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Neupogen - only a single injection?

autoimmune reproductive immunology neupogen

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#1 Coastal

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Posted 04 January 2013 - 12:18 AM

I am looking for some feedback from those of you experienced with or knowledgeable about neupogen for use with immunological protocols. My RE says that his clinic policy is to do only a single injection a couple of days prior to embryo transfer. Most of the reading I have done on the topic seems to suggest that neupogen is usually used in regular injections over several weeks. Has anyone had experience with a single injection? Do you think there is value to a single injection?

Thanks in advance!

Me - 32

DH - 31

I have endo and multiple autoimmune issues. 

TTC since April 2010

IUI with letrazole in August of 2012 - BFN

IUI with letrazole and stims in October of 2012 - BFN

IVF 2013

started BCP on Jan 13

started superfact on Jan 21

stim day 1 on Feb 2 with 150 IU of Puregon and 75 IU of Repronex - got big welts from Repronex!

after 3 days, Repronex was switched for Luveris and Puregon increased to 225 IU accordingly

Day 5 u/s showed slow response with 8 follies total and the largest at only 6mm

Day 8 u/s showed lots more follies with varied size. E2 climbing rapidly, told to quit superfact

Day 11 u/s - largest follies at 17mm - E2 levels too high. Off all stims.

ER on Feb 16 - 12 eggs collected, 9 fertilized (6 by ICSI and 3 by IVF). Dose of intralipids.

Begin heparin, baby aspirin, estrace, and prometrium

3 day Transfer on Feb 19 of all three remaining embryos - each of average quality (2 from the IVF and 1 from ICSI)

 

 


#2 Laura1976

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Posted 04 January 2013 - 04:29 AM

Coastal, I too had read that most women in the US were on Neupogen for extended periods. I was looking to have that treatment protocol when I approached Dr. H about Nuepogen. After he finally said, after extensive research on his behalf that he would use it I didn't care how. I too am ANA and APA positive, along with other immune/blood issues... I had not gotten PG in 3.5 years of trying and the Neupogen protocol worked for me 150%. I look forward to hearing about your cycle.
  • gibasgirl and mountainchick like this
ME 35 SO 32 TTC #1 since September 2008

See 'About me Page' for more cycle history

November 29/11 - Unexplained IF/Recurrent loss testing

Compliment C3 & C4 below acceptable range
LA Ratio DRVVT above acceptable range
Lupus Inhibitor demonstrated
Antiphospholipid IgG above acceptable range
Antiphospholipid IgM above acceptable range (more than double)


Consultation @ VFC December 10/11

IVF/ICSI #2 (with Intralipid therapy) January/February (Victoria Fertility Clinic)
BCP December 16 -29/11 & January 6 - 28/12
Vitamin D (2000iu daily) and Iron Supplement (Ferrous Gluconate 300mg daily) - Start December 24 until Dr advises otherwise, PregVit 5 (Starting January 12/11), Vitamin E (800iu daily) until Heparin begins (Starting January 14/11) Fish Oil (1200iu daily)
Superfact (0.5mg) - Start January 22/12
Dexamethasone (0.5mg) - Start February 4/12 until beta

After ER - Doxycycline (100mg), Estrance (2mg), Prometrium (200mg 3x day), heparin 5000 units (2x day), calcium (1500mg daily), low dose aspirin (81mg daily)
Intralipids - February 13/12 and day of ET
Neupogen Uterine Flush - Day of ER

February 2/12 - E2 35p/mol
February 4/12 - 300iu Gonal-F & 75iu Repronex
February 9/12 - U/S & E2 - RIGHT- 11, 9, 10, 19, 8, 12, 11, 10, 13, 6 LEFT: 12, 7, 10, 10, 8, 6, 5, 5 E2 2635

