2) 签证申请
<br/>   
<br/>　　签证申请宜早不宜迟。美国签证是一年的有效期，因此在成行之前一年内申请都可以。注意签证有效期和在美国的合法居留期限是两个完全不同的概念。签证有效期是指签证自签发之日起，一年有效。例如，我们签证是08年10月10日签发的，有效期至09年10月9日。就是说只要我们在09年10月9日之前进入美国，这张签证都是有效的。而在美国合法居留的期限，也就是通常说的签证期限，是不会记载在签证上的。这个合法居留的期限，是在凭签证入关时，美国海关工作人员根据你访美的目的而临时决定的。一般来说你如果说你是去美国旅游的，他们会给你6个月的合法居留时间；如果说商务，会给你3个月的时间。这个期限是自你进入美国的日子算起，到期你必须离境。到美国生子，6个月足够了。就算只给了3个月，也没关系，3个月到了如果你还没生或是还在坐月子，你可以凭医院证明去美国移民局申请签证延期，一般都可以批下来。就算批不下来，在审批的那个过程中，你是合法的驻留，不用担心。
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<br/>　　不要找中介申请签证。中介喜欢唆使你在申请材料上作假，而这有可能导致永久拒签。中介收费很黑，一般美国签证收费10万左右。实际上，领事馆只收取一个人1000元人民币左右的预约签证面谈费用。所有资料表格都是免费发放的，也可以自己从使馆网站下载打印。有中文说明，很容易填写。不懂英文都可以自己按指示完成表格。。

美国商务签证。一年内可多次往返，每次停留时间不超过3个月。我们是合法居留有效期的最后一天回来的。
<br/>    如果不能在3个月内回来，可以在美国当地移民局申请延期。
<br/>     

1）户口
<br/>   
<br/>    如果是第一胎，那么国内可以上户口。当然如果符合第二胎的政策，即使是第二胎国内同样可以上户口。上户口具体操作方法是：
<br/>   
<br/>    在中国驻美使领馆为宝宝申请中国旅行证。回国的时候，在美国出关时用美国护照，在国内进关时使用中国旅行证。这样在中国的海关记录上宝宝就没有被记载为美国公民。然后你就可以去你的户口所在地派出所为宝宝上户口。和户籍警一定要说孩子没有申领美国护照，给他们看旅行证。如果你们符合政策派出所没有理由不给上户口。
<br/>   
<br/>    如果不符合第二胎的政策，想上国内户口也不是不可能，那么就可能需要交一笔罚款。具体操作方法还是和上面的一样。
<br/>   
<br/>    国内上了户口不影响宝宝的美国公民身份。不同国家之间户籍资料不可能共享，没有办法查到。
<br/>   
<br/>    2）国内长期居住的问题
<br/>   
<br/>    如果没有或者没法给宝宝上国内户口，那么宝宝长期合法居留中国是一个问题。旅行证的有效期是两年，宝宝两岁以后就是非法滞留中国了。
<br/>   
<br/>    这方面很难查到官方政策。据说是到时候去当地公安机关可以申请旅行证延期。谁知道这方面的情况麻烦分享一下，谢谢了啊。
<br/>   
<br/>    我一个朋友的解决方法是，每两年带小孩去美国一趟，回来的时候又可以有两年的有效期。那个人在美国有生意，经常两边跑，所以可以这样。但是这个方法不适合大多数人。
<br/>   
<br/>    也许，交点罚款，给孩子弄个国内户口是一个最为彻底的解决这些麻烦的办法。但是公务员或是事业单位，国有企业的人如果这样，也许会因此丢掉饭碗。
<br/>   
<br/>    我目前也没有做准备，先看看再说，相信船到桥头自然直。
<br/>   
<br/>    3) 教育
<br/>   
<br/>    如果有了国内户口，就没有了国内上学的麻烦问题。但是如果宝宝上不了国内户口，国内上学就会有一些麻烦。
<br/>   
<br/>    幼儿园没有区别，外籍的和中国小朋友一样的收费，一样的待遇。
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<br/>    小学开始到高中毕业，外籍学子如果在国内公立学校的话，上海的标准是加收借读费每学期6000元人民币左右。如果你经济宽裕，这个也不是什么问题。而且，有资格收外籍学生的学校都是很好的学校，本地人想进也得额外收费，搞不好交的比这个数目还多。呵呵。
<br/>   
<br/>    上私立学校的话就不会收借读费，但是私立学校学费本来就已经很贵了。
<br/>   
<br/>    另外如果在上海的话，可以上美国学校，那是美国政府针对美国驻华工作人员开办的学校。学费很贵，一学期2万美金左右，但是那里面是原汁原味的美国教育，只有美籍学生才可以进去。不过好像听说低收入家庭可以申请减免学费，这个只是听说而已，没有核实，不可盲目采信。
<br/>   
<br/>    当然也可以去美国接受教育，小学到高中毕业不收任何费用。但是必须有人陪读，那个是一笔大费用。或者找个美国家庭寄养，这个办法也有风险。如果有亲戚在美国这个办法就很可行，
<br/>   
<br/>    外籍学生在国内上大学占尽优势。如果是学生美国国籍，之前一直在中国接受教育的话，那么考个清华北大的留学生易如反掌。就拿清华为例，外籍学生申请来留学，一般只要中文考试成绩合格，其他学科的考试那是走过场。这就是为什么很多有门路有权势的人高考之前为子女改国籍的原因。网上很多类似的帖子，北大医学院的留学生很多是非洲穷国国籍，但是有着地道的中文姓名……
<br/>   
<br/>    既然是美国国籍，为什么不去美国上大学呢？那个学术氛围和师资声望，国内大学目前无法望其项背。
<br/>   
<br/>    我的计划就是今后带小孩去美国上学，至少去美国上大学。当下我最主要的目标是，努力挣钱，存钱。若干年后，也许我会开始实施这个计划。

