucky. My RE prescribed them so they counted as infertility and as a fed, my otherwise excellent health insurance does not cover infertility.

I count myself lucky too though in expending only about $5k total on this process, including initial testing (and IUI but not IVF). I see from the other thread that many people spent far more.

[Anonymous]

Anonymous wrote:I'm also one of the immune PPs in this thread and was on Neupogen and intralipids - but not 7:34. I don't think you should listen to the PP here. They treat different things entirely. Highly doubt I would have had successful pregnancies on one or the other - I definitely needed both. Trust your doctors and stick to the protocol they set for you.

I agree that nothing you wrote looks like Neupogen is necessary - lovenox, prednisone and IL seem like the big ones here and are used to treat the clotting and NKs.

what kinds of things would be a red flag for Neupogen?

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm also one of the immune PPs in this thread and was on Neupogen and intralipids - but not 7:34. I don't think you should listen to the PP here. They treat different things entirely. Highly doubt I would have had successful pregnancies on one or the other - I definitely needed both. Trust your doctors and stick to the protocol they set for you.

I agree that nothing you wrote looks like Neupogen is necessary - lovenox, prednisone and IL seem like the big ones here and are used to treat the clotting and NKs.

what kinds of things would be a red flag for Neupogen?

low Tregs and I also have some genetic factors that impact my body's ability to recognize the embryo. Neupogen allows better tolerance in the uterine environment by increasing the number of T regulatory cells in the uterine lining, thereby making it easier for your body to recognize the embryo is not a form of "altered self" ie cancer that needs to be destroyed.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'm also one of the immune PPs in this thread and was on Neupogen and intralipids - but not 7:34. I don't think you should listen to the PP here. They treat different things entirely. Highly doubt I would have had successful pregnancies on one or the other - I definitely needed both. Trust your doctors and stick to the protocol they set for you.

I agree that nothing you wrote looks like Neupogen is necessary - lovenox, prednisone and IL seem like the big ones here and are used to treat the clotting and NKs.

what kinds of things would be a red flag for Neupogen?

low Tregs and I also have some genetic factors that impact my body's ability to recognize the embryo. Neupogen allows better tolerance in the uterine environment by increasing the number of T regulatory cells in the uterine lining, thereby making it easier for your body to recognize the embryo is not a form of "altered self" ie cancer that needs to be destroyed.

Thanks. I've had the immune bloodwork but don't have anything labeled "Tregs" on mine. Do they have another name or series of letters/numbers associate with them?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'm also one of the immune PPs in this thread and was on Neupogen and intralipids - but not 7:34. I don't think you should listen to the PP here. They treat different things entirely. Highly doubt I would have had successful pregnancies on one or the other - I definitely needed both. Trust your doctors and stick to the protocol they set for you.

I agree that nothing you wrote looks like Neupogen is necessary - lovenox, prednisone and IL seem like the big ones here and are used to treat the clotting and NKs.

what kinds of things would be a red flag for Neupogen?

low Tregs and I also have some genetic factors that impact my body's ability to recognize the embryo. Neupogen allows better tolerance in the uterine environment by increasing the number of T regulatory cells in the uterine lining, thereby making it easier for your body to recognize the embryo is not a form of "altered self" ie cancer that needs to be destroyed.

Thanks. I've had the immune bloodwork but don't have anything labeled "Tregs" on mine. Do they have another name or series of letters/numbers associate with them?

There are many different kinds of Tregs. I think on your tests they may be listed as CD25+ CD4+ but that also depends on if you go through RFU or Reprosource. Just one cell subset doesn't tell the whole story, I think your doctor would also look at the FoxP3 in conjunction to determine if yours are in the normal range. This is why it's good to make sure you are seeing a doctor who knows how to interpret these tests.