Neupogen recommended but do I need anything else?

UKGirl

4 Posts
Reply Posted on: Jan 15, 2013 at 7:29am
A brief bit of history from me...

I'm in the UK and have had 4 cycles of fertility treatment now (2 x fresh, 2 x frozen) with three BFNs and one BFP which resulted in early miscarriage - blighted ovum.

I have been to see Dr Gorgy in London and he has tested me for everything. It has been found that I have Homozygous MTHFR and also I am missing the 3 relevant "KIRs". In addition to this I have elevated antithyroid antibodies and hypothyroidism.

Dr Gorgy has told me I need clexane and G-CSF/Neupogen for my next cycle. However I am unclear, even after speaking to Dr Gorgy's clinic, whether I will need to continue with prednisolone for the antithyroid antibodies?

Also, would you recommend intralipids? I have never used these before BUT I am using donor sperm, which has not had the DQa test done on it, so in theory I could potentially have a DQa match with the donor sperm. There is no way of testing the donor's blood as it's totally anonymous, and I have frozen embryos of my own created with this sperm.

Any advice would be appreciated. Thanks.

Dr. Braverman

2026 Posts
RE: Neupogen recommended but do I need anything else? Posted on: Jan 15, 2013 at 7:45am
I think the clexane will cover the anti thryoid antibodies. It sounds like he has you on the correct regimen. The idea of DQalpha matching is no longer correct, it is the full HLA analyisis that is important and the likelihood that this is your problem with donor sperm is quite low. And Intralipids are NOT the treatment for high order HLA matching.
. If your NK activity were high I might add it.
Please understand I do not know our entire history so I cant confirm that these recommendtons are correct, but this is what I would do with the information you gave me. Ultimately you must always follow the advce of the doctor who is currently caring for you.

Also it is very important when using immune treatments to follow all of the correct immune parameters after treatment , regardless of whether you are pregnant so the treatments can be adjusted, this is often missed but quite as important as the initial testing if not more important.

Good Luck.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

UKGirl

4 Posts
Reply RE: Neupogen recommended but do I need anything else? Posted on: Jan 15, 2013 at 7:53am
Wow, thanks so much for the VERY quick reply. Much appreciated. :-)

My NK cell activity is, thankfully, totally normal... so it's good to know you think intralipids are probably not necessary. That's one less battle to have with my clinic.

I didn't realise clexane was also used to treat antithyroid antibodies! I thought it was just for the thrombophilias. Wow.

Unfortunately I am in a bit of a tricky situation as I am unable to have my cycle with Dr Gorgy, as my frozen embryos are stored up north, and my own clinic here at home will allow me to follow Dr Gorgy's immune protocol but are offering no help with it really. So in some ways I am sort of patching together treatment from different clinics.

I really hope that clexane and neupogen brings me my baby.

Thanks once again.

Dr. Braverman

2026 Posts
RE: Neupogen recommended but do I need anything else? Posted on: Jan 15, 2013 at 8:05am
Please update us on your success!! If you need assstance once pregnant do not hesistate to call us I would be happy to assist you .
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.