How are you doing? I am sorry I did not get back to you earlier.
I did intralipids and neupogen. We just met with the RI last week (Dr. Braverman in NY) and he is now recommending Lovenox and taking Beta HCG 2x per week (kind of like a continuing booster shot) during the 2ww and maybe continue it... This change is based on the results of immune testing after the cycle. My NK activity went from 24 to 9 using the neupogen/intralipids. Dr. Braverman thinks that seeing how low the NK cells went that this is not my big issue thus his other recommendations (I also have 7 HLA matches with DH and 1 Dq Alpha match.)
I think I told you that I am also in the middle of the ERA (Endometrial Receptivity Analysis). This is a test from Spain if you Google it. My RE wants to rule out any endometrial issue.
Please let me know if I can help in any other way. This is so hard, isn't it?
Take care of yourself.
I'm doing okay - pretty amazing how we learn to compartmentalize to deal with everyday life.
I'm glad you have a plan for the next go around. I think the lovenox, especially, seems like a great addition. Have they considered adding oral steroids too? Do you know what level of NK cells they are looking for?
I meet with my RE again on Friday. I've been doing a lot of reading. I made a list of all I wanted tested. Some I have already been tested for but I'm going to have them retested just in case they have changed.
Here's what I came up with:
Anatomical issues: repeat hysteroscopy, high resolution ultrasound with doppler to check uterine blood flow, perhaps repeat the HSG (first HSG was clear and the one I had several months after the loss showed a blocked (spasmed) tube - I'm thinking maybe it could be inflamed or something)
Autoimmune/clotting issues: ANA (& all related autoantibodies - anti-Sm, etc), NK cells, Th1/Th2 ratios, protein c deficiency, protein s deficiency, antithrombin III deficiency, homocysteine levels, antiphospholipid antibodies, lupus anticoagulant (I have had factor leiden, prothrombin, and MTHFR genes tested before)
Infection issues: ureaplasma/mycoplasma, Group B strep, chlamydia, bacterial vaginosis
Endocrine issues: TSH, T3, T4, anti-thyroid antibodies
Biochemical issues: beta 3 integrin (E-tegrity test), Endometrial Receptivity test.
Do you have any other suggestions to this list?
thank you so much for thinking of me!