immune treatments for repeated chem pregnancies? seems most people do them for later m/cs?

[Anonymous]

seems most people who found immune treatments beneficial did them for more clinical pregnancies or later miscarriages, like 7-12 weeks or later. what if you're having repeated chemical pregnancies, like the beta starts at 20 and rises to 25 on the second beta. or starts at 20 and is 15 on the second beta. does IVIG and Intralipids etc. work for that?

[Anonymous]

Immune problems can be the culprit for late miscarriages, early miscarriages, chemical pregnancies or repeat implantation failure. IVIG or intralipids are likely to help with any of these scenarios if your blood work reveals an actual immune problem.

[Anonymous]

My bloodwork is very dubious- High TNF alpha are the only thing they found

[Anonymous]

Anonymous wrote:My bloodwork is very dubious- High TNF alpha are the only thing they found

I'm confused -- how is this dubious?

[Anonymous]

Anonymous wrote:

Anonymous wrote:My bloodwork is very dubious- High TNF alpha are the only thing they found

I'm confused -- how is this dubious?

because from all the literature I've read, high TNF alpha alone, without abnormal natural killer cells, isn't indicative of needing IVIG?

[Anonymous]

I definitely think high TNF indicates an issue and also probably a need to look out for RA in the future, potentially. Maybe not IVIG specifically but IVIG will definitely lower your TNF. Humira, Remicade, and Simponi don't work for everyone which is why I think those treatments aren't used as much anymore. IVIG is the best thing you can do for that.

My NKs weren't terrible and my TNF wasn't terrible and I had many CPs and many miscarriages. I also know several others who had losses in 2nd trimester due to their immune issues. Those early days during implantation are so crucial for things going well. Best to find the issues and treat them then to have something happen later.

[Anonymous]

Anonymous wrote:I definitely think high TNF indicates an issue and also probably a need to look out for RA in the future, potentially. Maybe not IVIG specifically but IVIG will definitely lower your TNF. Humira, Remicade, and Simponi don't work for everyone which is why I think those treatments aren't used as much anymore. IVIG is the best thing you can do for that.

My NKs weren't terrible and my TNF wasn't terrible and I had many CPs and many miscarriages. I also know several others who had losses in 2nd trimester due to their immune issues. Those early days during implantation are so crucial for things going well. Best to find the issues and treat them then to have something happen later.

Thanks I'm the poster who has 2 kids from prior FET but I only have 1 PGS normal embryo left and deciding whether to do IVIG - I've had a 4 total chemical pregnancies while trying for my 2 kids, but nothing past 4.5 weeks (3 of the 4 were PGS normal). My 2 live births were totally normal/fine without any immune treatment.

Would intralipids be ok or do I need IVIG ?

W

[Anonymous]

Np: is there any reason to suspect immune issues if I've never gotten pregnant - no chemicals, nothing. From age 30-33? DH normal. All other tests normal. I have embryos on ice but haven't done FETs yet - wondering if I should do more testing before I give this a shot.

[Anonymous]

Anonymous wrote:Np: is there any reason to suspect immune issues if I've never gotten pregnant - no chemicals, nothing. From age 30-33? DH normal. All other tests normal. I have embryos on ice but haven't done FETs yet - wondering if I should do more testing before I give this a shot.

Also NP, also in your same shoes - TTC for 3 years, <30, 7 failed IUIs, 3 failed fresh IVFs, not a hint of a BFP to show for it. Using a proven donor (so "DH normal"). Bit the bullet and did immune testing - just got the results back with SIGNIFICANT abnormalities (out of whack NK cells, gene mutations, the lot). Don't have a treatment plan yet, and can't guarantee that this'll work for me in the long run, but the peace of mind from finally hearing there's something clinically wrong after three years of "you're just having bad luck!" is worth it. I would recommend it if you can find the money and are continually unexplained elsewhere. We also have frozen embryos and wanted to do more testing before wasting them.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I definitely think high TNF indicates an issue and also probably a need to look out for RA in the future, potentially. Maybe not IVIG specifically but IVIG will definitely lower your TNF. Humira, Remicade, and Simponi don't work for everyone which is why I think those treatments aren't used as much anymore. IVIG is the best thing you can do for that.

My NKs weren't terrible and my TNF wasn't terrible and I had many CPs and many miscarriages. I also know several others who had losses in 2nd trimester due to their immune issues. Those early days during implantation are so crucial for things going well. Best to find the issues and treat them then to have something happen later.

Thanks I'm the poster who has 2 kids from prior FET but I only have 1 PGS normal embryo left and deciding whether to do IVIG - I've had a 4 total chemical pregnancies while trying for my 2 kids, but nothing past 4.5 weeks (3 of the 4 were PGS normal). My 2 live births were totally normal/fine without any immune treatment.

