Interlipids and IVIG

Jean

10 Posts
Reply Posted on: Jul 15, 2013 at 9:06am
Dr. Braverman,

I just found out that I cannot afford, nor does my insurance cover IVIG. I am looking to do an August frozen embryo transfer after finding out since my last failed "perfect" IVF (IVF#2) cycle that out of all the tests done (everyone one you can think of) I have elevated Natural Killer cells (21%- 19% is normal) and hubby and I have 4 partial HLA Matches (DQ Alpha, DQ Beta, HLA C & HLADR).

It is now recommended I do Interlipids. I wanted to know your thoughts on the liklihood of success under these facts to hopefully lessen my killer cells to allow me to get pregnant. I do not know if I normally have NK Killer Cells or if the constant contact of the "matching" is causing it but either way, I wanted to know if you thought I have a chance with Interlipids and what your experience has been with patients like me.

Dr. Braverman

2026 Posts
RE: Interlipids and IVIG Posted on: Jul 15, 2013 at 12:56pm
The workup is far to incomplete to make any recommmendations , I dont know why IVIG was recommended in the first place. I would be happy to provide guidance for you , I would need to have a consultaiton with you to go over all of your history in detail as well as get the immune workup completed. Matching is not causing NK cell elevation. Please read my blog on HLA.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Jean

10 Posts
Reply RE: Interlipids and IVIG Posted on: Jul 15, 2013 at 2:15pm
IVIG was recommended since we have 4 HLA/DQ Partial Matches that may be causing the NK Killer Cells to activate and is known to be stronger than Interlipids. I believe I did have a full panel of tests done and can send to you as I have a call set up for next week with you to consult.

What other tests can be done to figure out what is causing the NK Killer Cells that I may not have done?

Generally speaking, is Interlipids good for reducing killer cells regardless of the cause to get pregnant?

Dr. Braverman

2026 Posts
RE: Interlipids and IVIG Posted on: Jul 15, 2013 at 2:19pm
matching does not cause elevated NK cells and you dont treat symptoms you have to identify the problems first. Yes of course send me what you have and we can reveiw when we speak.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Jean

10 Posts
Reply RE: Interlipids and IVIG Posted on: Jul 16, 2013 at 6:48am
Dr. Braverman,

Since the matching is not causing the NK Killer Cells what are other possible causes of the "activation" of these Killer Cells? Just wondering what else could be causing it or what are the possible causes.

Generally speaking, what are the different treatment plans available to help NK Killer Cells.

I have had 2 perfect IVF Cycles and have no other known issues except "unexplained"- just tring to get to the bottom of this.

I am currently supposed to do a frozen cycle with Interlipids (10 days before), Predisone, Baby Aspirin, etc. , and want to see what other treatment options are out there.

Dr. Braverman

2026 Posts
RE: Interlipids and IVIG Posted on: Jul 16, 2013 at 7:06am
my advice is always the same. I would not transfer embryos without a complete workup . As I stated the problem may not be elevated NK cells , these may just be a symptom of another issue (such as immune HLA haplotypes) (see my blog on this) and you need to direct the treatment at the root cause and not the symptom. NK cells are known to fluctuate in al patients . Please schedule a consult with me(if you are out of the area we can do a free 10 min chat to reveiw my thoughts on this) .
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.