Anonymous
Post 12/07/2018 12:33     Subject: NK cell and TNFa- Did you use IVF?
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:My Neupogen protocol was to start at 5dpo and continue through 11-12 weeks. I normally just used up whatever vial of meds I had since placental function is established at that point. If I started at 5dpo I normally started testing at 8dpo so I knew ASAP if I could go off it and wait until the next cycle. IVIG will work to get the NKs down but be aware mine spiked after my first infusion and then came down after the 2nd infusion, so it may take more than one. It's a huge clue that you were able to get pregnant on predisone. Why are the recommending lovenox? Just because of MTHFR? Is your Hashimoto's well controlled?


PP, what is your dose of Neupogen daily?


My weight based dosage was 1mcg/kg of Neupogen daily. So the more you weigh the higher the dosage and I got about a week's worth of meds from one of the larger vials.


Thanks for responding! Did you monitor your white blood cell counts, and if so, was there a target above which you were not supposed to go?


We did monitor them and no one was concerned at all with those numbers. I think at one point my WBC were 28. It's expected when you are on a medication that's job is to increase WBC.


I'm the same. KIR AA and I'm 2 C1 and DH was C1 C2 and we had matching C1. I did the same Neupogen protocol and Prednisone. I also did high dose Fish Oul. My NK cells spiked on Intralipids in my failed PGS cycle. I skipped them in my 3 day fresh transfer and it worked with Lovenox Neupogen and Prednisone and fish oil. I'm also Compound MTHFR.


Question for PP, for Prednisone, how high was your dose? And how long did you continue prednisone as well as Neupogen into your pregnancy?
Anonymous
Post 10/04/2018 23:15     Subject: NK cell and TNFa- Did you use IVF?
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:My Neupogen protocol was to start at 5dpo and continue through 11-12 weeks. I normally just used up whatever vial of meds I had since placental function is established at that point. If I started at 5dpo I normally started testing at 8dpo so I knew ASAP if I could go off it and wait until the next cycle. IVIG will work to get the NKs down but be aware mine spiked after my first infusion and then came down after the 2nd infusion, so it may take more than one. It's a huge clue that you were able to get pregnant on predisone. Why are the recommending lovenox? Just because of MTHFR? Is your Hashimoto's well controlled?


PP, what is your dose of Neupogen daily?


My weight based dosage was 1mcg/kg of Neupogen daily. So the more you weigh the higher the dosage and I got about a week's worth of meds from one of the larger vials.


Thanks for responding! Did you monitor your white blood cell counts, and if so, was there a target above which you were not supposed to go?


We did monitor them and no one was concerned at all with those numbers. I think at one point my WBC were 28. It's expected when you are on a medication that's job is to increase WBC.


I'm the same. KIR AA and I'm 2 C1 and DH was C1 C2 and we had matching C1. I did the same Neupogen protocol and Prednisone. I also did high dose Fish Oul. My NK cells spiked on Intralipids in my failed PGS cycle. I skipped them in my 3 day fresh transfer and it worked with Lovenox Neupogen and Prednisone and fish oil. I'm also Compound MTHFR.
Anonymous
Post 09/06/2018 14:09     Subject: NK cell and TNFa- Did you use IVF?
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:My Neupogen protocol was to start at 5dpo and continue through 11-12 weeks. I normally just used up whatever vial of meds I had since placental function is established at that point. If I started at 5dpo I normally started testing at 8dpo so I knew ASAP if I could go off it and wait until the next cycle. IVIG will work to get the NKs down but be aware mine spiked after my first infusion and then came down after the 2nd infusion, so it may take more than one. It's a huge clue that you were able to get pregnant on predisone. Why are the recommending lovenox? Just because of MTHFR? Is your Hashimoto's well controlled?


PP, what is your dose of Neupogen daily?


My weight based dosage was 1mcg/kg of Neupogen daily. So the more you weigh the higher the dosage and I got about a week's worth of meds from one of the larger vials.


Thanks for responding! Did you monitor your white blood cell counts, and if so, was there a target above which you were not supposed to go?


We did monitor them and no one was concerned at all with those numbers. I think at one point my WBC were 28. It's expected when you are on a medication that's job is to increase WBC.
Anonymous
Post 09/06/2018 09:43     Subject: NK cell and TNFa- Did you use IVF?
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:My Neupogen protocol was to start at 5dpo and continue through 11-12 weeks. I normally just used up whatever vial of meds I had since placental function is established at that point. If I started at 5dpo I normally started testing at 8dpo so I knew ASAP if I could go off it and wait until the next cycle. IVIG will work to get the NKs down but be aware mine spiked after my first infusion and then came down after the 2nd infusion, so it may take more than one. It's a huge clue that you were able to get pregnant on predisone. Why are the recommending lovenox? Just because of MTHFR? Is your Hashimoto's well controlled?


