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  • "KayJay" started this thread

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Thursday, March 25th 2010, 10:29am

steroids the answer?

Everything seemed to be going perfectly for us leading up to our BFP only to all go wrong in the end. We had a fantastic number of eggs and an above average number of blastocysts frozen. We decided against transfer in a fresh cycle due to potential OHSS but as our clinic has recently started using a new freezing technique it seemed to be a good decision as our chances were now just as good with FET as with a fresh cycle and my body was given time to recover. We had two blasts transferred and both implanted. Unfortunately a scan at 8 weeks 5 days showed no heartbeats so neither of our twins made it.

As someone who always wants answers/explanations I am reluctant to believe that this is down to 'bad luck'. My clinic is extremely thorough and I was already on clexane, gestone, progynova and pregnancare plus as a precaution. Leading up to EC I was also prescribed dexamethasone...as I said my clinic is extremely thorough and these are the steps they take with every patient and this is what they believe leads them to have some of the highest success rates in the country.

Despite all this I am about to m/c my twins. It seems so unfair that this is happening and I have this niggly feeling that this could have somehow been prevented. In the past I've suffered from urticaria (allergic reaction causing eye lids, lips, fingers to swell and welts on my body which are very itchy). This has come and gone over the years and doctors have been baffled as to what causes these reactions. When I was younger this used to be a real problem but my reactions have died down over the years and not been such an issue. At one stage I was told I was allergic to salycilates including aspirin and other anti-inflammatory drugs so was given a list of foods to avoid and that seemed to do the trick but since I've reintroduced a lot of these foods and have found I don't always react to them - this makes me question whether this diagnosis is correct. I've also noticed that regardless of what I eat if I am stressed I tend to have a reaction.

Of course when asked if I have any allergies I do tell them about salicylates/aspirin/anti-inflammatories to be on the safe side. I don't know enough about allergies and from research I've done over the years it seems to be one of those grey areas that medical professionals are quite unsure about. I just wish they knew more and could say whether this could be the cause of our infertility and come up with a suitable tx.

One particular time in my life in my early twenties my DH then my boyf took me to A&E as my face had swollen so badly all over and my body was covered in welts (I looked like someone who had reacted badly to hair dye). The docs were once again baffled, they pumped me full of steroids and kept an eye on me. We literally waited until I deflated! Thinking about this experience I am now wondering if steroids are the answer for me??? Do I have an over active immune system that has killed off my babies?! I find it quite frustrating that I am trying to piece this all together rather than the doctors doing so and I know I can't be 100% that this is what has caused my m/c and I guess I have to accept that it's one of those things they just don't know enough about right now.

I've read that a number of ladies are taking prednisolone (spelling?) and wonder if any exlanation has been given to you as to why it is prescribed? Why you are taking it? Any thoughts / comments would be appreciated...



  • "KayJay" started this thread

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Thursday, March 25th 2010, 10:29am

Wow! Sorry such a long post but really helped gather my thoughts!



JENSQUI

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Thursday, March 25th 2010, 12:15pm

I am really sorry to hear about your loss. It is so cruel and difficult when you have seen the heartbeat. Sadly this is something i have experience of as it happened with 2 of my 4 miscarriages. I can understand you wanting answers and you may be right in believing that steroids could help. I don't know much about immunology so don't feel qualified to comment on that. Stress i believe is a very common cause for many skin complaints so it may be that rather than any other immune reaction that has caused your problems in the past. As a recurrent miscarrier i had the standard nhs tests - twice - and all came back as clear. Unfortunately not all of the causes for mc are known so there isn't an exhaustive battery of tests or treatment. It is still believed that a large number of mcs are due to something being wrong with the embryo. I know just how frustrating it can be when told that. I will never know if it was just bad luck 4 times in my case but good fortune happened in the end with my 5th pregnancy. Take care and i hope you find the answers x


me 38, DP 44, ttc since 2005
BFP May 07 - HB seen @ 8 wks but CRL only 7 weeks, m/c @ 9 wks
BFP Jan 08 -m/c @ 11 wks (D&C)
BFP Jun 08 - early loss
BFP Dec 08 - HB & CRL ok @ 8 wks, but sac too small, m/c @ 9 wks
BFP Apr 09 - Martha born 9th Jan 2010
BFP Feb 12 - Eliza born 13th Oct 2012

