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Thread: IVIG / Intralips / How to proceed

  1. #1
    Join Date
    Mar 2015
    Posts
    1

    Default IVIG / Intralips / How to proceed

    I have had 3 miscarriages. 1 own egg and 2 with donor eggs. I am on my third donor egg transfer cycle. 1 am 42 and being treated by Dr Slater at ICRM (thank you for your consult this past December when you visited for the holidays).

    Before my last transfer - here are my numbers in Dec from RIA (Dr Matzner in California):
    • NK 1:50 - 13.5%, some suppression with IVIG.
    • Positive APAs - Phosphoethanolamine and Phoshoinositol)
    • Normal IP


    One week before transfer on 2/19, I did: 4ml 20% intralipids and started taking Lovenox and 81mg aspirin daily.
    One week after transfer - 4ml 20% intralipids
    Pregnant! Hives started 5 days after transfer. Tx with 1 - 5mg prednisone daily

    I re-tested two weeks after my transfer. Here are my new results:
    • NK activity 1:50 is now 21.3% with NO suppression with IVIG (1:50 is 30.5%)
    • IP is now abnormal: CD16/CD56 = 17% and CD5 B cells = 23%. Rest normal.


    Dr Matzner recommended IVIG
    I did 20 mg of IVIG 3 weeks post transfer and the next day, 100ml of intralipids.

    I went in for my first ultrasound 1 month post transfer (6 weeks, 5 days):
    - twins! however, one was a blighted ovum. The other has a strong heartbeat and was measuring two days behind.

    I am now scared to death. The intralipids (which I did twice) did not bring down my NK levels and my IP is now off the charts (previously it was normal).

    Dr M wants me to do two days in a row of IVIG in two more weeks. IVIG is not covered by insurance and is very costly.

    Questions:
    • Why did my IP all of a sudden become positive?
    • Why did my NK levels skyrocket despite two intralipid treatments?
    • Is there any hope for my one remaining embryo?
    • Should I do IVIG when my in vivo test indicates no suppression?


    Dr M's lab does not test for intralipid suppression. I am 7 weeks PG today and scared to death that I will lose my one remaining baby.

    Any advice and insight for me is much appreciated.
    Patty

  2. #2
    Join Date
    Sep 2008
    Posts
    677

    Default Congratulations on your pregnancy. It is difficult to give advice about specific pa

    Quote Originally Posted by Patula View Post
    I have had 3 miscarriages. 1 own egg and 2 with donor eggs. I am on my third donor egg transfer cycle. 1 am 42 and being treated by Dr Slater at ICRM (thank you for your consult this past December when you visited for the holidays).

    Before my last transfer - here are my numbers in Dec from RIA (Dr Matzner in California):
    • NK 1:50 - 13.5%, some suppression with IVIG.
    • Positive APAs - Phosphoethanolamine and Phoshoinositol)
    • Normal IP


    One week before transfer on 2/19, I did: 4ml 20% intralipids and started taking Lovenox and 81mg aspirin daily.
    One week after transfer - 4ml 20% intralipids
    Pregnant! Hives started 5 days after transfer. Tx with 1 - 5mg prednisone daily

    I re-tested two weeks after my transfer. Here are my new results:
    • NK activity 1:50 is now 21.3% with NO suppression with IVIG (1:50 is 30.5%)
    • IP is now abnormal: CD16/CD56 = 17% and CD5 B cells = 23%. Rest normal.


    Dr Matzner recommended IVIG
    I did 20 mg of IVIG 3 weeks post transfer and the next day, 100ml of intralipids.

    I went in for my first ultrasound 1 month post transfer (6 weeks, 5 days):
    - twins! however, one was a blighted ovum. The other has a strong heartbeat and was measuring two days behind.

    I am now scared to death. The intralipids (which I did twice) did not bring down my NK levels and my IP is now off the charts (previously it was normal).

    Dr M wants me to do two days in a row of IVIG in two more weeks. IVIG is not covered by insurance and is very costly.

    Questions:
    • Why did my IP all of a sudden become positive?
    • Why did my NK levels skyrocket despite two intralipid treatments?
    • Is there any hope for my one remaining embryo?
    • Should I do IVIG when my in vivo test indicates no suppression?


    Dr M's lab does not test for intralipid suppression. I am 7 weeks PG today and scared to death that I will lose my one remaining baby.

    Any advice and insight for me is much appreciated
    Patty
    Congratulations on your pregnancy. It is difficult to give advice about patients specific treatment without benefit of evaluation and consultation. In general, IVIg increases live birth in patients demonstating both APA and NK cells. Dr. Coulam

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