Would intralipids be ok or do I need IVIG ?

W

If you are just dealing with TNF intralipids will not be effective for that. So, I'm guessing you would need to be on prednisone as well. IVIG is good because it treats TNF and NKs and also increases your Tregs.

[Anonymous]

Anonymous wrote:Np: is there any reason to suspect immune issues if I've never gotten pregnant - no chemicals, nothing. From age 30-33? DH normal. All other tests normal. I have embryos on ice but haven't done FETs yet - wondering if I should do more testing before I give this a shot.

Friend of mine had never been pregnant and ended up having pretty severe immune issues. By the time she found them she was in her 40s and ended up moving on to adoption. She did try one "kitchen sink" IVF that did not work. I'm sure that's not the case for everyone who has never been pregnant but I don't think it hurts to have testing done. There have definitely been people who get testing and nothing is found and then it turns out they had another ovulation issue (or similar) that was why they could not get pregnant. My losses started when I was 29 and you are still young so I think doing testing will help your piece of mind. No sense wasting good embryos if the environment is not ideal.

[Anonymous]

If you are just dealing with TNF intralipids will not be effective for that. So, I'm guessing you would need to be on prednisone as well. IVIG is good because it treats TNF and NKs and also increases your Tregs.

Op here: I was told my t regs are "very good"

Yes my last cycle we did prednisone with the Intralipid

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I definitely think high TNF indicates an issue and also probably a need to look out for RA in the future, potentially. Maybe not IVIG specifically but IVIG will definitely lower your TNF. Humira, Remicade, and Simponi don't work for everyone which is why I think those treatments aren't used as much anymore. IVIG is the best thing you can do for that.

My NKs weren't terrible and my TNF wasn't terrible and I had many CPs and many miscarriages. I also know several others who had losses in 2nd trimester due to their immune issues. Those early days during implantation are so crucial for things going well. Best to find the issues and treat them then to have something happen later.

Thanks I'm the poster who has 2 kids from prior FET but I only have 1 PGS normal embryo left and deciding whether to do IVIG - I've had a 4 total chemical pregnancies while trying for my 2 kids, but nothing past 4.5 weeks (3 of the 4 were PGS normal). My 2 live births were totally normal/fine without any immune treatment.

Would intralipids be ok or do I need IVIG ?

W

If you are just dealing with TNF intralipids will not be effective for that. So, I'm guessing you would need to be on prednisone as well. IVIG is good because it treats TNF and NKs and also increases your Tregs.

p here: I was told my t regs are "very good"

Yes my last cycle we did prednisone with the Intralipid

[Anonymous]

Anonymous wrote:

Anonymous wrote:I definitely think high TNF indicates an issue and also probably a need to look out for RA in the future, potentially. Maybe not IVIG specifically but IVIG will definitely lower your TNF. Humira, Remicade, and Simponi don't work for everyone which is why I think those treatments aren't used as much anymore. IVIG is the best thing you can do for that.

My NKs weren't terrible and my TNF wasn't terrible and I had many CPs and many miscarriages. I also know several others who had losses in 2nd trimester due to their immune issues. Those early days during implantation are so crucial for things going well. Best to find the issues and treat them then to have something happen later.

Thanks I'm the poster who has 2 kids from prior FET but I only have 1 PGS normal embryo left and deciding whether to do IVIG - I've had a 4 total chemical pregnancies while trying for my 2 kids, but nothing past 4.5 weeks (3 of the 4 were PGS normal). My 2 live births were totally normal/fine without any immune treatment.

Would intralipids be ok or do I need IVIG ?

W

I would go with what your doctor recommends. IVIg is usually considered more of a treatment than intralipids and if your TNFs are high perhaps that's why. My NK and TNF numbers were only slightly elevated; I did prednisone and intralipids with success (but treated several other issues simultaneously). For higher numbers you may need more intervention.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

I would go with what your doctor recommends. IVIg is usually considered more of a treatment than intralipids and if your TNFs are high perhaps that's why. My NK and TNF numbers were only slightly elevated; I did prednisone and intralipids with success (but treated several other issues simultaneously). For higher numbers you may need more intervention.

Well my doctor initially said that intralipids were fine, and I didnt need IVIG. my TNF alpha is 37.5, I don't know if that's "high"- and NK totally normal and T-regs "very good." I did prednisone and intralipids with my last FET, which was a BFN, but that embryo had a pretty crappy thaw and wasn't great to start with so I am not sure if the immune treatments didnt work or if embryo related.