  • "KayJay" started this thread

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Thursday, March 25th 2010, 12:27pm

Thanks for your reply Jen. Part of me does wonder if we've just been unlucky but most of me thinks I don't want to ignore my previous health problems/allergies in case they are playing a part in our infertility. I just spoke to my DH who said he has wondered the same thing but didn't want to make a big deal out of it since it could upset me. Bless him I know he is always looking out for me but if my health issues are a cause than I would rather know and do something about it than continue to suffer on this journey. I want to raise this in a follow up with my consultant and see what can be done in terms of tests. I wouldn't feel comfortable going straight into another FET cycle without at least looking into this.

One things for sure we're both sure we will be parents one day and won't be giving up any time soon...



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Thursday, March 25th 2010, 2:20pm

Hi Hun

I was given prednisilone on my last pregnancy in jan this year which sadley for me they never worked but they have worked for many other ladies, steriods prednisilone is giving because some ladies have what are called nk cells natural killer cells and these cells can prevent implantation happing and can attack the babys placenta cutting off the oxergen supply etc. There is a womb biopsy done by a lady called siobhan quenby who is at the liverpool womans hospital the telephone number is 0151- 708-9988 this lady does the nk womb biopsy its a bit like a smear test and they then send it off to see if you have the nk cells. The only thing with this is most ladies have been told when having had this done that they do have nk cells and are given the steriods but the ladies who got the all clear from the result such as me mine was 1% classed as normal well the test cant always be 100% right as its hit and miss they pick tissue up as well if that makes sence because they cant see what there doing etc. It is very much so worth having it done she does it for free if you are a nhs patient as its a trial thing so even if your not a nhs patient she still may do it free so its worh phoning that number and asking to be put through to her sec and ask info on this. The other thing is the immune tests which they do the nk cell blood tests and these seem to be more accurate than the womb biopsy, if you do have nk cells not always will steriods work by them selfs they may need somthing else to help them work such as intralipids which is a fat infusion but it seems to do the trick for them who need it.

This reaction you are getting sounds like somthing that you are eating! am wondering what though it must be so confusing! maybe if you did have the immune tests somthing may show up.

There so worth having especially if you pay for ivf you would much rather know what you need to have before paying the money for ivf and suffering another loss.

You can follow my diary which i know you have posted in and thanks for your support, am just so confused myself and got sick and tired of being told it was bad luck and unexplained and that i will have a baby and 18 losses later still no baby and still being told i will have a baby - it come to the point where the £780 is so worth paying out becasuse you then know whats wrong with you and maybe they could just find out the reason why you have a allergy as well hun.

Pm me anytime ok hun

[zx127]

JENSQUI

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Thursday, March 25th 2010, 4:37pm

Just to say that i had the uterine nk cell test mentioned above. Not sure if the trial is still running. Also it was only free if you were a recurrent miscarrier and not undergoing ivf. Kar1 paid to have the test, was found to have elevated cells, took prednisolone and is very pg at the mo. X


me 38, DP 44, ttc since 2005
BFP May 07 - HB seen @ 8 wks but CRL only 7 weeks, m/c @ 9 wks
BFP Jan 08 -m/c @ 11 wks (D&C)
BFP Jun 08 - early loss
BFP Dec 08 - HB & CRL ok @ 8 wks, but sac too small, m/c @ 9 wks
BFP Apr 09 - Martha born 9th Jan 2010
BFP Feb 12 - Eliza born 13th Oct 2012

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Friday, March 26th 2010, 9:45am

Hi there. I too have taken Prednisalone but for implantation issues. I haven't had any of the immunology tests but am really thinking hard about it now. It seems if there are no other reasons coming forward it's a good one to test.... especially as the steroids alone may not do the trick. Sounds like you've loads of advice on here now....
Just wanted to say so sorry for your loss. xx


3 IUI and 5 IVF :BFN:
What's the future?
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High NK and high PAI-1
On Metformin & Immune Cycle

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Friday, March 26th 2010, 10:03am

Hi

I was given prednisolone, clexane, low dose aspirin and cyclogest until 12 weeks this time around following a mmc on my first round of ivf. I had to stop the clexane and aspirin at 7 weeks due to bleeding. I have no idea if this is what made the difference this time but it was certainly reassuring to be taking something that others have used successfully. it sounds like your clinic are very thorough, could you discuss your concerns over immune issues with them?

