Seeking thoughts and experiences on predisone / predisolone with embryo transfer

[Mudra85]

Hi everyone,

I'm looking for any thoughts and experiences you may be able to share on taking the steroids predisone and predisolone as part of your embryo transfer cycle.

I'm making preparations to go into FET 3, but a recent immune panel I did revealed my th1 and th2 cytokine levels are high, and that my th1 pro-inflammatory response is dominant. It's therefore looking like I need at least steroids to dampen down my immune response (even though I have no history of immune issues).

I know there are a few of you who've used steroids as part of your embryo transfer plan and I'd be really grateful if you could tell me whether:

1. You think they helped you to have an ongoing pregnancy and live birth where you'd had previous failed transfers with good embryos.

2. They helped to reduce your inflammation (th1 cytokine levels).

3. What dose you took and when you started taking that dose before transferring.

Thank you very much in advance.

[Chel91]

Hi hun, I'm getting my th1/th2 checked every 2 weeks I believe. Mine are well controlled on 40mg prednisone and tacrolimus. Prednisone needs 2 weeks for full affect so I was told. I'm currently waiting on beta testing to see if my current cycle is successful (I've had several failed / lost cycles before). My NK cells and APS are still a big problem for me though, so I have a lot to contend with. Hopefully you can get a plan with your dr to bring everything into line 💕 xx

[Mudra85 in reply to Chel91]

Thank you Chel! It's looking like I'm going to be on 20mg of Predisone. My clinic haven't mention tacrolimus, but I have seen others including yourself take it before. Do you know anything more about th1 and th2 levels? My very limited understanding is that th1 is pro-inflammatory and th2 is anti-inflammatory. Do you how bad it is to have high levels of th1 and th2? I'm keeping everything crossed for that your beta goes well, but I can imagine right now is a very daunting time for you! Xx

[Chel91 in reply to Mudra85]

Thank you! 💕 Did you ever read the "is your body baby friendly" book? I think there is some good info in there, but it's probably a little out of date now with some of the new research.

Are they going to re-test you after a few weeks on the prednisone? I think this is the only way to really see if it is working for you. Did they test your NK cells and antibodies as well? These plus the Th1 and th2 levels is what my doctor thinks is really important according to him, he does think they can "spike" and that it needs to be controlled. What were your levels if you don't mind me asking? Hopefully yours can be managed with the prednisone, I think it really does work for some ladies xx

[Mudra85 in reply to Chel91]

I actually downloaded the book recently. I had a quick look through, but I'm going to have a deeper dive soon I think. For now, I'm just trying to wrap my head around it all. I actually had my testing done through Fertilysis so I don't currently have any plans to retest. I am in contact with an RI though who I'm meeting again next week so I will ask him about this. My NK cells were also checked and they came out at just under the 12% threshold, so they were in range but on the higher end of normal. My cytokine results were as follows:

INFgamma/IL10 - 44% - high

TNFalpha/IL10 - 50% - high

I feel terrified that I've uncovered yet another issue and I just don't understand the significance of it in terms of being able to get and stay pregnant (even though I've been pregnant before a couple of years ago with the only issue being a genetic one not related to immunology).

Thanks for your insights on this, I really appreciate it! Xx

[Mudra85 in reply to Chel91]

Also, when you say antibodies, do you mean NK antibodies? I had my NK cells, NK cytotoxicity and cytokines tested. Xx

[Chel91 in reply to Mudra85]

Those are quite high results from what I know, but prednisone and the other things can really work wonders so I wouldn't worry too much! Hope the RI can give you some good help! 💕 Antibodies are things like ANA (Anti-Nuclear Antibodies), anti-dna, anti-histone, etc. Also, the blood clotting panel have their own antibodies they check for like anti-cardiolipin antibodies, which are really important. Also, they can check for anti-thyroid antibodies to make sure there is no thyroid issue too. Hope that helps xx

[Mudra85 in reply to Chel91]

They are really high from what I can gather too, although I've heard that Fertilysis has shown very high levels for others too when normally it wouldn't be that high. I've felt for a while that I may have needed a bit of extra help, but Doctors can be so reluctant to prescribe steroids. I'm having my antibodies checked for the things that you mention and I'm really hoping that nothing more comes up that is untoward. Luckily I don't have anti-thyroid antibodies as that was checked last year.

