Immunology

I just came back from a weekend in Chicago. I flew out there to consult with Dr. Kwak-Kim, a reproductive immunologist who took over the Beer Center in California after Dr. Beer retired and now has her own practice. I'm still waiting for the blood panel to come back, but the results of the sono were really interesting, and I thought her points about possible causes for RPL made so much logical sense. REs have always handled the miscarriages and IVF failures with a vague shoulder shrug and comments about either bad luck or egg quality.

So why is it that REs are so skeptical about the immunology field? I'm reading Dr. Beer's book, Is Your Body Baby-Friendly, and there's a huge section that refutes the hostility toward the field point by point. Dr. Davis @ Cornell, although willing to work with an immunologist, was also less than convinced, saying that (basically) they over-diagnose and overtreat people. Yet he's a brilliant doctor with his own controversial therapies.

I was reading about some of the treatments for immunological causes, and they make me nervous (drugs that cross the placenta taken throughout pregnancy with slight risk of birth defects and infusions from donated blood) so I'm scared to do it just because I haven't tried it yet, KWIM? But I'm also at a point where I desperately need answers and new avenues.

I'd love to hear thoughts, good, bad and ugly.

Re: Immunology

My problems are immunological & clotting... Dr B does the same thing as Kwak Kim and the only drug i take is Neupogen and its only for the first few weeks like till 9 weeks or so... What Drug is it that youd have to take throughout?

Re: Immunology

Re: Immunology

I'm currently 7 weeks pregnant and im using prednisone (steroid) until 12 weeks. i cant speak to the risks of prednisone while pregnant, i was told that it was "fine" and will be weaning off of it soon.

ive been doing intralipids (same idea as ivig but i dont know the difference- intralipids is just soybean oil) every 4 weeks from transfer till who knows when. my immune testing came back elevated after my first round of intralipids so I had to to do it again sooner.

I'm on Lovenox (heparin actually) for some other stuff, might be on it for the entire pregnancy.

I guess you have to outweigh the benefits vs the risks. If you are having early losses, immunologists will blame it on immune issues among other things, those who are anti-immune will chalk it up to poor egg quality or a fluke.

For me, if I can't even get out of the first trimester since my NK cells, cytokines etc are off the charts, its worth the risk to try these treatments. There are risks in every treatment, so I really didn't bother to worry about these much differently than other more "traditional" treamtents.
Good luck!

eta i also see it like this, which is why im not worried about the side effects of all these immune suppressants: my immune system is soo overactive, that these meds are just bringing me back down to normal. I've been on prednisone since august and i havent even gotten a cold!

Message edited 5/7/2012 7:21:08 PM.

Re: Immunology

Ditto to everything Cateyemm said!
IVIG is used as a last resort because it is bloodborne, so Dr.B uses Intralipids instead. Since last year, he's had great results with Neupogen alone. There is current research and literature that shows how Neupogen works to benefit those with immune issues for infertility. However its not FDA approved for infertility. I'm a case study where it has positively worked for me in decreasing my entire Nk assay and homocysteine levels. I've used Prednisone and Dextamethasone during cycles as well. I switched from dext to pred in the first tri and stopped neuopogen at 10 weeks and intralipids at 12. The perinatologist changes and controls all your meds to protect the health and development of your baby.

I've met with a handful of Drs about my case and consulted with others VIA phone. Most are unaware of immune issues and others deny them as a reason for my 6 losses. Few even said that they couldn't help me (which doesn't make sense if they rejected the immune idea) and some said I'd never be able to carry. Well I wish they could see me now!

Don't give up! Go with your gut and trust your instincts.

Re: Immunology

for me i believe a very important reason why for now god willingly i have beena ble to keep this pregnancy is bc of the thrombo and immune testing i had and the meds i am still on including a high dose(200 mg) of lovenox

i never got this far before and i think that ia a huge part

i def agree with pp..go with ur gut and trust your instincts

i wish you all the luck in the world

Re: Immunology

I think more Drs believe in the thrombo end than immune. I was on 15 mg prednisone until 10 week then weened off. Now Im on just 2.5 like every other day til the next week withch is like nothing. People with arthritis go on prednisone while pregnant. My peri did tell me it was good I was weening off since it's not really good for me to be on. I'm also doing intralipids every 3 weeks until 20 weeks. It's food based and I don't feel it's so bad. The peri was fine with this and sometimes puts people on it every 2 weeks.

Non believing Drs can say what they want, but how do you explain someone with multiple losses doing these treatments and quicky getting pregnant and carrying full term?

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i had immune issues with pregnancy, dr B prescribed intralipids, which did not do anything for me. I did 2 rounds of IVIG ( per dr B recommendation). I was also on prednisone until week 12, lovenox until the day before schedules c section.
my son is 5.5 months and healthy. i thank God and dr B every day