PP, what is your dose of Neupogen daily?


My weight based dosage was 1mcg/kg of Neupogen daily. So the more you weigh the higher the dosage and I got about a week's worth of meds from one of the larger vials.


Thanks for responding! Did you monitor your white blood cell counts, and if so, was there a target above which you were not supposed to go?
Anonymous
Post 09/06/2018 08:26     Subject: NK cell and TNFa- Did you use IVF?
Anonymous wrote:
Anonymous wrote:My Neupogen protocol was to start at 5dpo and continue through 11-12 weeks. I normally just used up whatever vial of meds I had since placental function is established at that point. If I started at 5dpo I normally started testing at 8dpo so I knew ASAP if I could go off it and wait until the next cycle. IVIG will work to get the NKs down but be aware mine spiked after my first infusion and then came down after the 2nd infusion, so it may take more than one. It's a huge clue that you were able to get pregnant on predisone. Why are the recommending lovenox? Just because of MTHFR? Is your Hashimoto's well controlled?


PP, what is your dose of Neupogen daily?


My weight based dosage was 1mcg/kg of Neupogen daily. So the more you weigh the higher the dosage and I got about a week's worth of meds from one of the larger vials.
Anonymous
Post 09/05/2018 12:10     Subject: NK cell and TNFa- Did you use IVF?
Anonymous wrote:My Neupogen protocol was to start at 5dpo and continue through 11-12 weeks. I normally just used up whatever vial of meds I had since placental function is established at that point. If I started at 5dpo I normally started testing at 8dpo so I knew ASAP if I could go off it and wait until the next cycle. IVIG will work to get the NKs down but be aware mine spiked after my first infusion and then came down after the 2nd infusion, so it may take more than one. It's a huge clue that you were able to get pregnant on predisone. Why are the recommending lovenox? Just because of MTHFR? Is your Hashimoto's well controlled?


PP, what is your dose of Neupogen daily?
Anonymous
Post 09/05/2018 11:14     Subject: NK cell and TNFa- Did you use IVF?
My Neupogen protocol was to start at 5dpo and continue through 11-12 weeks. I normally just used up whatever vial of meds I had since placental function is established at that point. If I started at 5dpo I normally started testing at 8dpo so I knew ASAP if I could go off it and wait until the next cycle. IVIG will work to get the NKs down but be aware mine spiked after my first infusion and then came down after the 2nd infusion, so it may take more than one. It's a huge clue that you were able to get pregnant on predisone. Why are the recommending lovenox? Just because of MTHFR? Is your Hashimoto's well controlled?
Anonymous
Post 09/05/2018 08:50     Subject: NK cell and TNFa- Did you use IVF?
Anonymous wrote:So you are KIR-AA genootype? I also have this, and my husband and I are both C2/C2. Neupogen worked for me! With the + APS you should be on lovenox (at the very least aspirin), is that in your list of treatments somewhere? AEB tests for a multitude of clotting factors so if anything else popped up you would know. I question if you need both IVIG and Neupogen, how high are your TNF-a and NKs?? Are they resistant to prednisone and have you tried intralipids?

I'm sorry you are in the club of ladies who have repeat losses. It's not a fun place to be but it does sound like you have a plan. I had 8 first trimester losses and did not need ART. There is plenty of evidence to suggest if you address the immune issues you may be able to get pregnant naturally, as long as the cause is immune related. If you are dealing with MFI or problems ovulating, treating your immune issues won't address those.


