Planning a Baby  Discussion Forum

Name: KiranC

Hello Archie,

How are you and Adwait? I really appreciate your efforts to help the girls on this board. I have faith on you and I really take your advice seriously. Just wanted to have your advice on reproductive immunology.

My History : Age - me 29 hubby 32 . TTC since 4 yrs. Unexplained infertility. Had 2 IUI. and 3 IVF/ ICSI (first IVF was cancelled due to high estrogen level). All failed.
I have regular 28 day cycle never missed the period. Husband has normal perm count but slightly high abnormal sperm (75%).

Present condition : Recently had laparoscopy and found mild endometriosis which was removed by laser. Never had any of the symptoms. And I think endometriosis is the result of first IVF in which estrogen level was very very high due to stimulation .

Had blood test for immunology ( before laparoscopy )and found that -

1> TH1:TH2 Cytokine ratio -
TNF-a 36.8 Normal Range - (13.2 - 30.6)
IFN-g 28.7 Normal Range - (5.8 - 20.5)

2> CD19+, CD5+ Cells 17.7 Normal Range ( 5 - 10 )

And Thyroid Antibodies, Histone Antibodies , DNA Antibody , NK Assay, Cd3% , CD19%, CD56% where normal.

We are now planning for 4th and last IVF.
My doc is saying that I definitely have some issues with immunology. Resulting in 2 IVF failure. And According to my doc -

Take Humira/ Embrel for 3 months then recheck the levels of TH1 and TH2 if they fall within normal range then go for IVF/ ICSI with IVIG and some steroids.

I have discussed the side effects of all these drugs with the doc and found that Humira/ Embrel is FDA category B drugs while steroid (dexamathosone and Prednisone ) are category C drugs.

We have decided not to go for Humira/Embrel as we think that my TH1 : TH2 ratio is slightly high because of mild endometriosis and now it should come down to normal after laser removal. And I am taking Fish oil (1000 mg ) to reduce Th1. But doc is not agree we us. He says laser removal is not going to help us.

We are definitely not going for humira/embrel . As we think this is not safe for me and for baby ( if +ve, Hope so ) as well.
We have to take a decision whether to go for IVF/ICSI with IVIG and low dose steroid OR simply do the IVF/ICSI. We do not want our baby to suffer the consequences. But still want to do our best to get the child of our own. This is the last try . If it fails then we have decided to go for adoption. As going for IVF/ICSI is very hard emotionally, financially and physically as well.

I understand that reproductive immunology is very recent topic and still require more study. Please Archie, can you suggest should we go for IVF/ICSI with IVIG and steroid OR not. Is taking low dose steroid is safe during first 3 months of pregnancy ? I am ready to take IVIG but I am very scared about this steroid thing and really want to avoid taking it.

Thanks for reading such a long message.

KiranC.

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