Humira

Anna1074

4 Posts
Reply RE: Humira Posted on: Dec 30, 2011 at 5:55am
Dear Dr. Braveman,

I have just learned that I am pregnant after egg donation. Due to elevated NK (15,4 % when it should be below 12 %), a very high T4/T8 index, i.e. suppressor cell and helper cell ratio, at 3,5 or even higher and a too high TNFa (9,9 when it should be below 8,1), I took 1 shot of Humira 40 four weeks before embryo transfer and 10 g IVIG three days before embryo transfer. In addition, I take 5 mg prednisolone daily.

On the day of the pregnancy test, I got 5 g IVIG. On that day, my NK were at 9,4%, T4/T8-Index at 3,5 and TNFa at 5,2. In light if the high T4/T8 index my doctor has recommended another shot of Humira 40. However, I am concerned that it could lowen my TNFa too much as it is only 5,2.

What would you recommend?

I would be very grateful for a response.

Best wishes,

Anna

Dr. Braverman

2026 Posts
RE: Humira Posted on: Dec 30, 2011 at 2:10pm
I would need to know much more to give you a recommendation at such a critical time. I dont disagree that you dont want to lower the TNF too low and not sure of the reasoning by your doctor. Where are you getting treatment?
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Anna1074

4 Posts
Reply RE: Humira Posted on: Dec 31, 2011 at 4:15am
Dear Dr. Braverman,

Thank you for you response. I live in Germany and get treatment here.

I could finally get hold of my doctor (who is on vacation) and he recommended again to me to rake the one shot, which I did. I hope that it was the right decision.

I am pregnant with twins after a ling struggle (I have POF so that we need egg donation) and hope that we keep the two.

Best wishes and a happy new year,

Anna

Dr. Braverman

2026 Posts
RE: Humira Posted on: Jan 1, 2012 at 1:30am
Ok well I have to assume your doctors know your case best, so feel comfortable with their decisions. Good Luck , and let me know if you need my help in the future, I wish you success.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Anna1074

4 Posts
Reply RE: Humira Posted on: Jan 1, 2012 at 6:25am
Thank you, Dr. Braverman. I wish you a great 2012!

I am still a bit concerned though I have taken the medicine as recommended and cannot change it now anyway.

I would appreciate if you could help me with the two questions:

1. In addition to Humira, I had 5 mg IVIG on the day of the positive pregnancy test (ET +14), as I had written before. My doctor said that IVIG and Humira compliment each other (in my case). Do you also gice IVIG AND HUMIRA in some cases with very little distance after a positive pregnancy test?

2. How much lowers one shot Humira the absolute level pg per ml? I.e. if my level was 5.2 pg per ml, will it be 0 after the shot or more likely something like 3 pg per ml or so?

I would very much appreciate your answer to this.

Best wishes,

Anna

Dr. Braverman

2026 Posts
RE: Humira Posted on: Jan 1, 2012 at 9:25am
no sometimes the level does not fall at all , at this point I would not worry as its most critical at time of implantationa and you are past this. IVIG and Humira have been found to be better than either one alone.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Anna1074

4 Posts
Reply RE: Humira Posted on: Jan 1, 2012 at 11:45am
Thank you so much for your support!