what to do next

missy

1 Posts
Reply Posted on: May 7, 2013 at 1:26pm
Dear Dr. Braverman,
I am at a loss for direction.
I have been TTC x5 yrs, i am 35yo, never conceived-numerous IUIs, IVF x5 with good day 5 embryos. hubby, okay sperm analysis, thats the extent of his testing.

Last month CD3 (on prednisone 10mg qd) my NK assay %CD56 was 13.1;
50:1 was 15.3 TNF-a:IL-10 (CD3+CD4+) 36.6 and IFN-g:IL-10 (CD3+CD4+) 23.9
-prednisone was increased to 10mg bid , IVIG infusion on CD10

CD 15 (s/p IUI w/letrozole, IVIG 400g/kg infusion (I am 50kg)-cd10)
my levels were elevated on %CD56 to 18.6 and TNF-a:IL-10 (CD3+CD4+) 55.1 and IFN-g:IL-10 (CD3+CD4+) 32.5
these levels resembled my levels on prior testing after ovulation and TTC on my own without any prednisone or other treatments.

the recommendation now is to double IVIG dose. would this be your recommendation, would using a TNF inhibitor be useful in this case?

(I have tried intralips in the past, high dose fish oil) I was also using lovenox bid since my implantation zone blood flow was very poor, I have moderate endometriosis. this is the extent of my history.

Dr. Braverman

2026 Posts
RE: what to do next Posted on: May 7, 2013 at 1:50pm
There are many other issues that need to be explored with you. Most notably HLA issues which may require a completely different thearpy. I would be happyt to help you with this.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.