Hi, I was ANA+ but with a fairly low titer (can't remember but maybe 1:80 or 1:160) and I had elevated NKs.  Four miscarriages (after a normal pregnancy/birth of first daughter) and then discovered this website.  Then my protocol became:  gluten free/dairy free diet, 1 tsp. daily of fish oil, prednisone (20 mg and then later went down to 10 mg), intralipids every 3-5 weeks throughout pregnancy, Endometrin for progesterone support, 5,000 IU Vitamin D.  Briefly was on Lovenox (Day 28 to Day 38) and was on baby aspirin but this too I stopped after several weeks at the suggestion of my RE as I had spotting from 6w5d to about 12 weeks (spotting was probably from inadequate immune suppression at time of implantation, not the blood thinners).  Had a full term healthy baby in June 2011.
<br/>
<br/>
<br/>I had had 100 mL of intralipid about 60 days prior to conception, then nothing because I moved across the country and had to find all new doctors, then fell pregnant and received my first intralipid on Day 29 (he did 20 mL).  All subsequent intralipids were only 4mL infused, as this is what Dr. Coulam thinks works best ("Less is more" theory of immune suppression).  
<br/>
<br/>
<br/>Anyway, the weirdest thing is that 20 months later, my NK cells are now coming out normal on the assay.  My naturopath thinks that being on supplemental Vitamin D for this period of time has possibly normalized my NK cells, but we are just guessing.  I also follow a paleo diet now and that seems to have improved my overall health.
<br/>
<br/>
<br/>Anyway, intralipids worked for me, but I also did all those other things, too.  Not sure if what you meant by "just intralipids" was just them alone with no other immune suppression, or if you meant as opposed to doing any IVIGs.   
<br/>
<br/>
<br/>Best wishes to you,
<br/>Julia B.
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<br/>

