is there any HARM in doing immune protocol recommended by RI? can it decrease chances?

[Anonymous]

I got pregnant with my first without any of this stuff, and now I had 1 chemical pregnancies and a BFN with tested embryos. I had a chemical pregnancy before my first also. But then went on to conceive my first. the RI found elevated TNF alpha, and some borderline borderline anti phosphlooid antibodies so the RI prescribed prednisone and intralipids and lovenox. Is there any HARM in doing those, even if I am skeptical of whether they're necessary?

[Anonymous]

I'm on this exact protocol right now and I don't feel that will do me any harm, though there can be some side effects to the prednisone and lovenox if you are on them for a very long time. You have to make sure to use calcium supplements to prevent bone density issues. In my case I'm skeptical about whether they are aggressive enough. And it isn't free. But if you're continuing to use IVF and have limited embryos, and you know you have the immune concerns, I don't see any reason not to try. If you have someone monitoring you you'll be able to tell from your bloodwork if the treatments are working.

[Anonymous]

How can you tell from the bloodwork if the treatments are working?

For PP on this exact protocol, you only take lovenox and prednisone for the transfer cycle? You stop if BFN and don't take unless you're currently in the cycle.

Curious PP how you got diagnosed and put on this protocol.

[Anonymous]

If you take lovenox for the duration of the pregnancy, be sure you see an MFM or OB who will do an antiXa test once a month to be sure the dosing is right and you don't have too much or too little clotting. I have had to adjust my lovenox upward from 40 mg (starting just before IUI) to 80 mg (at 30 weeks). I'm not sure why -- perhaps it's weight-based so becomes less effective as I gain weight. But especially if you are not sure you need this stuff, you want to be testing to make sure your numbers look good. I pay roughly $100/month for the lovenox and that's my copay!

Intralipids will not harm you in any way I can think of. Intralipids are not covered by my insurance. $500 per outing.

Prednisone can raise your blood sugar. You want to be on the lowest dosage needed. If you are seeing Abbasi she'll monitor your immune numbers and prednisone dose throughout the pregnancy. My copay for this is $1 a month.

[Anonymous]

Anonymous wrote:If you take lovenox for the duration of the pregnancy, be sure you see an MFM or OB who will do an antiXa test once a month to be sure the dosing is right and you don't have too much or too little clotting. I have had to adjust my lovenox upward from 40 mg (starting just before IUI) to 80 mg (at 30 weeks). I'm not sure why -- perhaps it's weight-based so becomes less effective as I gain weight. But especially if you are not sure you need this stuff, you want to be testing to make sure your numbers look good. I pay roughly $100/month for the lovenox and that's my copay!

Intralipids will not harm you in any way I can think of. Intralipids are not covered by my insurance. $500 per outing.

Prednisone can raise your blood sugar. You want to be on the lowest dosage needed. If you are seeing Abbasi she'll monitor your immune numbers and prednisone dose throughout the pregnancy. My copay for this is $1 a month.

WHo are your OB and MFM who order antiXa?

[Anonymous]

14:36 here. I'm working with Abbasi who is prescribing the intralipids and prednisone and Hammersley who is in charge of the Lovenox.

I'm not an IVF patient, but I'm told that if I get a BFN this month, I stop treatment, retest immune labs, adjust if necessary, and begin again on CD6 of the next cycle.

If I conceive I do another intralipid treatment immediately and then Abbasi will do repeat immune testing every 2-3 weeks to see if the targeted problems are responding to the treatments. And of course, we'll know if I'm successfully pregnant! Hammersley said she'd start with testing the Lovenox dose around 11weeks, but I might ask her to start sooner to prevent an early loss. I am not pregnant yet so I don't have an OB on the team. I will probably go to GW OBs or midwives if they'll take me.

[Anonymous]

Anonymous wrote:14:36 here. I'm working with Abbasi who is prescribing the intralipids and prednisone and Hammersley who is in charge of the Lovenox.

I'm not an IVF patient, but I'm told that if I get a BFN this month, I stop treatment, retest immune labs, adjust if necessary, and begin again on CD6 of the next cycle.

If I conceive I do another intralipid treatment immediately and then Abbasi will do repeat immune testing every 2-3 weeks to see if the targeted problems are responding to the treatments. And of course, we'll know if I'm successfully pregnant! Hammersley said she'd start with testing the Lovenox dose around 11weeks, but I might ask her to start sooner to prevent an early loss. I am not pregnant yet so I don't have an OB on the team. I will probably go to GW OBs or midwives if they'll take me.

15:01 here. Also Abbasi and Hamersley.

[Anonymous]

wait so you're doing intralipids, prednisone, lovenox etc and TTC naturally, not IVF? why?

[Anonymous]

For those who see Hamersley - how early in the process did you go to her? If you got pregnant, from which week is she monitoring you?

[Anonymous]

Anonymous wrote:For those who see Hamersley - how early in the process did you go to her? If you got pregnant, from which week is she monitoring you?

I saw her starting around week 9 or 10 for a pregnancy confirmation/dating scan. Saw her for the NT scan a couple weeks later. Again at 18 and 20 weeks for the anatomy scan (had to do it twice). Then monthly thereafter until 34 weeks, at which point I will see her weekly. This is on top of regular OB visits since she does not deliver. (But I skip the scanning stuff with the OB since she does it better.) I have also continued to see Abbasi (just the nurse) every 2-3 weeks for blood draws so she can monitor the immune stuff. It's a lot of appointments, but hopefully worth it in the end!

[Anonymous]

Anonymous wrote:

Anonymous wrote:For those who see Hamersley - how early in the process did you go to her? If you got pregnant, from which week is she monitoring you?

I saw her starting around week 9 or 10 for a pregnancy confirmation/dating scan. Saw her for the NT scan a couple weeks later. Again at 18 and 20 weeks for the anatomy scan (had to do it twice). Then monthly thereafter until 34 weeks, at which point I will see her weekly. This is on top of regular OB visits since she does not deliver. (But I skip the scanning stuff with the OB since she does it better.) I have also continued to see Abbasi (just the nurse) every 2-3 weeks for blood draws so she can monitor the immune stuff. It's a lot of appointments, but hopefully worth it in the end!

Thank you for responding PP. So presumably by the week 9 or 10 you were already on some sort of regimen for immunes and/or clotting issues. Was that whatever Abbasi prescribed for the IVF, or something else?

[Anonymous]

Anonymous wrote:wait so you're doing intralipids, prednisone, lovenox etc and TTC naturally, not IVF? why?

Not PP, but my guess is that she gets pregnant easily but can't stay pregnant.

[Anonymous]

Anonymous wrote:

Anonymous wrote:wait so you're doing intralipids, prednisone, lovenox etc and TTC naturally, not IVF? why?

Not PP, but my guess is that she gets pregnant easily but can't stay pregnant.

. I'm 14:36 and yes, that's correct. I get pregnant on my own but have chemical pregnancies. I tested for immune issues and found answers before considering IVF. I gather that's not always the case for people because many REs don't believe in or offer immune treatments.

[Anonymous]

It's somewhat unclear if fiddling with your immune system (i.e. through steroids, intralipids or IVIG) could increase the risk for cancer. But there's probably not much risk with short-term use.

[Anonymous]

Anonymous wrote:It's somewhat unclear if fiddling with your immune system (i.e. through steroids, intralipids or IVIG) could increase the risk for cancer. But there's probably not much risk with short-term use.

IVIGs have been tested and approved by FDS and are actually used for other conditions. So are the steroids. Why is it all of a sudden "unclear" for infertility patients?