CARE Fertility Bulletin Board

Josie21 · 22 Jan 2003

Hello girls,

I have some decisions to make following my forthcoming Chicago tests and would really appreciate some feedback.

The options for attempts relates to Immmune drug cycles so if you had 3 BFNs without immune drugs, then got BFP on 1st go with immune drugs, select "1st attempt", not 4th.

As usual there are so many combinations that I would be grateful (if you have the time) to also post: -

1. Name(s) of clinic(s) where each BFP or BFN was obtained
2. Immune drugs/dose used - and was there are different selection/dose for BFP
3. What is your Immune issue(s)
4. How many attempts before Immune drugs used
5. And anything else you feel is significant.

Thank you so much for your time. Very Happy

I hope I haven't over-complicated things!

Jo x

carol03* · 30 Mar 2004

Hi Jo

1. Care
2. Prednisolone d6-16 10mg, d17 (1dpt) 20mg, started reduction @12weeks, Clexane 20 (ET - 12 weeks)
3. Anti thyroid antibodies
4.
i) fresh nov 03 -ive
ii) frozen may 04 -ive (natural)
iii) fresh aug 04 -ive
iv) frozen jan 05 +ive m/c 8weeks (was a natural cycle converted to medicated at d21)
Level 1 tests Spring 05
v) frozen jun 05 +ive (clomid d2-6) EDD March 06

5. Had acupuncture on iv & v. Decluttered my life. Had a good diet. Tried not to take life too seriously. NB I should of had Aspirin as well but due to Asthma couldn't have it.

We have also been ttc 8 yrs .... with MF, but I also have a blocked tube.

Good Luck Jo

Carol

melaniep · 18 Jul 2004

Hi Jo

This is a really good idea to run this poll I would have welcomed it when i started my first immune protocol this summer. So here goes the answers to your questions :

1. Immune protocol set Mr Shehata at www.miscarriageclinic.co.uk IVF protocol set by CARE Northampton ( care were Happy to support Mr S recommendations )

2. Clexane 40mg s/c from day of EC
Prednisilone 25mg from day of EC
Aspririn 75 mg from start of long protocol.

3. My immune issues are that I have very high almost double in fact of NK CD69 activity

4.I had previously 1 fresh and 1 frozen attempt but both I bled from day 5-6 so never made the 2nd week of a 2ww.

5. Extra information - I also took 100mg of viagara from day 1 of stimms to day 8 to improve blood flow this was not prescribed I just bought it over the internet and thought it could not do any harm. Due to my early bleeding I also had 100mg of gestone injections started from day of ET and still continuing. Also had weekly acu and acu on day of ET.

We decided to Mr S to get an external opinion outside of CARE and also because he charges only £200 fro his immune testing. We also like the fact that he has published lots of research and is well versed in this area both from failed implantation as well as early m/c. In total we had been ttc for 9 years with female factor our issue.

This cycle was not our best at all I stimmed for 19 days ( nightmare) and ended up with only 2 embryos to replace 1 grade 1 (4 cell) and 1 grade 2 ( 6 cell) with none to freeze. I am pleased to say we are now 11 weeks pg with twins and things are going well so far.
I wish you every success in what you decide to do.

Melaniex

ClarePat · 23 Nov 2004

Hi Jo

1. Name(s) of clinic(s) where each BFP or BFN was obtained
5 ICSI at Bourne Hall , 4 BFN, 1 biochem

2. Immune drugs used - and was there are different selection/dose for BFP
20 mg Clexane, increasing dose of prednisolone up to 40mg, Ivig once before +ve and once after

3. What is your Immune issue(s)
We share an antigen and I had moderately higher natural killer cells

4. How many attempts before Immune drugs used
5

5. And anything else you feel is significant.
I also had high resistance blood flow and so took viagra for first two weeks before transfer, this drastically improved my blood flow but I think the Ivig also helped to stop me killing the embryoes myself. Now 35 wks pregnant and 4 weeks and a bit weeks to go!!! Very Happy

Good luck

Josie21 · 22 Jan 2003

emilypillbeam · 14 Nov 2004

Hi Josie
1. Repromed, Clifton Bristol (but immune protocol from George at Care).
2. Clexane 20, Prednisolone, 4x cyclogest 400mg - (was advised to hav ivig but declined).
3. Anti - thyroid antibodies, significant levels of ANAs, normal levels of NK cells but very elevated killing capacity.
4. 4x iui BFN
2x fresh ivf cycles biochems BFN
5. Also had assisted hatching for 1st time on successful cycle, took fish oils and Zeta West vitamins....?????

