> > Hi,
<br/>> > I had two Neupogen washes done last June with Dr. Braverman. I had them on
<br/>CD10 & CD12 of a FET cycle. My cycle ended up being canceled because of fluid in
<br/>the uterus. It seemed that in my case, my uterus did not absorb the Neupogen,
<br/>but this is not the norm. It did however help thicken my lining. The following
<br/>cycle, Dr. Braverman did not have me do the washes, but had me start Neupogen
<br/>injections on CD6. That cycle worked and I am now 22 weeks pregnant. Neupogen is
<br/>the bomb...I failed with IVIG, Humira and Simponi. I hope this helps!
<br/>

> Congrats on your pregnancy!聽 Unfortunately, the things you mentioned -
swelling, rapid weight gain and a crazy appetite are all fairly normal on higher
does of prednisone.聽 When I was pregnant Dr. B upped my dose from 20mg/day to
40mg/day at 5 weeks due to super high TNF.聽 I got so puffy and gained 30 lbs by
the end of the first trimester (crazy!!!).聽 The puffiness was really bad...I
didn't even look like myself.聽 I was miserable.聽 I also had major mood swings
and insomnia from it.聽 The good news is that most of this went away after I
tapered off of it at 14 weeks (completely off by 17 weeks).聽 Well, I didn't
lose the 30 lbs but I didn't gain a whole lot more the duration of my
pregnancy.聽 I didn't take the glucose test until 28 weeks but it makes sense
that your glucose might be elevated while on prednisone.聽
>

 

14周开始从40减量，17周停。

After last year DE cycle, we were completely crushed, devastated and hopeless
<br/>until learned this wonderful immune group and RI world. You ladies are so
<br/>incredible and extremely knowledgeable ! After consulting with Beer center and
<br/>Dr kwak, I was diagnosed with Elevated NK, high TNF cytokines, high CD57 cells
<br/>inside uterus, MTHFR c677, PAI-1 mutations. I combined their protocols using my
<br/>OWN eggs for this cycle. I did 4 Humiras, 3 LITs, 20+Ivigs (thru out preg),
<br/>lovenox, Dex/Prednisone, metformine, Metnax, V-E, V-D3, Fish Oil.....
<br/>>
<br/>

In my case, whenever my TNF and NK spiked, IVIG will bring it down nicely within a week. Very very effective when combined a higher dose of prednisone (40mg). IVIG is my golden ticket. wish I had a chance to try Intralipid, but Dr. K never recommend it and I certainly don't want to risk my baby after TTC 7.5 years. It seems to me Dr. Kwak prefers more IVIG over prednisone. She likes to prescribe ivig for most of her patients and keep to give them even at 3rd tri.
<br/>  The only downside is I have to keep getting IVIGs (huge financial burden) throughout my preg b/c my # are flutrated a lot. My last IVIG dose was at 33 weeks.

I guess it all depends on her NK and cytoknines #s...
Dr Kwak consistently checks our labs and tweaks the steriods dose thru-out the entire prego.

During the first tri, I was pretty much taking 20~30mg preg (there are few days, I had to take 40mg due to NK and Cytoknines spike)

I stop taking it at 24 weeks, but start weaning off around 22 weeks (10mg for 1 week and 5mg for another week, then stop).
Again, Dr.Kwak asked me to back on 20mg Pred at 31 weeks b/c of my high TNF#, then weaning off at 33 weeks...

I think 20mg is pretty safe dose. My OB also mentioned there are some ladies who need to take it for entire pregnancy.
Regarding how/when to stop steroids, it is pretty hard to say. too many variables and each body is different. There is no cookie-cutter for that.
best luck to your friend.

