IVIG dose


3 Posts
Reply Posted on: Jun 15, 2014 at 4:10am
Dear Dr Braverman,

I'm 28years old with a history of one misssed miscarriage @ 12 weeks, and 4 failed IVF cycles over the past 3 years. The immune testing i've done recently has shown MTHFR C677T Heterozygous mutation, NK cells 57+ (blood) of 27% and CD 56+ cells (uterus) at rate of 95 per HPF (1hpf=0.34sqmm).

My treating Dr has recommended 20mg Prednisolone, 40mg Clexane, 100mg doxycycline/day and either Intralipids or 15g of IVIG. We decided to try the IVIG.

However, the Dr that will be administering the IVIG (different to treating Dr) has said that based on my bodyweight of 62kg I should be having 25g IVIG. What dose in your opinion would you use? Obviously I want what is going to work and don't want to under treat but worry there is danger of oversuppresion too if I go with the 25g.

I also wonder if the IVIG dose is only 15g, would using the much cheaper intralipids be just as beneficial?

Also, this will be a frozen embryo transfer and I'm stuggling to get my lining past 7.4mm (on 8mg estrogen daily). Would you recommend I push for viagra (the only drug my clinic uses)?

Thank you kindly for your advice.

Dr. Braverman

2026 Posts
RE: IVIG dose Posted on: Jun 15, 2014 at 4:40am
First you should be aware that Intralipids and IVIG are not completely interchangeable, second you do not have enough information to make a correct choice between any of the treatments you have been offered, so I can not give you any insight into correct treatment. You should certainly have a "complete" immunology profile performed before you transfer any more embryos so you dont guess at the correct treatment. (See our Diagnostic Testing section and sample reports). With that said I think you should be more in the range of 1gm/kg wieght if you use IVIG and the endometrial biopsy has not proven to respond to these treatments or be a suitable means to evaluate the "cause" of your losses. There are many treatments availabe for uterine lining issues but it depends on the cause of the lining problems, and there are many . If the lining is three layered Im not as concerned about the lining being yoru primary problem as long as you get it over 6mm. I would be happy to assist you with your care, if you fill out a consult request form we can schedule a free 10 minute chat to review your case.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.