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Discussion Starter · #1 ·
Hi,

has any been put on prednisone and clexane while doing ivf, who have also got stage four endometrosis. Would love to hear from you.

FGC



 

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Hi there,

i have stage 4 endo and have put myself on pred and clexane (with the help of a doc unrelated to the hospital where i had ivf, as that hospital didn't believe in immune issues, my the one i am at now does). i am on my 3rd ivf cycle at the moment and am on clex, pred and intralipids and baby aspirin. do you know why you have been put on these drugs?

ask any more questions you want  ^hugme^

Sam x
 

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Discussion Starter · #3 ·
Hi Sammi11,

I haven't been put on these drugs, I was reading old blogs of woman who have put on these drugs and just want more info as to what they do for you. Have you ever been told that your fallopian tubes are swollen(hydrosalpinx)? For the first time I have been and apparently its toxic to implantation. Good luck with your cycle, sending you lots of happy thoughts!!!

FGC
 

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Hi FGC

Normally Clexane and Pred are prescribed by clinic after undergoing immune testing

I am going to move your post to the Immunology board where the ladies there will probably be able to advise more on the issue

Regarding the hydrosalpinx, have you seen anyone regarding having them clipped or removed to aid implantation

Em
 

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hi fgc:  you might want to read the sections on corticosteroids, clexane, natural killer cells and treating empirically in the faq.

as holly says, if you have hydrosalpinges, it normally means you'd have a much better chance at ivf if your tubes are clipped/removed (by laproscopy) first.
 

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Discussion Starter · #6 ·
Thanks ladies,

Problem is I have had 2 laps before neither successful because the ovaries and tubes are stuck all over the bowel? Where did you get your immune blood work done? Was it arcg?

Thanks FGC
 

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most ladies go to care, argc or Dr G for immune bloods.  have a look in the FAQ under section A for appointments.
 

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Hi

Yes i have hydrosalpinxes. well i only have one tube now, and this tube comes and goes with hydrosalpinx. i had my 4th lap in nov and the surgeon said at that time it was clear, but not in great shape, but he didn't clip or remove it.
I have had 2 previous IBFs which didn't work.
I had testing for immunes at CARE nottingham and with Dr Gorgy in london, and the level 1 tests i managed to get free via my GP.

With severe endo and adhesions often come hydosalpinxes, and endo can often come with other immune issues too. endo is an autoimmune disease, so if you have endo you are likely to have more autoimmune illnesses, or test positive for immune anti bodies for various things. You may be lucky and not have any, but the level 1 and 2 tests and to test to see if you do. Some women with severe endo have thyroid problems too, or rheumatoid arthritis etc. I have a clotting problem too that was only discovered via these tests and is important to know because of the increased risk of mniscarriage and DVT/stroke - with medication it can be ok.  Its a huge topic with alot to read up on. the best place to start is Agate's FAQ's at the top if the immunes section of FF - you will find alot of info there.

please feel free to pm me if you want to ask anymore questions and endo etc

Sammi
 

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Discussion Starter · #9 ·
Hi Sammi11,

Thanks for you help, much appreciated. Couple of questions, is this the first time that you have used these immune druggs with IVF? Did you use them previously? I have made an appointment for Dr Gorgy for monday week. I have 5 very good embryos in spain and want give them the best chance possible.  Lots of luck and positive thoughts.

FGC
 

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Hi FGC,

This is the first time i have had intralipids, but both previous IVFs i used steroids, and the last ivf i also added clexane into the mix. I had only had level 2 tests done when i had the 2 ivfs and the 1 x fet, but since then i have had level 1 tests aswell (rather silly that i got them done in that order, since i have issues discovered with level 1 and level 2 tests). Gorgy will probly have you on pred, clex and intralipids. depending on what your results show up, some ladies use humira, and LIT too. BUt he'll let you know when he has your results.

BY the way, i have read that women with endo and immune issues sometimes do far better with FET than with fresh -  :)  thats a nice thought for you. On our FET cycle i got my only ever 'lightly' positive pee stick.

Sammi
 

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Hi FGC, I have stage 4 endo and was on prednisolone, clexane, aspirin and intralipids for my last cycle. The cycle didn't work but I think that was because of the quality of my eggs. I'm moving to donor embryo and intend to go with the same immune protocol. I have raised anti thyroid antibodies.

Sammi can I ask you about the success of frozen over fresh in women with endo and immune issues? I'd read about that somewhere before and at the moment I'm trying to decide between them, as to which would give me the better chance? Would be great to hear what you know about it...

Good luck in your cycles girls...
Lillyan
 

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Hi Lilyan,

I think it could have been in the Beer book, 'Is your body baby friendly?', but i will have a long think today and see if i can recall where exactly. Why don't you post on the endo board and see if anyone there knows why FET is sometimes more sucessful.
I think its to do with the immune 'flare' happeneing less with a FET than a fresh...but thats all the details i can dredge from my poor wee sunday morning brain at the moment!

