Immune protocol and IVF - helpful or not?
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Anonymous
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After 3 miscarriages in a row, I decided to go an get an immune panal gone at Chicago (RSU) before we used our very last frostie. Sure enough, it came up with issues with my natural killer cells and cytokines. The Dr. hasn't come back with her recommendations yet, but it appears it will be a mixture of IVIG, lovonox, humira and prednisone.
My RE here doesn't believe in immune testing and said he strongly preferred (it felt like something of an ultimatum) that I not use lovonox and prednisone. Now I'm at a crossroads - do I follow his advice? Take our frostie to another clinic for a FET? Or go ahead and take the lovonox and prednisone without his knowledge? |
Anonymous
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Hi, I am another poster who has been posting here a bunch recently about immune issues. I had 2 children previously through IVF- I had a chemical pregnancy before each kid, and then I just had 2 chemical pregnancies back to back with PGS tested embryos before I went to an immune guy. He found elevated cytokines (those are the TNF alpha cells, right?). My natural killers were normal, but TNF alpha were high. I actually had started with Lovenox before my second pregnancy because after my second chemical pregnancy I had a clotting factors panel done and they added Lovenox to my protocol (and I got a BFP with my DD). I used Lovenox for the 2 recent chemicals, and then I just for my last frozen got a BFN using prednisone and intralipids. As I stated in my other posts, I may have gotten my BFN because my embryos were twice thawed, and this last frozen didnt survive the thaw with as many cells as they'd like (prob too much stress from a second thaw), so it's hard to know if the immune protocol didnt work, or if it was the embryo, or me.
long way of saying, bottom line: it's all a crap shoot. If you've had 3 miscarriages in a row (seriously? back to back? how many weeks were they?) i'd ABSOLUTELY try the immune protocol. for me, i was more dubious because I had 2 kids and 2 healthy pregnancies before without any immune protocol. But if you're trying to conceive for the first time, and had 3 miscarriages in a row, ti's worth a shot. For me, I like to throw the whole kitchen sink approach at it if you're going to all this trouble, and if a reputable doctor has given you reason to believe it would be helpful, I'd do it. my doctor isn't big on the immune stuff, but he doesn't discredit it. He was happy to refer me to a separate RI and then incorporate his protocol into my treatment, through the RI, while doing the FET through my clinic. Hope this helps! (although reading it back, not sure I gave any good advice!) |
Anonymous
Are you at Shady Grove? I had 3 consecutive miscarriages with them over the course of 15 months (not IVF, though) and they told me it was just a numbers game and I had to keep trying. They don't "do" immune or thyroid stuff. I suspected immune or thyroid issues based on family history so I got a second opinion from Dr. Abbasi at CFA. Like you, my NK and cyotokines came back wacky, along with a clotting issue and Hashimoto's (thyroid autoimmune disease). I did Abbasi's protocol -- intralipids, prednisone, synthroid, lovenox -- and am now 30 weeks pregnant off an IUI with her. (Did a medicated IUI because I also have long and irregular cycles and she felt forcing ovulation earlier might help.) Since you would have to transfer an embryo you already have, that is a harder decision than mine was. I felt SG was giving me the run-around and I just didn't think their advice was correct for me. (I had a successful first pregnancy and got pregnant easily and I just felt like something was "off" and that it was more than numbers.) I guess it comes down to how much you trust your doctor and whether you want to try the immune stuff. I would not try it without his knowledge. You need to be monitored on prednisone and lovenox and he's obviously not going to do that. You could do a consultation with Abbasi, who to my knowledge is the only local RE who does immune treatments. Or you could finish up with the embryo you have and hope it works, and if it doesn't, start afresh at a different clinic that is willing to take less conventional treatments into account. |
Anonymous
PP, is this a local doctor you are working with who is willing to incorporate an RI's protocol? Who is it and who is your RI? |
Anonymous
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Do it! IVIG is amazing. I had so many chemical pregnancies and early miscarriages, I practically diagnosed myself with immune issues. Finding someone to treat them was another story... so you are lucky if you are already in good hands! I do think fertility is a huge money maker, so they are not interested in any new therapies beyond IVF. And immune therapy won't solve ALL infertility, it has to be the right treatment for you. For me it definitely was the right treatment! Not only did I get pregnant, the old fashioned way, (with twins) the month after my first IVIG treatment, but I felt like it helped with other health issues I have as well. I didn't have to do Lovenox, so I can't comment on that. But definitely, definitely, do not go with the "just keep trying" the same approach with SG. |
Anonymous
| PP. I did have a little prednisone in the mix... no worries there, it is a super low dose. With my history, even my SG doc was willing to try the low dose prednisone. But that alone wasn't enough to do the trick. |
Anonymous
| PP. I did have a little prednisone in the mix... no worries there, it is a super low dose. With my history, even my SG doc was willing to try the low dose prednisone. But that alone wasn't enough to do the trick. |