I am so sorry you are going through this...It's just not fair. :hugs:

My Diary - Bry and the Flumps!


1st IVF March 09 :BFP: mm/c at 9 weeks :bawl:
2nd IVF Oct 09 :BFP: [zx076] [zx076]


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Friday, March 26th 2010, 10:24am

Hi Kayjay I am so sorry for your loss.

I had a BFP when I did IVF in October but it resulted in a chemical pregnancy. This time around they prescribed me prednisolene I asked why and they said that when there isn't really an explanation for it not working they just try it to see if improves chances. I think mine didn't work last time as my lining was very thin (only just over 6 at ET) This time they also gave me viagra and my lining went to over 10 so I think that has helped too. I have to take the steroids up to 12 weeks - I haven't had any side effects I am not sure what they are doing but if they help me keep this pregnancy then I will happily take them for as long as necessary. Sorry I can't give you more info and wishing you all the love and luck for your next attampt.



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IVF Jan/Feb 2010 - :BFP: twins bab11 bab11


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Friday, March 26th 2010, 1:23pm

Hi KayJay

Once again, I am so sorry for your loss...

I have had 5 tx now - 4 ICSI and one FET. I'm 42 years old now too, so diminishing chances..
Of the 5 tx, I got 3 BFPs. I miscarried twice and am now almost 12w pg.
My cons prescribed Prednisolone this time, after having had the 2 m/cs. I had no immunology tests done. My cons just said that in patients with m/c issues, Prednisolone has been shown to improve chances. To be honest, I was very reluctant to take it! I was having a Natural FET cycle to try to get away from all the drugs, as I always felt pretty rough on the ICSI drugs, so to then be told I should take another drug, and a steroid at that (which I always consider to be quite a heavy duty medication) was difficult to accept.
Anyway, I am taking it, and so far so good. I think I can stop taking them at 12w, so am looking forward to that...

Sounds as though your clinic does not shy away from prescribing its ladies whatever drugs it thinks are necessary, so I'm sure they'd be happy to give you a go on them if you wanted to.

Good luck with your research hun. I hope you feel a little clearer about things soon, and feel ready to go on with your FET in the near future.
January 2010 - Natural FET cycle
Harriet Amelia was born on 16th October 2010 - we are SO happy!!!


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Friday, March 26th 2010, 3:45pm

When our first cycle did not work and we were told there was a 70% chance of success with my age etc. I really contemplated going down the immunology route. We spoke to the director of the Lister about it, he himself was not a huge believer but he said many doctors on his team are, so it is a tricky one.
I would say do not jump into anything straight away, I figured we would do 3 full IVF cycles and then persue immunology testing, fortunately our 2nd cycle worked and all seems to be going to plan, fingers crossed.

I totally know what you mean about getting answers and the need to do anything to get them. But fingers crossed for your next FET.
blowkiss

Jo x

2nd IVF :BFP:

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Sunday, March 28th 2010, 5:01pm

Hi KayJay,

I am so very sorry to hear your sad news. :hugs:

Prednisolone is essentially used in many women who are suspected to have implantation/ ferility issues and /or have repeated miscarriage ~ and in very simplistic terms, it works by suppressing the immune system to increase chances of holding on to your baby and not rejecting it. Oviously whether it may work will entirely depend of exactly what immune issue you have, and to what level of severity it affects you.

I have used Pred twice ~ the first time was after 3 miscarriages and it seemed to work ie my baby was still alive at 16 weeks. However tragically the baby coincidentally had a lethal abnormality and we had no option but to terminate as she could never have survived. I then got pregnant again 2 weeks after this (!) and took prednisolone again, but my baby died at 13 weeks for reasons unknown. This time I decided I couldnt go this again, and went and had the immune tests of which you speak at the ARGC whom I thought were excellent.

