if you continued intralipids well into first trimester, like until 9/10 weeks, why? what Dx?

[Anonymous]

thanks. i assumed i wouldn't need any more intralipids after the immediate after BFP one.

[Anonymous]

up until 14 weeks. I had DOR and borderline immune issues. it was our throw everything at the wall cycle but it worked.

[Anonymous]

But once you were confirmed really pregnant like a heartbeat, why more intralipids? Did you have history of miscarriage?

[Anonymous]

Anonymous wrote:But once you were confirmed really pregnant like a heartbeat, why more intralipids? Did you have history of miscarriage?

no. my RE said why not? I did them every two weeks till 14 weeks. Insurance covered it, it was only $50 a treatment so I agreed

[Anonymous]

I had elevated NKs and then later other issues with the placenta and with DD#2 I went back on them when I was dx with IUGR. I was basically on them my whole pregnancy for my last 2 kids.

The only way to know if you need more is to get testing. Getting more won't hurt you but if you don't need them your doctor should be able to confirm through testing.

[Anonymous]

Anonymous wrote:I had elevated NKs and then later other issues with the placenta and with DD#2 I went back on them when I was dx with IUGR. I was basically on them my whole pregnancy for my last 2 kids.

The only way to know if you need more is to get testing. Getting more won't hurt you but if you don't need them your doctor should be able to confirm through testing.

OP here: my only bloodwork problem is elevated TNF alpha, which I've had the entire time. Just the TNF alpha. NK cells are fine. No history of miscarriages.

and insurance doesn't cover it- so it's a $300 fee to the nurse, $300 to my doctors' office, and $185 for the intralipids itself. So $785 per intralipids.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I had elevated NKs and then later other issues with the placenta and with DD#2 I went back on them when I was dx with IUGR. I was basically on them my whole pregnancy for my last 2 kids.

The only way to know if you need more is to get testing. Getting more won't hurt you but if you don't need them your doctor should be able to confirm through testing.

OP here: my only bloodwork problem is elevated TNF alpha, which I've had the entire time. Just the TNF alpha. NK cells are fine. No history of miscarriages.

and insurance doesn't cover it- so it's a $300 fee to the nurse, $300 to my doctors' office, and $185 for the intralipids itself. So $785 per intralipids.

DP. Wow that's expensive. What doctor are you with? I was with Abbasi and my intralipids, also not covered by insurancce, were $500 a pop. Just the payment to the company. Doctor didn't take a cut. I had them done at home, using OptionCare. It was great because after the nurse left I could work from home.

I had 3 or 4 treatment total, as the numbers indicated were neccessary. Last one was around 14 weeks, I think. I had both NK and TNF issues.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I had elevated NKs and then later other issues with the placenta and with DD#2 I went back on them when I was dx with IUGR. I was basically on them my whole pregnancy for my last 2 kids.

The only way to know if you need more is to get testing. Getting more won't hurt you but if you don't need them your doctor should be able to confirm through testing.

OP here: my only bloodwork problem is elevated TNF alpha, which I've had the entire time. Just the TNF alpha. NK cells are fine. No history of miscarriages.

and insurance doesn't cover it- so it's a $300 fee to the nurse, $300 to my doctors' office, and $185 for the intralipids itself. So $785 per intralipids.

DP. Wow that's expensive. What doctor are you with? I was with Abbasi and my intralipids, also not covered by insurancce, were $500 a pop. Just the payment to the company. Doctor didn't take a cut. I had them done at home, using OptionCare. It was great because after the nurse left I could work from home.

I had 3 or 4 treatment total, as the numbers indicated were neccessary. Last one was around 14 weeks, I think. I had both NK and TNF issues.

Same poster just adding that while it's expensive -- in total I think we paid about $6000 out of pocket for an IUI, intralipids, frequent blood tests, and meds throughout the pregnancy -- it is worth it if you bring home a healthy child. If you already have a BFP and it's going well, don't screw things up now just to save a thousand or even two thousand. Starting over will cost much more than that. Yes, maybe you don't need them, but what if you do? At some point you have to trust your doctor.

My doctor actually recommended ongoing prednisone for me over intralipids. I was on the prednisone through the end of the pregnancy. I pushed back a bit but she said she thought it was more effective for me than intralipids, and certainly it was cheaper and easier. I wasn't thrilled about it but a successful pregnancy was most important to me so I agreed.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I had elevated NKs and then later other issues with the placenta and with DD#2 I went back on them when I was dx with IUGR. I was basically on them my whole pregnancy for my last 2 kids.

The only way to know if you need more is to get testing. Getting more won't hurt you but if you don't need them your doctor should be able to confirm through testing.

OP here: my only bloodwork problem is elevated TNF alpha, which I've had the entire time. Just the TNF alpha. NK cells are fine. No history of miscarriages.

and insurance doesn't cover it- so it's a $300 fee to the nurse, $300 to my doctors' office, and $185 for the intralipids itself. So $785 per intralipids.

Okay well I think I have probably responded to your posts in the past. What were your latest results? There is some overlap in inflammation markers TNF-a and NKs are just two. There are lots of things that are at play here. No miscarriages, but you have RIF, correct? Betas were good, correct? If you can post all your immune numbers from your last tests that would be helpful.

It's naive to think these are the only 2 numbers your doctor is looking at and weighing with treatment options. It's not light reading but if you want to understand more I highly recommend reading and trying to educate yourself. If you can't trust your doctors decisions then by all means advocate for yourself but do it intelligently. [url]http://onlinelibrary.wiley.com/doi/10.1111/aji.12483/pdf[url]

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I had elevated NKs and then later other issues with the placenta and with DD#2 I went back on them when I was dx with IUGR. I was basically on them my whole pregnancy for my last 2 kids.

