High TNF

rupert5

2 Posts
Reply Posted on: Apr 10, 2014 at 1:00pm
Hi Dr. Braverman, I had my first DE transfer in January and we transferred 2 great blasts from a young, proven donor. My 1st beta was 182, 2nd beta 4 days later was only 243, 3rd beta 2 days later was 424, and 4th beta 5 days later was 2260. Ultrasounds at 6w5d and 7w5d showed a normally growing baby with a good heartbeat. At the 9 week ultrasound the heart had stopped. We have 13 frozen embyros and I want to rule out immune issues before proceeding with another transfer. I received some of my immune results back from reprosource and it shows a TNF alpha level of 13.6 Is this considered very high and have you had good results by treating with intralipids? I also did some research and it seems that high TNF levels can be linked to a low BMI. As my BMI is 16.5, is that also an issue?
4 failed OE IVFs (1 chemical)
1 DE IVF: missed miscarriage at 9 weeks after 2 ultrasounds at 6w5d and 7w5d showed heartbeat and normal growth

Dr. Braverman

2026 Posts
RE: High TNF Posted on: Apr 10, 2014 at 2:25pm
I am very sorry for your loss. Please read the diagnostic testing section on my website, you will then understand that you have practically no information to make a correct diagnostic recommendation. If you havent had our full panel then you cant possibly know what to do next, and if you have lost a DE pregnancy this is almost certainly an immune implantation issue. As a rule however ILs do not treat elevated ctyokines.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

rupert5

2 Posts
Reply RE: High TNF Posted on: Apr 11, 2014 at 4:45am
Thanks for your response. You ordered the couples immune panel and we're still waiting on the rest of our results, however the cytokine results were faxed to my RE and they let me know some of them were flagged as high. I'm just very curious to know if a high TNF reading is treatable or if this means I'll need a gestational carrier.
4 failed OE IVFs (1 chemical)
1 DE IVF: missed miscarriage at 9 weeks after 2 ultrasounds at 6w5d and 7w5d showed heartbeat and normal growth

Dr. Braverman

2026 Posts
RE: High TNF Posted on: Apr 11, 2014 at 6:21am
No I high TNF alone does not at all mean you need a gestation carrieri and is almost always treatable. When we get back the rest of the results Ill know why it is elevated and will recommend treatment. An elevated TNF if very common in our patient population. Please dont be thinking about gestataional carriers at this point. As soon as the remainder of your results are in and I have had a chance to reveiw them along with your history we will go over everything with you or y our doctor.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.