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  • "SugarBabyLove" started this thread

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Reg: Jun 25th 2010

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Friday, June 25th 2010, 7:31pm

Help please with results from Immune tests

Quick intro...New to the boards, 4 m/c.. first two no fertility treatment and 7 weeks only.. 3rd one, 1 treatment with clomid, scan healthy at 8 weeks, but m/c at 12wks. Last one very short, not a very BFP but BFP and hormones never really kicked off.
Started TTc at 38 when I married my DH, am now 43, first two conceptions almost honeymoon style but since then a lot of intervention.
We are on the road to DE in Spain now but would like someone to help me with my results from Chicago before we finalise our plans....
reckon all normal except
Leukocyte Antibody detection Reference Range
T Cells IGG 1.4 - 50.0 - 100.0
BCells IGG 40.6 - 50.0 - 100.0

TH1:Th2 Intracellular cytokine TNF/IL10 IFN/IL10 Ratios (CD3+ CD4+)

TNF/IL10 28.7 %+Cells 13.2 - 30.3
IFN/IL10 6.8 %+Cells 5.6- 21





MTHFR A 1298C mutation Heterozygous Mutated
PAI-1 4G/5G Mutation Detection Homozygous Mutated


Are my numbers for LAD negative.....there is a little minus after them?

Have taken Clexane, aspirin, prednisolone, high dose folic, B6 and B12, Clomid/Femara, HCG and cyclogest.
Am taking a break from all except vits as FSH very high and DE the only route for us.

Was recommended IVIG for IVF cycle and an NK assay and TH1:TH2 Cytokine test 7 - 10 days after each IVIG. No mention of LIT am confused and clinic (not necessarily the one we're choosing for DEIVF has only talked about intralipids.
No mention of DQ Alpha but summary mentions borderline response to crossmatch done to determine how well I responded to DH. Is that the same?

If you haven't fallen off to sleep reading this I would love to hear some words of wisdom! Thank you!

Posts: 3,164

Reg: Feb 16th 2009

Children: Yes please

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Friday, June 25th 2010, 9:16pm

Have you read the dr beers book? It's great for this. Afraid I'm not good on the specific results but I'm sure you'll have a response very soon. Good luck! Depending on the results are you planning one last go without de? X


3 IUI and 5 IVF :BFN:
What's the future?
MY DIARY


High NK and high PAI-1
On Metformin & Immune Cycle

  • "SugarBabyLove" started this thread

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Reg: Jun 25th 2010

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Friday, June 25th 2010, 10:32pm

Hi Sammy1

Thanks for your reply. Am not going to try one more go before DE, It's just that if I have DEIVF in Spain I think I'll have to organise intralipids myself(or whatever!)....I was told 2 years ago that this was the only route for me with my poor response to high dose of fertility drugs...IVF was downgraded to IUI... Anyway 2 years on I'm ready, at the time I wasn't ready for DE. I think your sign off looks great, have you a bump now? S

ruthie

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  • "ruthie" is no longer a member of FZ

Posts: 3,607

Reg: Aug 31st 2008

Location: Cornwall

Children: 3 angels looking after us.

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Saturday, June 26th 2010, 10:01am

Hello,

you've had quite a journey over the past few years it seems!

Firstly, the TNF levels are normal. The 28.7 value and the 6.8 value are your results, the other numbers are the reference range and your values are fine so that's ok.
Did they tell you they were abnormal and if so in what way? They are certainly within the ref ranges and I'd personally be delighted with a TNF of 28 as mine has hit 57 at its worst!

I don't know so much about LAD testing, just that they like your levels to be above 30%. Am I reading it right that your T cells were 1.4% and your B cells 40.6%. If so then your T cell % is definitely low.
Some clinics recommend LIT before tx but the only doctor who was doing it in the UK (Paul Armstrong) has lost his licence for it so I don't think anyone is having it now. My clinic (ARGC) don't bother with LAD testing as theymonitor NK cells really closely and just treat those if they rise.

I wouldn't worry about the MTHFR mutation. It's heterozygous which means you only have 1 copy of that mutation. People with 2 copies are the problematic ones. It is thought that about half the population of the US is heterozygous for an MTHFR mutation. Also the type of mutation you have (A1298) is considered the less serious one.

The PAI - 1 mutation is one of the thrombophilias ie clotting probs and being homozygous is associated with an increased risk of m/c. However it would normally be treated with clexane and aspirin which you are already having.

From that the most signif thing looks like the LAD results. The LAD cross match shows that you and DH have a higher risk of producing a baby with a DQ alpha problem and DQ alpha testing may be indicated. However as I said above my clinic don't see the point as they wouldn't do any different tx.

I would also question your clinic as to whether TNF testing in pregnancy is worthwhile. Firstly, if your results are correct above then your levels look fine. Secondly none of the tx they are recommending specifically lower TNF levels. The only tx proven to do that is Humira and you can't take that in pregnancy. I've had quite a lot of Humira for my TNF levels (with mixed results) prior to tx, but ARGC only monitor NK cells during pregnancy and stimms. They can only give you steroids and or IVIG, both of which are effective on NK cells but nnot on TNF levels.

Having said that CARE have now stopped using Humira full stop and only use intralipids now. Again, no proven efficacy for high TNF levels but they use it for all their patients with high TNF and or high NK levels and seem to do ok.

From a money point of view, not sure what TNF monitoring would achieve.

Personally I'm following ARGC's protocol to the letter , but also having intralipids empirically in the hope that that helps.

Hope all that makes sense. Let me know if you have any other queries.

xxx

  • "SugarBabyLove" started this thread

Posts: 5

Reg: Jun 25th 2010

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Saturday, June 26th 2010, 10:22am

Hi Ruthie,

I now have my fingers crossed for you!!

Thankyou for that it is much clearer now. The clinic I'm attending seems to recommend Intralipids instead of IVIG (Instead of LIT???) but am only attending for a second opinion (I think ) as booked in for consultation in Madrid for DEIVF in 10 days.... Meeting nurse on Monday so I will ask lots of questions....like will they do the intralipids if I'm going elsewhere(Spain) fot the tx. My brief chat with Spanish doctor gave me the impression that he doesn't deal in the autoimmune area so I'd do that separately.....?


LOL
:D :D

  • "SugarBabyLove" started this thread

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Reg: Jun 25th 2010

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Saturday, June 26th 2010, 10:35am

PS Ruthie you read the values correctly....I had the ref range in on the right but it obviously aligned itself back to left.....




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