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Thread: IVIg vs. Intralipid

  1. #1
    Join Date
    May 2011
    Posts
    3

    Default IVIg vs. Intralipid

    Hi Dr. Coulam,

    My husband and I are 100% DQ Alpha match. My daughter is now almost 6 and was conceived on my 5th IVF (first time to use IVIg and worked. I used 60g). We have been trying for #2 for 3 years now. I got pregnant once in 2009 with IVF and Intralipid but was ectopic. We have been going through several rounds of natural IVFs to bank embryos and now we have 5 blasts frozen, and we are ready to transfer.

    My question is IVIg vs Intralipid. I did NK Activity test recently and the levels were normal as I haven't been pregnant for a year and half: 50:1 was 7.0% and 25:1 was 4.5%. With IVIg 12.5 suppression, 50:1 went down to 3.2% (from 7.0%) and 25:1 went down to 3.0% (from 4.5%). However, with Intralipid, the levels didn't go down at all. With Intralipid 1.5mg/ml, 50:1 was 7.1% (vs. 7.0% without) and 25:1 was 4.6% (vs. 4.5%). I understand that IVIg and Intralipd may not suppress anything if the original level was normal, but would you think that in my case, I should use IVIg rather than Intralipid? IVIg is so expensive, so I don't want to use it if I don't need to, but given my age (almost 42), I can't afford to waste any potentially viable embryos. If IVIg can improve the odds, we are willing to pay for it. I would really appreciate your opinion.

    FYI, my CD 3 and CD 19 were normal but CD 56 was 23.7% (normal is 12% or below) and CD 19/CD 5 was 13.6% (normal is below 10%).

    Thank you so much.

  2. #2
    Join Date
    Sep 2008
    Posts
    677

    Default

    If your APA are normal and NKa suppression is equal with IVIg and intralipid, there is no evidence that IVIg would be more hlepful to you than intralipid. Dr. Coulam

  3. #3
    Join Date
    May 2011
    Posts
    3

    Default

    But doesn't the test result suggest that NKa suppression isn't equal between ivig infra intralipid for me?

  4. #4
    Join Date
    Sep 2008
    Posts
    677

    Default

    Both suppressed to within normal range (under 10%). Dr. Coulam

  5. #5
    Join Date
    May 2011
    Posts
    3

    Default

    I just want to make sure I understand - The facts that the level went to a half with IVIg while with Intralipid the level slightly went up don't mean much because the original level was already below 10%?

    Thank you so much for all your help. I really appreciate it.

  6. #6
    Join Date
    Sep 2008
    Posts
    677

    Default

    Any level below 10% is within normal range. Both medications suppress your NK killing to within normal range. Dr. Coulam

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