I joined this group back in August 2011, after Dr. G. Sher (of Sher Institutes) diagnosed us with a 100% match with DQ Alpha and HLA. He had recommended using a surrogate or IVF + donor sperm.
<br/>
<br/>I wanted to update because a lot of things have happened since then. I haven't been active in the group for awhile. We were very discouraged and devastated after hearing Dr. Sher's diagnosis. We didn't know how we could afford a surrogate or any other options. Plus, we weren't ready to accept the news. There is hope though! I want you all to know, miracles really do happen. If it can happen for me, it can happen for you. xoxo
<br/>
<br/>In April 2012, I met Dr. Kwak-Kim (A Reproductive Immunologist) in Illinois. I live in Ohio, but we made the trip for our first visit to complete and evaluation and testing. I didn't know if a 2nd opinion would even help at all, but I thought it was worth a shot. She was so thorough, caring, and knowledgeable. She tested me for more things than any other my other doctors combined. My insurance covered almost all of it, as it will billed as autoimmune disorder - not infertility. All further follows ups were done via email and phone - at no charge.
<br/>
<br/>We discovered that I had poor blood flow to my uterus, through Dr. Kwak-Kim's high tech ultrasound machine. I've never seen a machine like that, that could pick up so much detail. We found through extensive blood work, that I have 3 blood clotting disorders: PAI-1, MTHFR (Hetero), and Factor XIII. I have a positive ANA and APA. My Cytokines and T Cells are elevated, as well as my NK Cells. She found that I have atypical PCOS - where my hormones reflect PCOS, but my ultrasound does not really look like most PCOS patients. I do get cysts occasionally though. No other doctor had made these findings, and I've been tested and examined a lot. Even though we found so much wrong, these issues were treatable!! And there was hope finally!
<br/>
<br/>I also have Diminished Ovarian Reserve and Endometriosis, as well as RPL (11 early losses - mostly chemical pregnancies). I had a Septum in my uterus, which was missed by previous doctors, and not found until November of 2011 during a Lap. It was repaired, and is supposed to have contributed to some of my losses. We did the Lap "for the heck of it", but we found Endo and the Septum. I'm so glad I went ahead with the surgery then.
<br/>
<br/>Anyway, back to April/May 2012 - I began Metformin 1,000mg daily, Prednisone 10mg starting at 2dpo, Progesterone 400mg starting at 2dpo, Lovenox 40mg (1 injection) starting on cycle day 6/when period was over. I also began high dose Folate/B Vitamins and baby Aspirin. My body doesn't absorb Folate normally - which not only affects a growing fetus, but it also can attribute to poor egg quality before you can even get pregnant. These were all Dr. Kwak-Kim's recommendations/protocol. I also took Fish Oil 1,200mg 2-3 daily, on my own accord. It's supposed to be a natural blood thinner and anti-inflammatory.
<br/>
<br/>Only about 6-7 months later, I got my positive pregnancy test. We didn't do IVF, or even IUI. I did a Femara/Follistim combo with timed intercourse. We didn't have the money to pursue more aggressive treatment yet, and Dr. Kwak-Kim said to try somewhat naturally for a little while. Much to our surprise, the pregnancy has continued to progress. We are still in shock and disbelief, feeling so grateful and lucky. I am almost 15 weeks pregnant now, and I never even made it close to that mark before. I've had zero problems, but I must continue frequent monitoring via ultrasound and labs.
<br/>
<br/>Since becoming pregnant, I now take 2 Lovenox injections instead of 1, 30mg of Prednisone instead of 10mg, and 800mg of Progesterone instead of 400mg. Higher doses of Progesterone are supposed to be better for immune patients, per Dr. Kwak-Kim. She wants the progesterone levels to be at at least 40-60. Some of my immune labs are still elevated or abnormal, but we're keeping a close eye on things. I do have many risk factors due to my diagnoses and meds. It will be worth it no matter what though, as long as we have our baby in August.
<br/>
<br/>So 2 years in August since we got that devastating news from Dr. Sher, and we'll hopefully be holding a baby in our arms at last.
<br/>
<br/>Other tidbits: I also lost 26lbs in those 6 months leading up to my pregnancy. The Metformin definitely helped with that. I wasn't obese, but my weight had gone up a lot since we began TTC. I went gluten free 3 months prior to my successful cycle. It didn't work out so well, so I did go back to regular foods (but healthier). I think that may have helped. I also drank a tablespoon of Apple Cider Vinegar everyday in the cycle prior to getting pregnant, for cleansing/detox purposes. It's great for balancing the body. I was on a break that cycle, due to a cyst. They had me on birth control pills for 40 days or so. For some reason, I feel like that suppression helped with our next cycle.
<br/>
<br/>I wanted to add that Dr. Kwak-Kim has been at this for a loooong time. She even experienced infertility herself. She studied DQ Alpha/HLA matches, and found the studies to be inconclusive. It is NOT the end all, be all in achieving pregnancy. I've met several other ladies who've gone on to having several children with DQ Alpha/HLA matches.
<br/>
<br/>I hope this gives you all some hope! I am sending out positive vibes to you all. If you have questions, I am happy to help in any way possible. You can reach me here or at BaileyLisaL(at)Hotmail(dot)com. I also have a blog: http://lisabttc.wordpress.com.
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<br/>~God Bless and may all your dreams come true~
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<br/>

