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Miscarriage, Multiple Miscarriage and/ or Immune Issues Moderated by Carolyn B. Coulam, MD
Carolyn Coulam MD, specializes in helping those experiencing recurrent pregnancy loss and implantation failure. Dr. Coulam is a pioneer in the field of reproductive immunology. She is board certified in reproductive endocrinology and infertility.

Dr. Coulam is a long-time advisor to INCIID and has been answering patient questions since INCIID's inception. Dr. Coulam's professional member profile is located here. Visit the Reproductive Medicine Institute (Chicago).

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Old 11-09-2008, 09:48 AM
Choice4 Choice4 is offline
INCIID Junior Member
Join Date: Nov 2008
Posts: 79
Default IVIG therapy a thing of the past? See Safe and cheaper alternative

Hi i found this on the Sirm board written br Dr Sher

Is Ivig Therapy A Thing Of The past?

Geoffrey Sher, MD Yesterday, 06:48 PM
Post #1


It is no secret that SIRM has long advocated aggressive treatment of immunologic implantation dysfunction in women undergoing IVF. In cases where there has been Natural Killer Cell activation (Nka) (as evidenced by an abnormal K562 target cell test) we have championed the use of IVIG to down regulate (deactivate) the Nka. In this manner, many women who otherwise might not have achieved success with IVF have gone from infertility to family.

For us at SIRM , advocating the use of IVIG over the last decade, has come at a considerable price. Clearly, women requiring IVIG have been concerned about the cost (more than $4000 per dosage), reported side effects and, given the HIV/hepatitis scare, have been reluctant to receive a blood product. To make matters worse, under-informed critics have for unexplained reasons played on such unfounded fear often raising it to the level of alarm. The fact is that over the years we have administered IVIG to thousands of women, without a single report of viral transmission and few significant (but always transient) side effects.

In 2006/7 reports began to surface regarding a low cost (about ten times less than IVIG) synthetic product called Intralipid, which upon being infused more than a week prior to embryo transfer would lower Nka and further more, was virtually free of side effects.

In late 2007 we began evaluating the effect of Intralipid in patients who had activated Natural Killer cells, and for whom IVIG therapy would otherwise be indicated. Thus far we have treated numerous women with Nka using Intralipid 20%. More than 60% of the patients achieved viable ongoing pregnancies, showing Intralipid therapy to be at least as effective (and perhaps even more so) than IVIG. There were no significant side effects and patient tolerance of this treatment was and remains high.

Geoff Sher
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