I'm sorry for your losses too... when did you start on Neupogen? I'm seeing Abbasi at CFA. She says the Neupogen is for the KIR-AA genotype, but the IVIg is to treat the NK cells. I don't have the numbers in front of me, but the lab tested my sample with IVIg and NK cell activity decreased with increasing amounts of IVIg. I'm taking aspirin now, but the hematologist also mentioned lovenox. It seems we can get pregnant easily... we've conceived every 2-3 months after each loss, but I can't stay pregnant. Coincidentally, my partner's SA was great in every respect except for morphology (1%). We're still waiting to hear back on our PGS results for our last retrieval... if none are good, then I'm just wondering what my options are as we won't pursue IVF any more.
Anonymous
Post 09/05/2018 08:43     Subject: NK cell and TNFa- Did you use IVF?
OP here. Here's some more info. I'm 41. I've had Hashimoto's since my mid-20's. Had my first child at 38 with no major complications. We've been TTC since I was 39. I did not have any testing on any of the miscarriages, but I did have a NIPT on the first miscarriage. They only test a few trisomies, but they were negative. Coincidentally, the one where I miscarried at 12 weeks, I was on prednisone from during the cycle I conceived because I had a bad case of poison ivy. No blood clotting issues, heterozygous for MTHFR, but my homocysteine levels were normal.
Anonymous
Post 09/05/2018 07:06     Subject: NK cell and TNFa- Did you use IVF?
So you are KIR-AA genootype? I also have this, and my husband and I are both C2/C2. Neupogen worked for me! With the + APS you should be on lovenox (at the very least aspirin), is that in your list of treatments somewhere? AEB tests for a multitude of clotting factors so if anything else popped up you would know. I question if you need both IVIG and Neupogen, how high are your TNF-a and NKs?? Are they resistant to prednisone and have you tried intralipids?

I'm sorry you are in the club of ladies who have repeat losses. It's not a fun place to be but it does sound like you have a plan. I had 8 first trimester losses and did not need ART. There is plenty of evidence to suggest if you address the immune issues you may be able to get pregnant naturally, as long as the cause is immune related. If you are dealing with MFI or problems ovulating, treating your immune issues won't address those.
Anonymous
Post 09/04/2018 22:01     Subject: NK cell and TNFa- Did you use IVF?
Are in you in DC? I recommend Tortoriello at SIRM in NY for these kinds of issues -- at least as a consultant for a last cycle or two.
Anonymous
Post 09/04/2018 21:41     Subject: NK cell and TNFa- Did you use IVF?
Anonymous wrote:We've been trying to conceive #2 since January of 2017. I've had three miscarriages, one at 12 weeks and 2 at 8 weeks. Testing with an RE found high NK cell activity, elevated TNF, and slightly elevated cardiolipin antibodies. The RE also found a possible alloimmune issue... My partner is C1C2 and I express a receptor that doesn't like C2. I also have Hashimoto's and positive ANA. The RE recommended IVF with PGS and then for FET, IVIg, neupogen, and prednisone. We are waiting on results from PGS testing on round 2. The first round yielded no normal embryos. I'm not optimistic about this round, and my partner and I have already decided that we won't pursue any more IVF treatment after this. I'm wondering if anybody has had any success not using IVF despite any of the above issues?


How old are you OP? Have you had tissues from your miscarriages tested? Immune issues prevent implantation and early stages. At 12 weeks, it's something else that's at play.
If you had D&C it's possible to get tissues re-tested, I had that done by my MFM's office (Hammersley).

Have you had your blood clotting panels done in addition to immunes? anything there?
Anonymous
Post 09/04/2018 19:49     Subject: Re:NK cell and TNFa- Did you use IVF?
OP, I'm sorry for your losses. Have you been on egg quality supplements for 3 months prior? Have you and your husband both been tested for MTHFR?
Anonymous
Post 09/04/2018 18:10     Subject: Re:NK cell and TNFa- Did you use IVF?
I got pregnant on the first try at 35, happy and healthy pregnancy and easy delivery. Started TTC #2 when I turned 36. It's been 5 years now, 4 IUIs, 3 IVFs, trying every month on our own and zero pregnancies. I got all the infertility tests done plus surgery and nothing was found, no male factor either.

Then went to Dr. Abassi and got the immune issues blood tests done and they found high NK cells and one other abnormality. I decided I did not want to do all those meds because I did not want to suppress my immune system for nearly a year as I have a very strong family history of cancer in my family tree. I felt that if it was meant to be, it would be. I never did get pregnant and I'm now 41. I've come to accept having an only child.
Anonymous
Post 09/04/2018 05:51     Subject: NK cell and TNFa- Did you use IVF?
We've been trying to conceive #2 since January of 2017. I've had three miscarriages, one at 12 weeks and 2 at 8 weeks. Testing with an RE found high NK cell activity, elevated TNF, and slightly elevated cardiolipin antibodies. The RE also found a possible alloimmune issue... My partner is C1C2 and I express a receptor that doesn't like C2. I also have Hashimoto's and positive ANA. The RE recommended IVF with PGS and then for FET, IVIg, neupogen, and prednisone. We are waiting on results from PGS testing on round 2. The first round yielded no normal embryos. I'm not optimistic about this round, and my partner and I have already decided that we won't pursue any more IVF treatment after this. I'm wondering if anybody has had any success not using IVF despite any of the above issues?