Please feel free to PM me. ^hugme^
 

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I can't remember reading that... but its probably been suggested somewhere... all I can think of is that with a fresh cycle, its more likely you will have very high estrogen levels. estrogen stimulates endometrial lesions to be more active and endometrial lesions pump out inflammatory cytokines like TNFa... so I guess it sounds logical that the more controlled estrogen levels used in FET might result in lower TNFa, NKa etc in some ladies compared to fresh... although I'd guess it would vary a lot between individuals... for example, poor responder ladies wouldn't have so many graffian follicles developing so wouldn't have terribly high estrogen even on a fresh cycle... and then there is the difference between natural and medicated FET... I'd guess that some ladies might be taking a lot of estrogen on a medicated FET but others wouldn't?
 

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Thanks girls - very interesting. I have Beer's book here so will have a look through it.

The estrogen levels, particularly in medicated cycles, raises a related issue that I was going to post about - I've been having pain in my left side (around my ovary) for the last two weeks or so, which has got worse in the last few days since af arrived (I did OE-IVF in Jan with ET on 24 Jan, BFN on 4 Feb, AF arrived 9 Feb). My endo is quite widespread but the left ovary is worst affected - after my last lap in Oct they told me they would only give me 6 months to try to get pg and then they would have to remove it. There's a large endometrioma that keeps recurring there - it has infiltrated the ovary wall and they can't remove it with taking the ovary. I was concerned about the effects of all the IVF meds on the endo, but haven't had any problems till now. I was on puregon (600), 2 x 10ml suprefact, 75 luveris, 75mg aspirin, 25mg  prednisolone, 100mg clexane, intralipids and then crinone gel x 2pd & estrofem x3pd  after transfer. I'm trying to ignore the pain and hoping it'll ease off when af finishes but my gut instinct is the endometrioma is back, as a result of the meds (the estrofem maybe??), and that I probably need to do something about it i.e. have the ovary removed, before going ahead with another cycle. I would really appreciate your opinions on whether you think it's likely that the meds could have aggravated the endo, and whether I should do something about it now.....Thanks all
 

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Thanks girls - very interesting. I have Beer's book here so will have a look through it.
 
The estrogen levels, particularly in medicated cycles, raises a related  issue that I was going to post about - I've been having pain in my left  side (around my ovary) for the last two weeks or so, which has got  worse in the last few days since af arrived (I did OE-IVF in Jan with  ET on 24 Jan, BFN on 4 Feb, AF arrived 9 Feb). My endo is quite  widespread but the left ovary is worst affected - after my last lap in  Oct they told me they would only give me 6 months to try to get pg and  then they would have to remove it. There's a large endometrioma that  keeps recurring there - it has infiltrated the ovary wall and they can't remove it without taking the ovary. I was concerned about the  effects of all the IVF meds on the endo, but haven't had any problems  till now. I was on puregon (600), 2 x 10ml suprefact, 75 luveris, 75mg  aspirin, 25mg  prednisolone, 100mg clexane, intralipids and then crinone gel x 2pd  & estrofem x3pd  after transfer. I'm trying to ignore the pain and hoping it'll ease off  when af finishes but my gut instinct is the endometrioma is back, as a  result of the meds (the estrofem maybe??), and that I probably need to  do something about it i.e. have the ovary removed, before going ahead  with another cycle. I would really appreciate your opinions on whether  you think it's likely that the meds could have aggravated the endo, and  whether I should do something about it now.....Thanks all
 

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when you do any kind of stimulated cycle (ivf, iui etc), the way it works is that you pump in something to up your FSH - in your case puregon... that stimulates your antral follicles to turn into graffian follicles... and they basically pump out estrogen as they go (which makes your uterine lining grow)... so the more follicles you grow, the higher your estrogen levels get... and then you've had the estrofem on top... so I guess its possible that the endometrioma could have continued to enlarge as a result of high estrogen levels.  I guess you'd need a scan to see the appearance of the ovary and then get advice on whether it needs to be removed?
 

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Hi Lilyan,

re. the FET V fresh cycle question...it wasn't in the Beer book, my mistake. i have read it SOMEWHERE, and also Mr S - immunes doc in london/surrey told me aswell. I was doing a natural FEt at the time with steroids from under his guidence, and he definately said that he has had ALOT of successes on FETs that had previously been unsucessful with fresh IVFs, due to a less severe immune responce.

My FET, when i was under his guidence, was a faint positive on test day, and that was a natural cycle of FET with good estrogen levels. The estrogen in all the stim drugs used in a normal cycle really agrivate my endo, and grow me several new cysts aswell as the follies  :(

Best

Sammi x
 

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Thanks girls. I rang my clinic and they advised a scan.

On the fresh vs frozen - it makes sense re the immune response - I'll definitely be reading up on it some more......

Thanks for your responses

Lillyan
xx
 

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Discussion Starter · #20 ·
Hi Lillyan,

Sorry about your BNP. I have used a donor programme in Spain if you want any details. The clinic has high success rates and keep in  very close contact.

I have 5 frozen ones in spain, need to sort out the immune problems from the endometrosis first though, before I go back out.

Best of luck FGC

 
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