My gorgeous twins were born 12 days ago.
Wishing you very good luck
Emily xxxxx

Josie21 · 22 Jan 2003

Wow!
Thank you for your votes and details - this is giving me a lot of hope. It's interesting how there are more frozen BFPs than fresh!
I hope some more details will appear over the coming months.
Congratulations to all of you who've had a BFP, especially Emily, whose ink is still drying!
I really appreciate everyone taking the time.
Jo x

Josie21 · 22 Jan 2003

Carol & Emily
would you mind editing your reply to show what dose of pred you took please? I have seen a few different doses & am v interested (in case you hadn't noticed! Laughing

). I have so many thoughts now and options are appearing. Thanks so much again.
Thanks.
Jo x

amanda s · 09 Jan 2002

sorry just realised i have pressed wrong button

ticked no 4 as was fourth cycle but got positive on first immune cycle and was a fresh cycle.
Took double cyclogest, asprin, ivig, clexanne and asprin

Are you able to amend

amanda

karen st · 28 Nov 2001

hi amanda

i am glad you clicked onto this site, as that is good news for me to hear . i am on my 5th fresh cycle now, the last 4 and 4 FETs to no avail, but this is my first cycle with full immune tx, so thanks for the confidence. it can work.

josie
good work you are doing here. thanks

karen

Josie21 · 22 Jan 2003

Hi Amanda - I can't correct it but don't worry.
I wonder whether it would be a huge hassle to edit your post and popin the info I mentioned in my original post, hon? Don't worry if not, I am just finding it hugely helpful.
I am so excite about having the Chicago tests. I can hardly wait!

Karen - thanks, glad it's helping. We could do with a bigger sample!

Jo x

Carol333 · 05 May 2004

Very good idea this.

1. Tried to conceive for 9 yrs - never got pregnant until I used immune treatment -
Aged 43yrs. Used own eggs.
Details of BFN and BFP

Exeter - 3 IUI's and one ICSI fresh cycle - BFN
ARGC - 1 x ICSI fresh cycle - BFN
ARGC - 1 x ICSI fresh cycle, first attempt with immune drugs - BFP

2. Immune drugs used -
3 x IVIG's
dexamethasone, clexane, asprin, gestone
Took 9 x fish oils a day for approx. 12 months before cycle (Eskimo fish oils)
Protein powder from day 1 of cycle to day before egg collection (Powder from boots in blue container)
Husband also took Fertility Plus for men for 10 months.

3 Immune issues
NK issues
50:1 15.9

4. How many attempts before immune used?
3 x IUI's and 2 x ICSI all BFN

All the best to everyone trying and God Bless
Carol333

helen u · 31 Jan 2001

Hi Josie,

CARE Nottingham and satelite Leicester all 4 cycles.

I fit none of the above.

Unexplained infertility since 1995.

2001 Sucess IVF no 1. DD now 4.

2003 3 fresh failures

Jan 2004 Had Chicago tests and Doppler Studies; TH1/TH2 56. All else normal. Doppler 11/20

February 2004 Conceived naturally on viagra dummy run. Took aspirin, clexane and prednisolone from 5.5 wks pregnant (when I found out) till 12wks. DD no 2 just turned one.

Going for an FET soon. Just doing the viagra.

Good luck,

Helen

P.S I'm no fan of immunoglobulin and remicade regimes. I wasn't prepared to take them as thought the evidence was very poor.

ClairePezza · 28 Apr 2003

ARGC - Success with first FET with this clinic.

Treatment :
IVIG day after transfer (procedure with FET due to checking viability of thaw)
Prognova tablet twice per day
Gestone injection 100mg during 2ww until 13 weeks
baby aspirin - ongoing
heparin/Clexane 20mg twice daily- ongoing til 28 weeks
IVIG day after positive pregnancy test
2 more ivig's throughout pg- no more repeat nk bloods required from now! (NK bloods checked every 2 weeks progressing to every 4 weeks)

Original male factor 100% antisperm antibodies following VR reversal - ICSI tx required.
Immune issues: elevated nk cells - typically 24% on 50:1 ratio
diagnosed with implantation failure

2nd attempt was successful on immune drugs - January fresh ICSI unsuccessful. NK cells damaging implantation was thought to be route cause and recommended FET due to naturalness of cycle and lack of exposure of embie to nk cells in mother and in uterus.