The information you've provided is really helpful, so thanks again! xx

[IVFat40]

Hi hun, I took steroids (20 mg prednisolone from memory) for my 6th transfer (8th embryo transferred); after the 7 previous embryos (all 5 day blastocysts) had failed to implant/been early chemical, this one is now asleep next to me. I had testing which had shown I had high uterine natural killer cells, which was the reason for being prescribed steroids. I would absolutely recommend taking the steroids, I believe they're a (probably the) major reason I was able to have my son. Started the day before transfer of I'm remembering right, and took till 12 weeks. All the best of luck hun.

[Mudra85 in reply to IVFat40]

Thank you for your reply. That's really helpful and it's good to hear predisone worked for you!

[Eternalwarrior]

Hello lovely

I have a few autoimmune diseases and high antibodies and I truly believe that I only had my son thanks to prednisone and hydroxychloroquine in my case too.

I had recurrent miscarriages and a late loss of a chromosomally normal baby and also a failed transfer with a PGT-A tested embryo which was top quality (AA) and I was on steroids only but a lower dose. Then my consultant decided to increase the dose. For my successful FET, I was prescribed 30 mg from before transfer and although I was only meant to take steroids for the first 12 weeks I spent nearly 7 months on them for different reasons. I was also on hydroxychloroquine for my autoimmune issues and started a few months before transfer.

I wish you all the best xx

[Mudra85 in reply to Eternalwarrior]

Thanks for this and I'm sorry to hear you went through all of that! I'm glad you were finally able to find something that worked for you in the end. What does hydroxychloroquine do? I have heard of it, but I'm not clear on exactly what it is for. Xx

[Eternalwarrior in reply to Mudra85]

Thank you, lovely. I was prescribed hydroxychloroquine to dampen my immune system, as the steroids on their own didn’t work in my case. I hope you also find something that works for you and feel free to ask me any questions or PM me if you need to chat. Take care and good luck xx

[Mudra85 in reply to Eternalwarrior]

Thanks so much, that's very helpful. Do you mind me asking what autoimmune issues you have? Feel free to PM me if you don't feel comfortable saying on here. I don't have any other markers other than high NK cytotoxicity and cytokines, but I'm waiting on some other immune tests and I can't help but think something may come up on that helping to explain things. Xx

[Eternalwarrior in reply to Mudra85]

I've just sent you a message xx

[Millbanks]

Hi lovely, have a look at my profile.

We tried everything over 5 transfers before finally using steroids on my 6th and it work.

I’m convinced it was the prednisolone - I was on 20mg a day up to 14 weeks xx

[Mudra85 in reply to Millbanks]

Thanks Millbanks I have seen you talk about your experience with predisolone before. Did you just have high NK cells and did you ever retest this before doing your successful transfer? Xx

[Millbanks in reply to Mudra85]

I only ever tested before the last transfer. And yes it was high NK and cytokines xx

[Mudra85 in reply to Millbanks]

Thank you! Hoping the predisone they're planning to give me knocks these high cytokines on their head xx

[Millbanks in reply to Mudra85]

Everything crossed for you my lovely.

Xx

[Ranchu90]

I used Prednisone.1. Helped me to keep the pregnancy after 3 chemicals. I transferred even my best embryo 5AB, PGS tested and was still a chemical.

2. I don't have elevated NK cells, I did lots of tests, all came back normal.

3. I was on 10mg/day, a low dose and also on immunosuppressants Tacrolimus. Started them on transfer day.

[Mudra85 in reply to Ranchu90]

Thanks Ranchu. I have also had a chemical with an excellent PGT-A tested blast and one good grade PGT-A tested embryo that didn't implant, so I'm hoping the predisone helps to calm my system down a bit to help me with this. I've suspected for a while that I may need steroids or other medication to help. Did you just have high cytokines (th1 and th2) like me?

A few people have mentioned tacrolimus to me, so I'm going to ask my RI about this when I meet him soon.

[Ranchu90 in reply to Mudra85]

I don't have any problems in regards to NK cells but I still need steroids to help me keeping the pregnancy going. I only had 2 gene mutations on MTHFR test and because of that I was on blood thinner injections. Tacrolimus I couldn't find it in the UK, it might be under different name. Usually patients that had organ transplant are using it for their body to not reject the new organ. Sounds crazy 😬🙄

[Mudra85 in reply to Ranchu90]

It is crazy all the different drugs they can use for reproductive immunology, but it seems they do help a lot of people. It does make sense why they'd use tacro in certain cases.