The only way to know if you need more is to get testing. Getting more won't hurt you but if you don't need them your doctor should be able to confirm through testing.

OP here: my only bloodwork problem is elevated TNF alpha, which I've had the entire time. Just the TNF alpha. NK cells are fine. No history of miscarriages.

and insurance doesn't cover it- so it's a $300 fee to the nurse, $300 to my doctors' office, and $185 for the intralipids itself. So $785 per intralipids.

Okay well I think I have probably responded to your posts in the past. What were your latest results? There is some overlap in inflammation markers TNF-a and NKs are just two. There are lots of things that are at play here. No miscarriages, but you have RIF, correct? Betas were good, correct? If you can post all your immune numbers from your last tests that would be helpful.

It's naive to think these are the only 2 numbers your doctor is looking at and weighing with treatment options. It's not light reading but if you want to understand more I highly recommend reading and trying to educate yourself. If you can't trust your doctors decisions then by all means advocate for yourself but do it intelligently. [url]http://onlinelibrary.wiley.com/doi/10.1111/aji.12483/pdf[url]

TNF alpha was 37.4 recently. I had IVIG before transfer, IVIG after confirmation of pregnancy, then intralipids around 7.5 weeks and now I am 9 weeks. No history of miscarriages, but history of chemical pregnancies where the first beta was bad and never made it to a second beta. Obviously seen the heartbeat at this point and graduated to OB etc.

I probably agree with the above poster that why risk it? Like even if deep down I am skeptical, what's another few thousand $$ at this point I guess.... sigh.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I had elevated NKs and then later other issues with the placenta and with DD#2 I went back on them when I was dx with IUGR. I was basically on them my whole pregnancy for my last 2 kids.

The only way to know if you need more is to get testing. Getting more won't hurt you but if you don't need them your doctor should be able to confirm through testing.

OP here: my only bloodwork problem is elevated TNF alpha, which I've had the entire time. Just the TNF alpha. NK cells are fine. No history of miscarriages.

and insurance doesn't cover it- so it's a $300 fee to the nurse, $300 to my doctors' office, and $185 for the intralipids itself. So $785 per intralipids.

DP. Wow that's expensive. What doctor are you with? I was with Abbasi and my intralipids, also not covered by insurancce, were $500 a pop. Just the payment to the company. Doctor didn't take a cut. I had them done at home, using OptionCare. It was great because after the nurse left I could work from home.

I had 3 or 4 treatment total, as the numbers indicated were neccessary. Last one was around 14 weeks, I think. I had both NK and TNF issues.

Same poster just adding that while it's expensive -- in total I think we paid about $6000 out of pocket for an IUI, intralipids, frequent blood tests, and meds throughout the pregnancy -- it is worth it if you bring home a healthy child. If you already have a BFP and it's going well, don't screw things up now just to save a thousand or even two thousand. Starting over will cost much more than that. Yes, maybe you don't need them, but what if you do? At some point you have to trust your doctor.

My doctor actually recommended ongoing prednisone for me over intralipids. I was on the prednisone through the end of the pregnancy. I pushed back a bit but she said she thought it was more effective for me than intralipids, and certainly it was cheaper and easier. I wasn't thrilled about it but a successful pregnancy was most important to me so I agreed.

I am also on prednisone. I was on 10 mg a day until about 5.5 weeks, now on 5 mg a day. Will go off totally in the next week (and hence maybe another intralipid as insurance policy after stopping prednisone may be good).

[Anonymous]

OP here: 10 weeks now and my ONLY thing that was ever elevated, TNF alpha, is now not elevated. it's now 27.7. Yet the doc still wants me to do intralipids next week at 11 weeks. I kind of am beginning to think these continued treatments are more of an annuity for the doc ($300 office fee, $300 to the nurse service, and $185 for the prescription). yet I am hesitant to disregard.

[Anonymous]

Dr. Braverman recently did a study concluding that high doses of fish oil do basically the same thing as intralipids. This could be another option if cost is the issue. He had my wife doing intralipids months ago, then recommended stopping them and just doing high dose fish oil. She's currently 16 weeks and didn't do intralipids before or during this pregnancy.

[Anonymous]

Anonymous wrote:Dr. Braverman recently did a study concluding that high doses of fish oil do basically the same thing as intralipids. This could be another option if cost is the issue. He had my wife doing intralipids months ago, then recommended stopping them and just doing high dose fish oil. She's currently 16 weeks and didn't do intralipids before or during this pregnancy.

Cost isn't that much of an issue, it just doesn't seem medically necessary. Is the risk of miscarriage after 8 weeks heartbeat any higher until 12 weeks than after? Like he said "because of first trimester and getting past miscarriage realm." I've never had a miscarriage past 5 weeks.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Dr. Braverman recently did a study concluding that high doses of fish oil do basically the same thing as intralipids. This could be another option if cost is the issue. He had my wife doing intralipids months ago, then recommended stopping them and just doing high dose fish oil. She's currently 16 weeks and didn't do intralipids before or during this pregnancy.

Cost isn't that much of an issue, it just doesn't seem medically necessary. Is the risk of miscarriage after 8 weeks heartbeat any higher until 12 weeks than after? Like he said "because of first trimester and getting past miscarriage realm." I've never had a miscarriage past 5 weeks.

Well, again, it's the what-if scenario. Would you rather do it if it's not medically necessary, or always wonder if it would have made a difference? Everyone has a different risk threshold.