“我穿的是孕妇牛仔7分裤、腰部贴身的黑色长袖蝙蝠衫，加上大丝巾和网球鞋，里面穿了一个紧身弹力背心，人看上去小很多。右手拿一个蝙蝠包，左手跨着一件外套，这样前后左右都可以挡住肚子。 ”陆小姐回忆称，果然，上飞机后没有一个人看出来她是大肚皮。

Well, I chose Enbrel because I was also being seen by a rheumatologist recommended to me by my RE who had been treating immune related infertility kind of on the side. His treatment called for Enbrel. I also have a very close family friend who is a rheumatologist who only uses Enbrel on his RA patients. Strongly believes that it is a better drug. So, I just made the decision based on that and DB's history with it was extensive so he was fine with it. I know that DS is a Humira fan and Chris now is more on the Humira side as well. I believe the difference is that Enbrel is an animal product and could eventually lose it's immune suppressing ability and Humira is not an animal product. I could be off on that, but I think that is the difference. Enbrel worked for me for months. I took it til week 16 of pregnancy. But most of us here are on Humira with wonderful successes.
<br/>
<br/>My dosage started at 50mg/week. I began with over 20 NKu's. After one month, I did another biopsy and the NKu's were about 8. DB increased my dosage to 75mg/week. I then re-biopsied after another month and the nku's were below 4. It took a while, but we finally got them down. I would try and get your results in hand as soon as possible. I was reading some of your posts and understand you will be doing IVF very soon. Although your consult is in about 10 days, I would beg Chris to just ask DS to review your records now, make a determination on the need for Humira and get you a prescription asap. Then you can still talk with him later, but at least you'll have your medicine in your system. You may just have a low amount of NKu's like 4 or 5, which means that you may not need as much as I did. I hope that is the case.  It would be nice to start IVF with as much Humira in your system as possible.
<br/>
<br/>I am sorry this is all a big rush right now, but I think it will be well worth it.
<br/>Hoping the best for you.
<br/>:)Liz

Thank you San
<br/>> > > What I did was biopsy first and to DB's surprise (because
<br/>my
<br/>> > cytokines were low), found the NKu's. PSL lab sent me the
<br/>> results
<br/>> > and the picture stained to reveal all the NKU's. We saw 22 at
<br/>> least.
<br/>> > I started 50mg Enbrel and did another biopsy after 4 weeks.
<br/>The
<br/>> > NKu's went down to about 10 or 12 and DB increased my dosage
<br/>to
<br/>> > 75mg/ week. I did another biopsy after 4 more weeks and the
<br/>> stain
<br/>> > revealed just 1. Anything under 4 is good. I have continued
<br/>the
<br/>> > Enbrel throughout my IVF cycle. DB said no need to biopsy
<br/>again.
<br/>> > > Best regards
<br/>

newbeginin 发表于 2011-5-30 11:51
<br/>录一下看到的姐妹保胎方法&nbsp;排卵后固肾安胎丸14天，怀上也一直吃&nbsp;吃到80天（也可以是滋肾育胎丸） ...

