neupogen empirically? And question about TNF-a

Megz

5 Posts
Reply Posted on: Sep 24, 2012 at 8:16am
is there any possibility of neupogen being given emperically, without immune testing as a last resort? And if so, what would be the dose for that? I know some RE's will give prednisone and lovenox, and other such meds even when testing comes back normal, or has not been done, simply as a cant hurt might help type of treatment...is neupogen one of those, or are the risks with misuse too great? what would be a low tharputic dose, if any at all?

Also- Can intralipids be done Emperically? My RE is offering them to me, ( or IVIG) without the presence of testng, due to my EXTENSIVE loss history ( 15 losses, ranging from 4 weeks to 19 weeks ( with 12 losses being consecutive over the last 20 months) and 3 live births ). I am on the fence...

Also- do you test TNF-a in your work up's? And what meds are used to treat it if it is high? can I see a regular imuneologist to get my TNF tested? as I have other possble auto immune issues that have just been brought to light. (hypothyrid and most recently diagnosed- Hidradenitis suppurativa and possible gluten intolerance) and can they RX me meds to use that are safe for trying to get pregnant?
8 losses in a year
dying for answers!

Dr. Braverman

2026 Posts
RE: neupogen empirically? And question about TNF-a Posted on: Sep 24, 2012 at 8:21am
My goodness, that is a complicated history . I would never treat empirically for such a case you need to find out why this is happening as sometimes the treatments can become the problems. You should call me for a consult so we can correclty diagnose the problem and offer you the correct treatment.
Neupogen is still in the "experimental" mode and should never be admistered unless the physician has extensive experience with it. Intralipids if given wihtout proper immune follow up could over suppres as could steroids.
If they are not familiar with the workup or treatments they should not be offering them.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Megz

5 Posts
Reply RE: neupogen empirically? And question about TNF-a Posted on: Sep 24, 2012 at 8:42am
Thank you for the reply-
I did contact you a while back,( 4 more losses ago) and had a basic consult, and I was so excited to have found a possible way to sort through this, and get things fixed, but I am unable to afford the consults etc...I have spent so much money on RPL testing and cycling with traditional fertility treatments in hopes of getting a "lucky" embryo to stick...so my savings is depleted. I am trying to find a way to work with my existng RE and not have to pay much more out of pocket...Or possibly see a regular immunologist to get some of the testing done with a DX code other than RPL or infertility...

If i could pay for the testing and consults, I would have been with you over 9 months ago, when I first started learning about immune related issues....But I had hoped that the "next time" would be different and eventually we would get a sticky baby....has not been the case...

we had recently ( in the last 5 months) moved on to femara to boost ovulation, Lovenox, all cycle long, high doses of progesterone and estrogen in the luteal phase, and even prednisone ( 20 mgs) starting the day after ovulation. But both of those cycles actually ended up being ectopic, ( one in June and one in sept) that had to be treated with methotrexate...so now I am in a holding pattern with I recover my folic acid levels from the methotrexate.


do you offer finance options?
8 losses in a year
dying for answers!

Dr. Braverman

2026 Posts
RE: neupogen empirically? And question about TNF-a Posted on: Sep 24, 2012 at 9:04am
yes we do offer financing just for these kind of situations , please call my office and ask to speak with Judy. You need to get this problem correctly identified. the money you will spend at the attempts that dont work will cost you much more in the long run.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.