February 9/12 Gonal-F lowered to 225iu Repronex remains at 75iu
February 11/12 - U/S & E2 - Right 14, 10, 11, 12, 10, 13, 12, 12, 14, 7 LEFT: 11, 8, 10, 13, 9, 8, 8 E2 5610
February 13/12 - U/S an E2??? & Intralipid Therapy
February 16/12 - E/R 20 eggs, 17 mature and ICSI'ed, 3 left to fertilize by regular IVF
February 17/12 - Fert Report 16 fertilized by ICSI, 1 fertilized by IVF
February 20/12 - Neupogen injection
February 21/12 - Transferred 2 Blastocysts ( 1 x Grade 19 Early Blast, 1 x Grade 19 Expanded Blast) and Intralipid Therapy and Acupuncture

“Here's all you have to know about men and women: women are crazy, men are stupid. And the main reason women are crazy is that men are stupid.” - George Carlin

#3 nervus optimist

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Posted 04 January 2013 - 09:19 AM

I was on it from around the time of transfer (I don't remember exactly when) daily injections until 10 weeks. I was on a really low dose so perhaps it's a larger dose as one shot and smaller dose over time... not sure.
best of luck on your cycle
:flowers:

I am 38, DH - 39
Genetic - IVF&PGD to prevent Genetic Disorder
IVF #1 - Nov/08 - MC @ 6 weeks, no embryos frozen
IVF #2 - Aug/09 - bfn
IUI #1 - Feb/10 - ectopic
PRIDE - Apr/10
Homestudy - July/10
Given the gift of donor embryos - Jan/12
Donor FET Jun/12 - 9 weeks - no heartbeat... MC
Donor FET Oct/12 - we're PG biggrin.png

===> Beautiful baby boy born 2013 babyboy.gif

Donor FET Oct/16 - chemical

April 2017 - surprise PG

===> Beautiful baby girl born 2017 babygirl.gif


#4 Cassandra_Angela

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Posted 04 January 2013 - 10:38 AM

For those of you that have used neupogen what was your dose?

It isn't something that my RE normally uses so I said I would gather some info before our next meeting

Please see "about me" section for details

Pictures tell a thousand words: https://www.instagra...dra_angela1981/


#5 nervus optimist

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Posted 04 January 2013 - 02:41 PM

just checked to be sure - I was on 60 micrograms daily.
we were told that there have been a few studies showing it has increased success for women with repeat PG loss.
was a nice bonus that my drug plan from work covered this one!
all the best on your next cycle
:flowers:
  • gibasgirl likes this

I am 38, DH - 39
Genetic - IVF&PGD to prevent Genetic Disorder
IVF #1 - Nov/08 - MC @ 6 weeks, no embryos frozen
IVF #2 - Aug/09 - bfn
IUI #1 - Feb/10 - ectopic
PRIDE - Apr/10
Homestudy - July/10
Given the gift of donor embryos - Jan/12
Donor FET Jun/12 - 9 weeks - no heartbeat... MC
Donor FET Oct/12 - we're PG biggrin.png

===> Beautiful baby boy born 2013 babyboy.gif

Donor FET Oct/16 - chemical

April 2017 - surprise PG

===> Beautiful baby girl born 2017 babygirl.gif


#6 Coastal

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  • Location:Vancouver Island
  • Interests:Cycling, running, cooking, films and my two crazy dogs.
  • Dx:Endometriosis
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Posted 13 January 2013 - 01:24 PM

Thanks for the feedback everyone! 

 

Laura, you did a single injection and a neupogen wash as well, right? Do you mind me asking if the wash was for a lining issue? Dr. H. mentioned that he normally does a wash only for thin linings and that success has been limited with that. But, I also read about all these ladies in the US getting a uterine wash for autoimmune issues too. This is where my propensity to google is probably just causing me more stress! :) Your success has certainly been a huge encouragement to me. I hope to also have some good news to share in the coming weeks. 

 

Nervus, thanks for sharing your experience. Your protocol sounds similar to what I have been hearing from women seeing RIs in the States. I'm not sure if Dr. H would consider doing a longer protocol with the drug if I had a history of losses. I have not been able to get pregnant, so the cause of my issues is not yet certain. 


  • gibasgirl likes this

Me - 32

DH - 31

I have endo and multiple autoimmune issues. 

