natural killer cell treatment
6 Replies
hopefully trying - April 22

OMG. I just saw your response to someone about Solu-cortef. I am on BCP right now and scheduled to begin IVF # 2 with a microdose lupron flare protocol (lupron on May 6 and follistim on May 8). Quick history: hypothyroid. Both parents and maternal grandmother hypothyroid. 68% sperm antibody result. 0 pregnancy. 3 failed IUI and 1 failed IVF (with 3 blasts transfer 1 excellent quality 2 slightly fragmented). Consistently thin endometrium.

I am in the process of getting my testing back from Millenova. Am waiting on ATA and ANA. I have not been able to get an interpretation yet (my doc is way over the fence i.e. very conservative but was willing for me to do the testing. he is not willing to do the ivig and if I could try something else more affordable it would be awesome). Some of the results are abnormal others are not. I will post what I've gotten back below in case you can help interpret. I have no idea where to go at this point. I'm trying to research and get info to advocate for myself but it's been difficult.

In range:
CD3 - 69.1
CD19 - 12.9
CD16+ - 8.8
CD16- - 5.5
IgA - 139
IgG - 907
IgM - 115
Embryotoxicity Assay: absent 0%
APA - see below. all the rest normal

Out of range:
CD4 - 54.8 high
CD8 - 14.2 low
Natural NK T:E 14.4 high
Suppression with IVIG 8.4 low
Suppression with Intralipid 9.5 low
APA - IgM PG: .203 high (range .118 - .188)
IgM PC: .162 high (range .090 - .108)

1) Can you tell me what the dosage and at what point in the cycle you do Solu-cortef?
2) Have you heard of Intralipid as an alternative?
3) Any other ideas? advice? suggestions?

 

Dr Smith - April 22

As for the specifc dosage of Solu-Cortef, you would need to consult with your doctor. I'm am not a physician and giving specific medical advice would cross the line for me. SoluCortef is given as a one-time injection at the time of transfer and followed with dexamethazone tablets taken daily for the first trimester. Intralipid is another experimental, low cost alternative to IVIg. The use of both Solu-Cortef and Intralipid are in the early experimental stages and there isn't much hard scientific evidence to support their efficacy in the treament of elevated NK cell activity. That being said, we are having early success with Solu-Cortef. We have not tried Intralipid (yet). You have an abnormal NK cell activity, so you would clearly benefit from some kind of treatment (IVIg, Solu-Cortef/Dexamethazone, Intralipid). If your doc is reluctant to treat you during your upcoming cycle, get a second opinion before you get too far into the cycle.

 

hopefully trying - April 22

Here's my dilemma. Through his nurse, my doc has been great about being willing to consider the immunological issues. However, he has been clear about his limits i.e. he's not an immunologist and tends to wait on the scientific research. He had said because this is still outside the standard of care he has not been willing to treat with IVIG. I've been working with his nurse by providing the research and articles I come across. She discusses it with him and in their IVF conference. They agreed to the testing but he felt the interpretation was outside his area of expertise which I can totally respect. He has indicated he will work with me monitoring etc if I want to do IVIG but that he won't do it himself. For multiple reasons, if there is a more afforable alternative to IVIG, I think it would make more sense to try that for this particular cycle.

I totally respect your limit issue in not providing medical advice when you're not an md but an embryologist. Given that I will need to provide some sort of info to them for their consideration, where could I go to find out what the appropriate doseage (solu-cortef) would be specifically for this kind of immunological fertility treatment?

 

Dr Smith - April 25

I'm going out on a limb here, but... I don't know where else you're going to get this information. I spoke with the RE I work with and this is the poop:

100 milligrams as a single injection on the day of transfer (Day 5-6). Followed by dexamthasone 1mg/day tablet for the first trimester.

Best of luck

 

hopefully trying - April 26

Thank you SOOOOO very much. I know that giving me this info feels like a risk and I appreciate your concerns. I promise you that I will take this information to my RE and it will only be in done in conjunction with his approval and part of my medical treatment plan. I hope that ya'll continue to have success and will be able to publish at some point. My RE's RN has been an incredible asset in working WITH me to research things from the "medical research" standpoint. It's been frustrating to find info. All of this is to thank you from the bottem of my heart!

 

Asunflower - May 5

Hopefully trying,
Did you use the solu-cortef yet? Just wondering if it worked!

 

hopefully trying - May 8

I have not used the solu-cortef yet so I don't know. Best of luck to you.

 

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