Please help! I need some urgent guidance with immunosuppressant protocol (dose and timings)

[Trying2FeelPositive]

Hi lovely ladies. Please please help!! I have two failed implantations and two miscarriages. And I am going in for another transfer in a week. I have very high Anti TPO (thyroid antibodies) levels and ANA (anti nuclear antibodies). After my insistence my doctor is getting me an intralipid IV today. But I think she is giving me a very low dose and I don’t know what’s the protocol. She is also going to give me an intramuscular immunoglobulin (she doesn’t want to give an IV for that) close to the transfer day. I have read up that all the clinics are supposed to start you on immunosuppressants more than a week before your transfer. It’s all so confusing. With the dose and the timings.

Can you ladies please advice what was the protocol for you all to suppress immunity before the embryo transfer? The dose and the timings? And is there anything else the doctors put you on for repeat implantation failures? I will be so so grateful for your help and guidance. All the best to y’all in your journeys!

[Jrss1]

Hi, I’ve had failed transfers so I got tested for NK cells. I was positive for the them. My doctor put me on steroids and intralipids. I started the steroids during stims and still taking them. The intralipids was done 4 days before transfer. I’m on my tww so I’m not sure if it’s worked yet (really hoping) I don’t know the dose of the intralipids but I’m sure it was based on my test result.

Best of luck with your transfer xx

[Trying2FeelPositive in reply to Jrss1]

All the best with your pregnancy! I am sure it will positive..please keep thinking only positive thoughts and nothing else. xx

[Zebedee1971]

The question I'd probably ask is who is it that tested you/prescribed the treatment for the ANA and anti TPO??I was under the care of a recurrent miscarriage specialist who specialises in immunity and he did all sorts of blood tests, then prescribed treatment according to my results. His treatment was separate to the ivf round we did in July, but I ended up getting pregnant naturally because of the meds he gave me. I have aggressive nk cells and was on :humira, hydroxy chloroquine, steroids, Intralipids... What makes you think the dose is too low for the latter? Why did you have to ask for it if its been prescribed??

[Trying2FeelPositive in reply to Zebedee1971]

Hi I am getting this done overseas since this is where I froze my eggs but I feel that I have to keep asking them for investigative tests in order to find out why my embryos refuse to implant. So only based on my research have I been able to ask them to get me tested. Maybe I am having some trust issues with them after 2 failed implantations

[Zebedee1971 in reply to Trying2FeelPositive]

So it's the ivf clinic that has prescribed?Have you sat down with an immunologist to go through the results and treatment? Or just an ivf consultant? Ivf doctors are not always supportive of immunology treatments, some can be sceptical of its effectiveness. I was lucky that the specialist I found worked for my local NHS Trust so all the ivf doctors there were supportive of him and believed in his work and knew his success rates.

My immunology/recurrent miscarriage specialist gave me a written plan with exact dosages and precise time frames of when to take the meds- he talked me through exactly what to take and when, and explained what everything does. I have never been confident with ivf but I trust in my specialist 100% and know that he completely knows what's right for my body (trust that was well placed as he got me to 31 weeks pregnant on his expertise).

[Trying2FeelPositive in reply to Zebedee1971]

Wow! They are refusing to even refer me to an immunologist! And saying that intralipid should be good enough. Can I please get the contact details of this specialist you spoke with? I will connect with his office ASAP and see if he can fit me in for a tele consultation. Thank you so much!!

All the best with the rest of your pregnancy. x

[Zebedee1971 in reply to Trying2FeelPositive]

If yuo have your results, you can book a zoom consultation with him and he can give you a second opinion on treatment plan. Specialists are always better than ivf consultants as you know you'll get the right protocol for your needs. I've pm'd his details to you now x

[Mellyboo111]

My protocol was I was given the steriods pills along with my progesterone and other medications as soon as my period started. Then a week after the day of my transfer I was given intralipids by IV an hour before transfer. Some people say they got intralipids a week before transfer and then after transfer but I only got it the day of transfer. This was my second transfer, at my first, the doctor did not take into consideration my autoimmune disease( polyarteritis nodosa). So I switched doctor and this doctor recommended this protocol and now I am pregnant. P.S. i was taken off the steriods pills as soon as i got the postive. I know i saw people on here saying they took it up to 12 weeks.

[Trying2FeelPositive in reply to Mellyboo111]

Thank you so much for your reply! Can you please tell me the dosage of the steroids and the name? Please? And my doctor is only giving me 4ml of 20% intralipid 8 days before my transfer.my transfer is most likely on the 12th of May.

[Mellyboo111 in reply to Trying2FeelPositive]

The name of the steriod is Methylprednisolone 4mg. I took one tablet per day

[Trying2FeelPositive in reply to Mellyboo111]

Thank you so much!

[BBHH1]

Prednisone after egg retrieval, so a few days before transfer. IV immunoglobulin also before transfer no problems doing that before transfer. Yes the treatment needs to start before transfer!