 

 

 

20的量很安全。

Congrats to your friend...I hope this is her rainbow baby! I was on prednisone
<br/>20 mg/day for high TNF. Dr. Braverman started weaning me off it at 12 weeks. I
<br/>cut the dose in half each week...so week one, I took 10 mg/day, then week 2, I
<br/>took 5 mg/day, then stopped. Hope this helps!
<br/>
<br/>Emily
<br/>
<br/>-----
<br/>Age: 35, One 3 year old boy, 5 total losses: 2 chemical pregnancies, Missed
<br/>miscarriage at 12 weeks(baby measured 11 weeks, chromosomally normal boy),
<br/>blighted ovum 7 weeks, missed miscarriage at 17 weeks(baby measured 13 weeks,
<br/>unable to obtain genetic results), Diagnoses: Homozygous A/A MTHFR gene
<br/>mutation, Vitamin D deficient, 5 HLA matches with husband, HLA "triad," high TNF
<br/>while pregnant. Current status: 26 weeks pregnant with a boy(Neupogen,
<br/>prednisone, Lovenox, Crinone, supps, acu)
<br/>
<br/>

Hi Eileen,

Congrats!!! I'm also Compound Heterzygous MTHFR. I was a Dr.B patient after 2 previous miscarriages. I had my daughter in Feb after TTC with his immune protocol. Your homocysteine levels aren't typically monitored during pregnancy, even with an RI. Treatment is just generally Lovenox, Baby Aspirin plus the bio-available form of folic acid (taking more of just regular folic acid won't help) and extra B6 and B12. There are prescription vitamins for this like Folgard, Neevo, etc. You can take the individual vitamins to make up these same levels without a prescription though. That's what I did (it's cheaper). I took 4mg of L-Methylfolate, 100mg of B6 and 1mg of B12 per day....along with an 81mg baby aspirin. I had Intralipids at CD10 while ttc, again at a positive Beta and then every 4 weeks after that through 16 weeks. I started off on 40mg Lovenox per day but then was increased to 80mg per day after my Anti-XA test showed that 40mg didn't thin my blood enough. Your RE should be able to order that test for you. Dr. B also had me on 1,000mg fish oil, prenatal, 400iu Vitamin E, 1,200mg Calcium (important when you're on Lovenox) and 2,000iu Vitamin D3. He also had me take 200mg progesterone suppositories (Prometrium) 2x per day through 10 weeks. I was also on 40mg prednisone through the first trimester (started weaning off at 14 weeks) due to pretty high TNF.

Having a 50% DQ Alpha match does not mean you automatically need Neopogen. Dr. B prescribes this for 5 or more HLA matches (DQ Alpha is just one of these). Did you have the full HLA panel run or just the DQ Alpha test? It's my understanding that Neopogen is prescribed before OV...

If I were you I would stay with what you're currently doing (Lovenox, Dex and Intralipids) and just add in the baby aspirin and the vitamins for the MTHFR.




Thanks,

 

 

14周强从40开始减量 

cycle (NK ~20s and TNF ~38). I took 20mg prednisone and had regular IVIG (every 2weeks) since...week 14 and 21. My NK jumped to 35 and TNF (th1:th2) jumped to 57 at week 21. Pretty...ivig. She also increased my pred dose to 40mg during the 1st tri and slowly weaned me...

I am not Hah, but I can tell you my story.
<br/>
<br/>IVIG, intralipid, and prednisone are all supposed to surpress immune system and lower NK and TNF to some extend.
<br/>Different people react the drug differently and each preg is different too. There is no such standard that you can predict how many ivig or pred you will get for this pregnancy.  It all depends on your lab results.  RI is consistently monitor the bloodwork (weekly, or bi-weekly) and decided if you need more ivig or pred, others....
<br/>
<br/>In my case, my NK and TNF were only slightly elevated before the cycle (NK ~20s and TNF ~38). I took 20mg prednisone and had regular IVIG (every 2weeks) since the begining of the cycle. However, both my #s spiked pretty high at week 7-8th. again two more spikes around week 14 and 21. My NK jumped to 35 and TNF (th1:th2) jumped to 57 at week 21. Pretty scary moment. I have to run into infursion center to get ivig immediately when i got the results.
<br/>
<br/>There are couple times Dr. Kwak asked me to get weekly ivig. She also increased my pred dose to 40mg during the 1st tri and slowly weaned me off at week 24. Now I am 26 week and might need 2 more ivigs.
<br/>
<br/>I am a very bad example :). Don't want to scare you away. I guess my body is very tough. and I cannot imagine how my baby can survive w/o Dr. Kwak's great care and those expensive drugs. I am so grateful to finally find Dr. Kwak and RI treatment.
<br/>
<br/>good luck to you all
<br/>XOXO
<br/>hanna
<br/>

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