I now wish I had had the tests done in the first place, but hindsight is easy? The hospitals that carry out these tests are ARGC, Care, Lister, and Paul Armstrong at the Portland. It revealed I did indeed have immune issues, and I am now being treated at Care (who are practically more easy to get to) with steroids AND intralipids for an extra boost and I will fingers crossed be 6 weeks pregnant on Tuesday with my 6 th baby. I will get the test results back this week as to whether these drugs are keeping my immune issues at bay, whilst pregnant. I dont think a simple uterine biopsy for NK cells is thorough enough to rule out any immune issues altogether, and IF you are going to have them done ~ have them all done. It would be awful to think all was ok, and then not. Some of my very good friends on FZ have have their uterine NK biopsy come back as fine, only to find out later on down the line through the blood assays ~ that they still have a problem. ARGC did indeed ask me lots of questions about skin complaints, allergies, and previous history of immune disease.

Have you read 'Is your body baby friendly?' by Alan Beer? If not I cant recommend it enough because it gives a thorough overview as to the immune system and indeed may answer a lot of your questions as it explains the effect of steroids etc on the different components of the immune system and it's easily digestible. I would also recommend that if you read this, and any of it rings true ~ to consider the immune tests if finances allow and discuss this with your care provider. I know of quite a few women who have wasted time and/or money/ heartache on tx the failed or ended in a loss because they weren't properly aware of their issues. I am one of these women!!

Do let us know how you get on,

Bunty

This post has been edited 2 times, last edit by "Bunty" (Mar 28th 2010, 5:06pm)


chatterbox

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Monday, March 29th 2010, 11:36am

Hi KayJay

Just to add that the trial at LWH with Siobhan Quenby has closed. I was informed that she has moved hospitals to Lancaster I believe.
I'll be taking prednisolone on this next IVF cycle and praying that it is my solution. (The Dexamethasone you took is also an immuno-suppressant) In retrospect I think I should have had the immunology tests (the biggies) and if this tx doesn't work then that's definitely the road we'll go down. Just xfingers that steroids are enough for me this time.

Big hugs. xxx

Me 40 DH 35 TTC 10yr
peritoneal mesothelioma, cystectomy 97 & 00
peritonectomy, lost both tubes & most of left ovary Aug 07


Dec 07 BFP b/ov m/c 9.6wk
July 08 BFN
Dec 08 BFP b/ov m/c 9.6wk

July 09 BFN
Nov 09 BFP 2 x sacs 1 b/o 1 no hrtbt m/c 9.2wk
May10 BFP at 8+4 m/mc @10wk scan ERPC

Found: High NK cells, DQ Alpha match, LAD neg & PAI-1 pos...

NOV 2010 - Immune IVF at CARE Manchester
:BFP: [zx076] :girl: born 25/8/11

OCT 2012 - Immune IVF at CARE Manchester
:BFP: [zx076] :boy: born 24/6/13

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Monday, March 29th 2010, 2:19pm

Hi Kay Jay,

After 3 early losses, I decided to pay privately and get some immune blood tests done. I had the Natural Killer blood test, and the male and female chromosome tests...

The natural killer test I had was not a biopsy, just a blood test to measure if my killer cells were raised. They came back slightly raised and my con decided to put me on 25mg of steroids per day starting from EC until 12 weeks pregnant.

I was worried to go on steroids as they are heavy drugs and they can cause side effects to you and to the fetus. But it was a risk I was willing to take and I am now the farthest i have ever been at almost 9 weeks pregnant! I truely believe this is down to the steroids...

I wish you lots of luck and I would suggest you try and get some NK testing done. I went to my local private hospital and paid about £380 for the test. And so far it has been priceless.

All the best, and do not give up. You will get there.
xxx
XXX BellaLove XXX





Feb '10 xfingers Hoping it sticks! xfingers

  • "KayJay" started this thread

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Monday, March 29th 2010, 3:27pm

Thank you all for the really useful responses. DH and I have decided to go back to our current clinic for a follow up consultation after my miscarriage. We will discuss our concerns about my over active immune system and see what they suggest. We are pretty sure that we want to go ahead with the immune tests if only to stop us wondering whether or not this is an issue for us. I know the docs tend to advise people to wait until at least 2 miscarriages (usually 3) before immune testing but given that I already know I have an immune issue I prefer to find out sooner rather than later. My clinic doesn't do the tests but I'll look into The Lister and ARGC (thanks Bunty!) I will also speak to my GP about whether any of the tests can be done on the NHS (although I'm not holding out much hope!)

Whatever the outcome of the tests we plan on having another FET cycle as we still have 7 frozen embryos. Hopefully this time around we'll have a better idea as to how my body can hang on to a pregnancy if it does need that extra bit of help...