<br/><br/>请问下，强的松和环孢素可以一起用吗？

没吃环了。

Debbie, this was all so very interesting. I learned a lot from
<br/>your
<br/>> post. Thank you.
<br/>>
<br/>> Several things were interesting to me: reason for splitting up the
<br/>> IVIg (Makes some sense), the lovenox placental abruption-reduction
<br/>> explanation, well, just several things.
<br/>>
<br/>> The comment about stopping humira during stims is very good news
<br/>and
<br/>> wise I believe. The anti-tnfa effect of this is very contrary to
<br/>the
<br/>> tnfa which is needed for implantation to occur (according to my RE
<br/>> who researches this.) It makes some sense (I guess) that it could
<br/>> affect eggs also. But I wonder why he doesn't say to restart 2
<br/>weeks
<br/>> after transfer? Then again, people have gotten pregnant on humira
<br/>and
<br/>> through IVF, so.
<br/>>
<br/>> I just wanted to mention that you can't do vaginal suppositories
<br/>> during the 2 week wait after your transfer (nothing should be
<br/>placed,
<br/>> cough, ahem, up there during this time.) I'm not sure DB knows
<br/>this,
<br/>> but you'll need to do another form of progesterone during that
<br/>time.
<br/>> I have awful reactions to the IM shots, after 10 days my body
<br/>attacks
<br/>> (I'm an hormone attacker though.) But you might want to ask him?
<br/>>
<br/>> Wishing you all the best in this cycle. I might be cycling a
<br/>little
<br/>> after you, i don't know, we're still deciding what to do.
<br/>>
<br/>> Marci
<br/>>
<br/>> --- In immunologysupport@yahoogroups.com, "indy942003"
<br/>
<br/>> wrote:
<br/>> > For those who don't know my latest, my Cytokines have always
<br/>> > responded slowly but well to Humira (last few months went from
<br/>42
<br/>> in
<br/>> > March to 26 in July), but shot up to 40 end of August. I had
<br/>> > allergy symptoms, as many in this area were having (sinus
<br/>pressure
<br/>> &
<br/>> > headache & slight drainage--no biggie) when the blood was
<br/>drawn. I
<br/>> > came down with a cold 3 days later---don't know if the allergy
<br/>> > symptoms & cold were related or just coincidence. I wasn't in a
<br/>> ttc
<br/>> > cycle, so there's nothing else that would cause my Cytokines to
<br/>> > shoot up and I have been on bi-weekly Humira since end of
<br/>> February.
<br/>> > I did have a booster LIT mid-June, and had slight increase in
<br/>flare
<br/>> > symptoms (joint pains, hairloss, flaky skin on face) even though
<br/>> not
<br/>> > reflected in my labs end of July labs. But these symptoms
<br/>seemed
<br/>> > mild. For about a month now, my joint pains have increased. Is
<br/>> > this from my allergies or cold? Delayed flare from LIT?
<br/>> >
<br/>> > DB said that allergies or cold could both cause increase in
<br/>> > Cytokines. He also said that his statistics are showing that
<br/>women
<br/>> > who have flares from LIT or Humira (yes I confirmed the LIT
<br/>part,
<br/>> as
<br/>> > we have only heard him talk about Humira flare stats) are
<br/>showing
<br/>> > higher pregancy rates in the end. He said that no matter the
<br/>cause
<br/>> > of my increased Cytokines, the same damage can still be done
<br/>> (TNF>40
<br/>> > can change the DNA in eggs & takes 17 weeks to heal). He says
<br/>my
<br/>> > joint pain is being caused by the NK cells in the joints. I
<br/>agree,
<br/>> > as I had joint pains before ever starting any anti-TNF drugs.
<br/>So,
<br/>> I
<br/>> > don't think the Humira is causing my joint pains. He feels that
<br/>> the
<br/>> > increase in my Cytokines shows that the bi-weekly Humira just
<br/>isn't
<br/>> > holding me, so he's increasing my dose to weekly---this was
<br/>exactly
<br/>> > what I was thinking that I needed. He also mentioned that if
<br/>need
<br/>> > be, Humira can be given every 80-hours, like Enbrel. This was
<br/>new
<br/>> > infoo.. So, I'm hopeful that the weekly shots will decrease my
<br/>> > joint pains, & Cytokines to <20 (he says <30 is good, but <20
<br/>> would
<br/>> > be best---so we'll wait until they're <20 before starting our
<br/>IVF
<br/>> > cycle). If I do well on the weekly Humira shots, the plan is to
<br/>> > stay on it weekly until heartbeat.
<br/>> >
<br/>> > I asked him about any preliminary results from the study that
<br/>Dr.
<br/>> > Zouves is doing on Humira. That if taken during stims in an IVF
<br/>> > cycle, can it cause immature eggs to be produced (per DB, this
<br/>has
<br/>> > only been unique to Enbrel, so far). DB said that the study is
<br/>> > showing "some association" and that I'm to stop Humira during
<br/>> > stims.. My IVF protocol is BCP's 1-3 weeks, Cetrotide for 4 days
<br/>> > (like Antagon), then stims. He said to take the last Humira
<br/>shot
<br/>> at
<br/>> > least 1 week before I start the Cetrotide & then restart the
<br/>Humira
<br/>> > the evening of transfer. I'm thinking he might have meant to
<br/>say
<br/>> > evening of retrieval. I'll have to double-check this with him.
<br/>> >
<br/>> > I've been on Heparin while ttc, as DB says that NK cells can
<br/>cause
<br/>> > the blood to clot faster. (I'm neg. for all clotting
<br/>disorders.)
<br/>> > In reading things here, all info. points to Lovenox being safer
<br/>&
<br/>> > better during pregnancy, than Heparin, so I asked DB about
<br/>> switching
<br/>> > me and he did. He said that he prefers Lovenox over Heparin &
<br/>the
<br/>> > only thing he doesn't like about Lovenox is the price (my
<br/>pharmacy
<br/>> > quoted $796.00 for 30 shots of 40mg----thank goodness that my
<br/>drug
<br/>> > plan covers it for a $40 copay). He said that with Lovenox, you