I am currently taking,,,,,,,,,,,,,,,,,,,

Much to my and my doctor's shock, my natural killer assay came back completely
<br/>normal. (Last pregnancy they were elevated throughout and I had intralipids
<br/>every 3-5 weeks during the entire pregnancy)
<br/>

Great that the IVIG is working!
<br/>Just wanted to share my experience. I was pregnant last year and had IVIG every three weeks from the beginning of pregnancy until I was 20 weeks. My NK cell activity never came down below 17% It was even up to 27 a few times%!! I was so worried during the first 4 months that my baby wouldn't make it, but the IVIG did it's job. The Beer Center said that regardless of my high levels, the IVIG is protecting the baby and to keep having it every 3-4 weeks. I had 30g the first 2 months, then my doctor lowered it to 25g.
<br/>After 20 weeks I stopped testing and had scans every two weeks plus non stress tests. Beer Center said if the baby was developing well, showing no signs of growth retardation that I didn't need IVIG. But in case there were ANY signs of trouble to have a dose right away.
<br/>
<br/>I had a fantastic doctor (I live in Europe) who had a 4d scanner and was able to check blood flow to the baby, my placenta, growth and all other things which can be negatively affected by high NK cells during pregnancy causing the baby to stop developing in the third and fourth trimester.
<br/>I now have a healthy baby boy after 3 consecutive miscarriages! IVIG definitely made a difference.
<br/>
<br/>Good luck!!

Hi Ladies,
<br/>>
<br/>> As promised here are my results following one IVIg infusion (25g): Just thought
<br/>> this would be interesting for anyone else considering IVIg.
<br/>>
<br/>>
<br/>>
<br/>>                         BEFORE             AFTER            NORMAL LIMITS
<br/>>
<br/>> TNF-a              44%                     27%               13.2  -  30.6
<br/>> IFN-g               21%                     23%                 5.8  -  20.5
<br/>>
<br/>> 50:1                  18.5%                  8.4%              10  -  40
<br/>> 25:1                  12.5%                  6.3%                5  -  30
<br/>> CD3                 76.6%                  67.6%             60  -  85
<br/>> CD19                5.7%                  20.2%               2  -  12
<br/>> CD56                17.8%                15.9%               2  -  12
<br/>> CD19+CD5+    28.1%                4.5%                 5  -  10
<br/>>
<br/>> All in all some good reductions in TNFa and NK cells although my CD19 has shot
<br/>> upwards which is a bit concerning and confusing. Also, IVIg is supposed to be
<br/>> very effective at reducing CD56 but it's only reduced mine by 2%. I have had
<br/>> another IVIg since this and am due another one next week and then I get retested
<br/>> - if anyone finds this information useful I will post my results again. Please
<br/>> note I am also on 40mg prenisolone, 40mg clexane, 75mg aspirin, 100ml
<br/>> prontogest, 800mg cyclogest and have had 2 x LIT for low LAD levels, no DQ alpha
<br/>> match, history 5 very early miscarriages.  
<br/>>
<br/>> Am now 10 weeks and 4 days with normal scans so these immune treatments seem to
<br/>> be working so far although as you can see a couple of my results are still high
<br/>> so am still on shakey ground I think.
<br/>>
<br/>>
<br/>> Hope this information is useful for some of you xx Jaynie
<br/>>
<br/>

Sure no problem, my levels were so bad and I had bleeding in 1st trimester so ended up having the 3 IVIgs only 2 weeks apart from eachother. Started at 7 weeks pregnant, then one at 9 weeks and the last one at 11 weeks. Haven't needed one since and now 16 weeks