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Monday, March 29th 2010, 3:51pm

Sounds like a plan, if you visit the Lister I believe Doctor Yau Thum, pronuonced tomb, is who you want to see apparently he is the main
man there for immunology, so make sure you see him specifically.

Jo x

2nd IVF :BFP:

This post has been edited 1 times, last edit by "Jo101" (Mar 29th 2010, 3:53pm)


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Monday, March 29th 2010, 7:27pm

Hi again,

Further to Jojo's post... I actually went to see Dr Thum for a consultation (see my diary of around July 5th last year), and I thought he was wonderful and extremely thorough. I also loved (along with a few of the other girls from what Ive read) Dr Demitri at the ARGC. Dr Nduwke at CARE is also amazing. All 3 in my humble experience are incredibly well versed in immunology, amongst other things. I am glad I went to see them all.

The level 1 tests you should get on the NHS, but you will have to pay for the level 2 testing. I stamped my feet after 2 losses, and pushed my age (then 36) and my hospital gave me all the level 1 tests after 2 losses.

I so hope you get some answers, I truly know how hard it can all be

blowkiss

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Monday, March 29th 2010, 9:23pm

Hi Hun

I think its worth speaking about all the tests available on the nhs at your next appointment, because you lost both babies at onec :sadface: e.g twins then it could just be badluck a lot of people do have losses and go on to have babies, therefor next time xfingers everything will be just fine, BUT it is well worth asking for the level 1 tests just to see if there all normal.

If you do go to the argc in the near future DONT see Dr Demitri i seen him last week, as nice as he is, wanted me to have ivf when i can get pg naturally having been pg 8 times in 1 year, he said its so he can have control of my pregnancy WHEN he can do this as soon as i get a bfp, this man is very well trained to get as much money from you as possible, I thought he was a load of crap to be honest and dh thought the same. Its the TESTS i am really interested in which the argc are the cheapest they are £805 not £780, i will be seeing a dr paul armstrong at portland in a few weeks time which i HIGHLEY recommend this man is great having spoken with him by email on many occasions and you get to see him in person not a understudy so i would suggest if you do consider immune tests level 2 to have them done at argc and go and see dr paul armstong at portland hospital. Goodluck hun xfingers [zx127]

This post has been edited 1 times, last edit by "bubble" (May 10th 2010, 7:51am)


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Tuesday, March 30th 2010, 1:07pm

Hi honey,
I think most of your questions have been really thoroughly answered.
My tx on my last cycle wad v similar to yours, the only difference being that I had had 4 lots of Humira pre tx to bring my cytokine levels down.
Sadly that cycle ended in BFN but I and the clinic think that was just bad luck as according to the current thinking my partic immune prob would cause later m/c rather than implantation failure.
I cannot recommend ARGC highly enough as they are extremely thorough and are more than happy to coordinate tx with other clinics.
I've always rather liked Dr Dimitri as he was easier to chat to than some of the other doctors and I know Angiebabe is a big fan of his too so if you do go there I wouldn't worry too much about who you see. I think it just depends whether you hit it off with someone or not.
Mr T oversees all the tx there anyway.

Personally in your position I'd have the immune testsdone as I'd want to feel I'd covered all bases. My only word of warning would be that ARGC told me that of the women they test 80% will have some abnormality so you kind of have to assume that they will find something wrong and may well recommend tx which is really pricey. My last cycle cost me about £3500 in immune tests and tx (plus cost of the ICSI cycle itself!) and I got off lightly. If I'd needed IVIG too we'd have possibly had £6000 on top of that.

This isn't to put you off, just to say that once you go down the immune testing route it's hard to say no to tx!

Best of luck honey - you are due some.

Xxx

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Tuesday, March 30th 2010, 1:13pm

OMG... I had no idea it was quite so expensive!!


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


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

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Tuesday, March 30th 2010, 1:33pm

I know, scary isn't it.
I jsut shut my eyes now adn hand over the credit card!

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Tuesday, March 30th 2010, 3:40pm

yeah it is an expensive business alright! but I guess if you achieve success then it is worth every penny.

Jo

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Tuesday, March 30th 2010, 3:43pm

Absolutley!!! Just the Immunology costs got my eyes watering!


