Elevated TFNa

LollyPop

0 Posts
Reply Elevated TFNa Posted on: Aug 6, 2011 at 1:15pm
Hello Dr Braverman,

I am preparing for my 3rd IVF cycle in 2 weeks (first cycle with immune treatment).

I have also just received my TFNa re-test results, after 4 shots of Humira and one IL. They are now at 36.6

I do not have any DQalpha matches with my husband and my NK results are well within range.

Would you recommend going ahead with the planned cycle, even though my TFNa's are still raised? I will be adding steroids, clexane and a further IL as well as an IVIG before transfer day.

Do you recommend re-testing cytokines again once a positive pregnancy test is achieved?

I appreciate your expert advice.

Thank you.

Dr. Braverman

2026 Posts
Re: Elevated TFNa Posted on: Aug 7, 2011 at 2:25am
May I ask at what center you are being treated. That is very aggressive management and should be performed with an experienced repro immunologist. I think I would proceed at this point, but Im wondering why the prednisone, IL and IVIG? What about INFgamma, NKT have they been performed?
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

LollyPop

0 Posts
Reply Re: Elevated TFNa Posted on: Aug 8, 2011 at 11:49am
Thank you for your reply, Dr Braverman.

My TNF-a came back at 36.8 (after an initial result of 40, which flared to 50 after the first round of Humira)

My IFN-g came back at 23.6

I also had very low LAD, and, after 3 trips to Athens for LIT, my levels have successfully increased.

I am being treated in the UK by a well known IVF doctor who specialises in immunology.

I am just looking for reassurance that going ahead with my planned cycle, despite the elevated cytokines, would be the wise thing to do. I will most likely *not* have the time to re-test the levels after the second IL & IVIG.

Thank you for your time.

Dr. Braverman

2026 Posts
Re: Elevated TFNa Posted on: Aug 9, 2011 at 12:40am
with the elevated INFgamma I can understand the aggressive treatment, I concur with thier management here. Good luck to you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

LollyPop

0 Posts
Reply Re: Elevated TFNa Posted on: Aug 10, 2011 at 8:36pm
Thank you for taking the time to respond, Dr Braverman