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

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]
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.[/quote]

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.[/quote]

NP.  Intralipids are much less expensive (and not a blood product).  For this reason, many doctors will recommend at least giving them a try before moving on to IVIG.  But PP is correct that other treatements like IVIG, Humira and Neupogen, are more indicated for high tnf-alpha.[/quote]

Is 37.5 high?

And what is the problem with blood product?[/quote]

It depends on the lab.  With my RFU bloodwork anything over 30 was high.  Problem with blood product is that it is not possible to get rid of 100% of all blood born illness.  Although rare, people do get blood born illness with IVIG.  It does happen but not very often, luckily.  [/quote]

so 37.5 may be so high that intralipids don't reduce it?  is TNF alpha elevated alone enough to cause repeated chemical pregnancies, with no other issues, and prior past successful pregnancies/live births?[/quote]

Yes[/quote]

PP who did intralipids and my TNF usually ranged between 19 and 25. When it got to 29 or so (range topped out at 30) my RE would have me do an intralipid treatment. The NKs were also usually no more than 1 to 2 points out of range. 37.5 is substantially higher than the numbers I was seeing, which may be why your doc recommends IVIg, particularly if you have already tried intralipids. But if you think there's an issue with the embryo, you could certainly ask to try intralipids with a different embryo.

At the end of the day, though, if you're going down this route you may need to try a couple different kinds of treatments and trust your doctor. For example mine had me stay on 10 mg of prednisone the entire pregnancy. Most people wean off in the second trimester. She felt I could not because every time I tried the numbers immediately went haywire (which may mean that the prednisone rather than the intralipids are what really worked for me). She's the doc and after consulting my MFM, I decided to go with her recommendation. [/quote]

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