<br/>> > have a higher concentration of it in the plancenta, it doesn't
<br/>thin
<br/>> > the blood, it just slows the clotting process & you don't have
<br/>the
<br/>> > risk of placental abruption as you do with Heparin. Heparin
<br/>thins
<br/>> > the blood. I also read an article that said that there is less
<br/>> bone
<br/>> > % loss with Lovenox.
<br/>> >
<br/>> > I discussed possibly changing back to Prednisone vs. taking
<br/>> > Dexamethasone while ttc (have tried both without problems except
<br/>> for
<br/>> > weight gain on both). He said Pred. is good for Cat. 3
<br/>problems,
<br/>> > but Dex. is good for Cat. 3 & 5---which I have both. Steroids
<br/>in
<br/>> > general decrease the immune system, so I asked why Pred. didn't
<br/>> also
<br/>> > work on NK cells. He said that they've tested it in the lab and
<br/>> > seen it in patients. They added Dex. to the test tube with the
<br/>NK
<br/>> > Assay and it helped prevent the NK cells cellular expansion,
<br/>where
<br/>> > the Pred. didn't. He also said there are less side effects on
<br/>Dex,
<br/>> > which Chris in his office has also mentioned to me. And he said
<br/>> > that Dex. can put on muscle weight when women are exercising
<br/>while
<br/>> > on it (he recommended weight training twice a week & walking 1
<br/>mile
<br/>> > a day getting HR to 140). Someone else mentioned that he told
<br/>them
<br/>> > this in their consult awhile back, and I thought DB had gone
<br/>mad.
<br/>> > Anabolic steroids put on muscle, not corticosteroids, like Pred.
<br/>&
<br/>> > Dex.. But DB said that Dex. has actually been abused by body
<br/>> > builders. Well, I believe what he's saying now, but still don't
<br/>> > discount the fact that steroids, like Pred. & Dex., put on fat
<br/>in
<br/>> > the abdomen, face, & back-----been there done that----just like
<br/>the
<br/>> > textbooks say. However, I'll be more inclined to exercise while
<br/>on
<br/>> > Dex. now-----move over Arnold----Ha!
<br/>> >
<br/>> > Here's my Immune med. line up:
<br/>> >
<br/>> > Baby aspirin daily staring CD 1.
<br/>> >
<br/>> > Lovenox 40mg daily starting day 6 of stims., changing to twice
<br/>> daily
<br/>> > with +preg. test.
<br/>> >
<br/>> > Dexamethasone 1mg daily (best taken in AM) starting day 6 of
<br/>> > stims.. Stop it to take RE's Medrol, then resume Dex..
<br/>> >
<br/>> > IVIg starting with first Cetrotide dose, then another IVIg with
<br/>1st
<br/>> > day of stims. (Basically a 2-day dose, but DB says he likes to
<br/>> > split them up. If given 1 day after each other (how he's
<br/>> > recommended in the past) the kidneys can become overloaded & he
<br/>> > indicated that we're missing out on the total benefit of the 2
<br/>> > doses. Nurses on board, help me think this one through. IVIg
<br/>is a
<br/>> > protein, so we know that can be hard on the kidneys, but I'm
<br/>trying
<br/>> > to understand why we wouldn't still get the same benefits from
<br/>the
<br/>> > drug--I'm thinking absorption would be the same. Perhaps he's
<br/>just
<br/>> > concerned about health of our kidneys, but explaining it wrong.
<br/>> >
<br/>> > Anyway, I'll be getting a 2-day dose preconception as listed
<br/>above,
<br/>> > then have blood drawn a week later to see if I'll need a single
<br/>or
<br/>> > double dose 2-days before transfer. Then due to my overly
<br/>> > aggressive NK cells, automatically get an IVIg 7-days post
<br/>> > transfer. We'll do the hpt testing starting 7 days post
<br/>transfer
<br/>> > every other day looking for the line to get darker & show up
<br/>> quicker
<br/>> > and if that happens, we'll go for a beta. Meena faxed me his
<br/>notes
<br/>> > from our consult, and I noticed on there that he wrote for IVIg
<br/>> > every 3 weeks during pregnancy. Maybe I've finally convinced
<br/>him
<br/>> > that I have more aggressive NK cells, than what I think he's
<br/>> thought
<br/>> > in the past. Or trial & error with his immune tx's has shown
<br/>him
<br/>> > that I'm in the top 1% of his "Olympic Team".
<br/>> >
<br/>> > Glucophage 500mg once or twice a day--my choice not to come off
<br/>of
<br/>> > it, but fasting free insulin levels good.
<br/>> >
<br/>> > Progesterone--probably vag. suppositories or shots if RE
<br/>suggests
<br/>> > it. DB mentioned that there is a new study showing less
<br/>> > comlications & longer gestations if the Progesterone is taken
<br/>the
<br/>> > entire pregnancy. I found this interesting, but we didn't have
<br/>> time
<br/>> > to talk about in further detail.
<br/>> >
<br/>> > Then I'll stay on the Fish Oil & Vit. E, and prenatal vitamins.
<br/>> >
<br/>> > I don't know when we'll be cycling, but I'm guessing it'll be
<br/>when
<br/>> > AF starts end of October. I have to get my Cytokines <20 and my
<br/>AF
<br/>> > is due this month in 2 1/2 weeks---probably not enough time.
<br/>> >
<br/>> > For those of you who went on the Humira weekly, how did DB tell
<br/>you
<br/>> > to test? He told us in the consult to take 1 shot, next week
<br/>take
<br/>> > another shot, and to do blood draw before take the 3rd shot.
<br/>But
<br/>> in
<br/>> > his notes that he wrote, which the ofc. is going by, he said to
<br/>do
<br/>> > the blood draw 2 weeks after the second shot. This is his
<br/>protocol
<br/>> > when you're taking the Humira bi-weekly. If I go by that, I'll
<br/>be
<br/>> > technically doing the blood draw a week after the 3rd dose.
<br/>> >
<br/>> > Sorry this got so long. I wanted to share some things with you
<br/>> > all.
<br/>> >
<br/>> > Debbie in Texas
<br/>