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


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

Tinkerbell09

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Tuesday, March 30th 2010, 7:18pm

I've always rather liked Dr Dimitri as he was easier to chat to than some of the other doctors and I know Angiebabe is a big fan of his too so if you do go there I wouldn't worry too much about who you see. I think it just depends whether you hit it off with someone or not.
Mr T oversees all the tx there anyway.


You go to see a dr for help and advice not to HIT IT OFF with him you dont want a friendship you want a answer .... Dr dimitri was nothing special maybe he has more knowledge in ivf seems he seems to of been ivf mad ...when i told him of my losses and never onec did he mention immune tests to me , It was only after the ear ache of ivf ivf ivf ivf that i said i have come today for immune tests - How can dr dimitri be great when he just told ME i need to have ivf even though i have conceived multiple times such as 8 times in one year, my last pregnancy being feb 2010 ??


If you sit down with this man and tell him you have lost multiple babys then he wont know what to say ! had nothing at all to say except chat about IVF AND HYSTROCOSCOPYS, you offer ivf to a person who struggles to get pg. GOODJOB its mr T who does make the decisions, you cant say that person is lovely just by hearing him on the phone!!!!!!!
He may be great to chat to about ivf by appointment BUT when it comes to a recurrent missed miscarriage patient he looks in shock! and speechless and very much clue less.
Felt he was no better than dr f at my old hospital well there dhs words not mine but i strongley agree.

Sammy 1, Immune meds are expensive, ivig starts from £1250 i will be having a ivig transfusion in a couple of weeks time even if my immune tests come back NORMAL.
Then i will be having intralipids at £300 ago from homecare which includeds a lady to give you the infusion at your home, Other meds such as humira which is £1000 +
Depending on how many times you need the meds yes it can be expensive but well worth it if you can afford it. and IF it works xfingers

This post has been edited 3 times, last edit by "bubble" (May 10th 2010, 7:53am)


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Tuesday, March 30th 2010, 9:24pm

bb

This post has been edited 1 times, last edit by "ruthie" (Mar 30th 2010, 9:27pm)


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Saturday, August 14th 2010, 7:28pm

HIya i was reading about the meds people are on and that pred is supposed to help sustaina pregnancy and then earlier in the thread BRYONY said that she stopped aspirin and clexane because of bleeding....did that really help? What about prednisolone? And some stuff says that pred can interfere with implantation...it is really too confusing.

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27

Saturday, August 14th 2010, 7:30pm

Tinkerbell I just wanted to ask have you had any more luck at the Portland? Are you still there and who do you see?

ruthie

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28

Monday, August 16th 2010, 9:43pm

Hi newhope it is really confusing.
Pred can't sustain a pregnancy as such. However, if immune issues are identified then often steroids are helpful as they are good at reducing levels of quite a few of the cells that make up the immune system. Some doctors will prescribe them empirically, ie without there being a clear, identified indication. That is likely to be what happens with me next cycle, as to date, my NK cells have never been high, but after so much implantation failure and m/cs my clinic will probably use them anyway.
There is no contraindication to steroids in early pregnancy from the foetal point of view. However, some doctors WON'T use them empirically because they believe that they can interfere with implantation. Basically implantation is an inflammatory process. The foetus burrows into the wall of the uterus, and inflammation occurs. Too much inflammation will reject the foetus, a bit like a when your body rejects something like a splinter in your finger, but if no inflammation can occur at all then the foetus won't stick as it were. Inflammation tends to be seen as a bad thing but sometimes it's helpful. For example the first few days of any wound healing are known as the inflammatory phase, when inflammatory cells rush to the cut or whatever and try to stick things together. It's thought that if you suppress inflammation too much, implantation could fail.

Ultimately you have to see what the doctors suggest. Most doctors don't worry too much about a low dose of steroids, higher doses could be contraindicated. The main thing is that noone really knows and the best way to decide re steroids is in combination with immune testing if that's possible.

Re clexane and aspirin, they both thin the blood, and in doing so can prevent clots and improve blood flow to the uterus. They are often given to almost any immune patient. I've had them with my last 3 cycles, even though no clotting problem has been identified. ARGC don't routinely test uterine blood flow, but at the clinics that do, they often give clexane and aspirin wven if results are fine. If however you had a bleed in pregnancy, they may decide to take you off them as they could ocntribute to the bleed.

Hope all that makes sense.

xxxx




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