Josie21 · 22 Jan 2003

Daphne 2 · 12 Oct 2005

Just a suggestion Josie, but have you posted this poll on the "Bumps, Babies and Beyond" board?

I can think of a number of pregnancies (?Helen H/? Helen W/?Maxie/?Nagina/?Kar..) who, if I recall correctly, followed an immune drugs protocol of some sort or another.

Perhaps these women check the Bumps and Babies board more than this immunology one? Your poll is a great idea and it would be nice to have as many responses as possible to give a clearer picture.
Hope I've not erred in suggesting this?
Good Luck.

Daphne

Josie21 · 22 Jan 2003

Thank you Daphne. Very Happy

I've posted a wee reminder! I hope they won't mind!
Jo
x

Josie21 · 22 Jan 2003

NickNick · 04 Dec 2005

1. Name(s) of clinic(s) where each BFP or BFN was obtained
a.Clinic abroad - BFN 1998
b. Bourn Hall - Biochemical Apr 2002
c. Bourn Hall - BFN Aug 2002
d. SFC - BFP 2004 (first using immune tx)

2. Immune drugs/dose used - and was there are different selection/dose for BFP
Used humira 4 x injections prior to cycle. Used clexane 20mg each day until 35 weeks pregnant. 75mg aspirin daily pre pregnancy and up to 30 weeks. Also took fish oil and vit e, 5mg folic acid, Vit B5, B12.

3. What is your Immune issue(s)
High NK killer cells.

4. How many attempts before Immune drugs used
2 fresh and one frozen

5. And anything else you feel is significant.
Thought long and hard about using humira - felt I had nothing to lose. Now have a beautiful 11 month old son who I never thought I would ever have.

Good luck to all immune tx people - I'm about to go thru it all again!
B x

annetteweb · 26 Jul 2005

Hi there, just got my BFP so here goes with the details:

1st IVF Liverpool Women's March 05, BFN, only 2 eggs.
Moved to CARE Manchester:
July 05, Polyp discovered and removed, short protocol advised due to previous poor response, uterine blood flow found to be poor, and immune cell CD19 and CD5 ratio found to be high at 26 (not sure I understand) Clexane 20mg & Baby Aspirin & Steroids recommended (Dexamethosone 1mg) and Oestradiol 2mg.
2nd IVF with above drugs - Sept/Oct 05 - much better response, 9 eggs, 6 fertilized, 2 grade 1s transferred and 3 frozen, Unfortunately BFN

3rd go - FET, 2 thawed and transferred, 24th Nov, doubled dose of Dexamethosone to 2mg, otherwise same drugs. Natural cycle though, embryos 3 cell and 4 cell - grade 2? Just got BFP today - Can't believe it!!!

Love Annette xx

Josie21 · 22 Jan 2003

bunnyfuller · 14 Dec 2002

Hi,

haven't been on here in an age....and now I am going thru the boards like a dose of salts!!!

1. Name(s) of clinic(s) where each BFP or BFN was obtained - CARE Notts

2. Immune drugs/dose used - and was there are different selection/dose for BFP - viagra (precautionary only, I never did scan) IVIg, Prednisilone, clexane and aspirin

3. What is your Immune issue(s) High TH1-2 ratio - mine was 52.3

4. How many attempts before Immune drugs used - one IVF chemical pg but previously four natural chemical pgs

5. And anything else you feel is significant - I had an allergic reaction to IVIg - not severe but enough for George to say no to any more, regardless of IVF outcome. Well, the cycle worked, Alice is almost 11m, and not only that - I fell pg naturally when she was 5m old, and all I had in 1st tri was prednisilone as wasn't prepared to pay out for more Chicago testing again (had also moved in meantime) Am now 25w 5d with a singleton au natural!
Interestingly, or oddly, during IVF immune cycle I stimmed superbly but only 2 eggs fertilised (we didn't do ICSI, DH did have sperm issues but they seemed ok on the day)

Josie21 · 22 Jan 2003

Skippy 2 · 26 Sep 2004

Bump for Micki

Josie21 · 22 Jan 2003