Hi Rachel,
<br/>I just wanted to add my experience- I too had a small SCH early in this pre=
<br/>gnancy (twins).
<br/>Yes, I had been on Enbrel but it was stopped when we first saw the heartbea=
<br/>t, and the SCH
<br/>wasn't seen until a little later on. I received 25 gms of IVIG and the SCH =
<br/>had almost
<br/>resolved by the next u/s, and was completely gone a week or two later. I ne=
<br/>ver had any
<br/>bleeding, and continued on my heparin and baby ASA (was also on some dex at=
<br/>the time).
<br/>Hope this helps!
<br/>Melissa D
<br/>26 weeks b/b twins
<br/>

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

newbeginin 发表于 2013-2-4 20:40
<br/>Hi,
<br/>I had two Neupogen washes done last June with Dr. Braverman. I had them on CD10 & CD12 of a F ...

<br/><br/>Liz, Thank you so much for responding and for sharing your
<br/>experience. I also had normal cytokine results and low CD56 cells
<br/>when last tested in late April. I re-tested NKs and cytokines last
<br/>Monday so will be interested to see what the results are. It was
<br/>great that your NKUs went down so quickly with the Enbrel. I will be
<br/>asking Dr S on Monday about going on a weekly dosage, and as I
<br/>started the Humira already on Tues 25th that would give me the chance
<br/>for at least 4 or 5 doses before the FET if needed. I had good
<br/>supression of NK activity with IVIG & dex in my last cycle/pregnancy
<br/>as this dropped from 22 pre conception to 13 with +ve preg test to
<br/>2.4 while pg @ 50:1 so I am hoping that the combination of Humira and
<br/>IVIG will be sufficient (along with the Arixtra, BA, dex etc of
<br/>course).
<br/>
<br/>I feel so much better about my FET after your reply. Thanks again.
<br/>
<br/>How is your recovery from your surgery going? Do you know when you
<br/>will cycle again?
<br/>
<br/>Kate
<br/>

Liz, Thank you so much for responding and for sharing your
<br/>experience. I also had normal cytokine results and low CD56 cells
<br/>when last tested in late April. I re-tested NKs and cytokines last
<br/>Monday so will be interested to see what the results are. It was
<br/>great that your NKUs went down so quickly with the Enbrel. I will be
<br/>asking Dr S on Monday about going on a weekly dosage, and as I
<br/>started the Humira already on Tues 25th that would give me the chance
<br/>for at least 4 or 5 doses before the FET if needed. I had good
<br/>supression of NK activity with IVIG & dex in my last cycle/pregnancy
<br/>as this dropped from 22 pre conception to 13 with +ve preg test to
<br/>2.4 while pg @ 50:1 so I am hoping that the combination of Humira and
<br/>IVIG will be sufficient (along with the Arixtra, BA, dex etc of
<br/>course).
<br/>
<br/>I feel so much better about my FET after your reply. Thanks again.
<br/>
<br/>How is your recovery from your surgery going? Do you know when you
<br/>will cycle again?
<br/>
<br/>Kate
<br/>