TTC since April 2010

IUI with letrazole in August of 2012 - BFN

IUI with letrazole and stims in October of 2012 - BFN

IVF 2013

started BCP on Jan 13

started superfact on Jan 21

stim day 1 on Feb 2 with 150 IU of Puregon and 75 IU of Repronex - got big welts from Repronex!

after 3 days, Repronex was switched for Luveris and Puregon increased to 225 IU accordingly

Day 5 u/s showed slow response with 8 follies total and the largest at only 6mm

Day 8 u/s showed lots more follies with varied size. E2 climbing rapidly, told to quit superfact

Day 11 u/s - largest follies at 17mm - E2 levels too high. Off all stims.

ER on Feb 16 - 12 eggs collected, 9 fertilized (6 by ICSI and 3 by IVF). Dose of intralipids.

Begin heparin, baby aspirin, estrace, and prometrium

3 day Transfer on Feb 19 of all three remaining embryos - each of average quality (2 from the IVF and 1 from ICSI)

 

 


#7 Lrghtp

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Posted 12 February 2013 - 07:51 PM

I have an ANA titer of greater than 1:320, a bunch of other antibodies (anti-thyroid, anti-ssDNA, etc. can't remember them all).  I also had thin lining but just once.

 

I had a single intrauterine infusion of Neupogen and then a BFP!!!  (I also had an endometrial biopsy in the cycle before).  I did not get shots at all.


  • gibasgirl likes this

Very long journey to this point... 4 years of *all* bad news, *all* the time.

2012 - gave up all hope of a baby

Decided to give one lost try with Dr. L. at Create - best recommendation we've ever received

Dr. L. works his magic...Jan 28/13 - 2 day 5 embryos transferred

Feb 8th; BFP on HPT, Day 17: 1st HCG 562, 6w1d u/s: WE HAVE A HEARTBEAT!! 97!

October 15th 2013 - Our perfect little baby arrives!! We are over the moon!

.

.

FET #1 - Single 5 day embryo transfer on June 17th/14

Protocol same as before: dexa, GCSF for lining, baby ASA, doxycycline, intralipids

June 23rd: BFP on HPT

Cramping and bright red blood on June 24th :o HANG ON LITTLE BEAN!

June 25th: HCG 90, June 27th: HCG 248 July 1st: HCG 1713

July 13th: we have a heartbeat - 118!

Almost 10 weeks of bleeding starting at 12 weeks (to about 21 weeks) - incl 2 large hemorrhages. 10 weeks of worry, thinking every day I've lost the bean. At one point subchorionic is 14cm!! Little fighter hangs on though...

Big scare at 16 weeks; u/s mentions possibility of amniotic bands. Detailed early anatomic scan says no amniotic bands. When u/s is NOT your best friend...

EDD: March 4, 2015


#8 Trippleb

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Posted 21 March 2013 - 12:21 PM

For those of you who have done the neupogen wash, what cycle day did you do it on? My RE wants to do it on the day of retrieval with a 3DT. I'm concerned it's to close together. Anyone else do the neupogen that close to transfer?

Me=43, Endo, AMA,DOR
DH=40, Low everything, Currently on Clomid to boost T levels - seems to be working
Lap 10/09 Removed endometrioma, stage IV endo and adhesions 
Lap 2/10 Endometrioma cysts & adhesions returned. 
Ivf #1 4/10 Antagonist, ET Cancelled. 
IVF #2 2/11 A/ACP+E2V C/P
IVF #3 6/11 Letrozole/Antagonist BFN
IVF #4 11/11 Low stim Antagonist BFN
Lap 3/12 Lap & Selective HSG
Many cycles of Letrozole and LP HCG w/TI and LDN
IVF #5 8/12 Low stim BFN
IUI #1 10/12 BFN
IVF #6 3/13 EPP+HGH, Low stim.  G-CSF wash


#9 KennyandFooty

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Posted 21 March 2013 - 08:10 PM


For those of you who have done the neupogen wash, what cycle day did you do it on? My RE wants to do it on the day of retrieval with a 3DT. I'm concerned it's to close together. Anyone else do the neupogen that close to transfer?


Everything I've read about the neupogen flush (only) is that it is administered between 3 and 5 days before transfer. I think ER is typically when it occurs, or for those doing a frozen transfer, according to the "age" of the embryos (5d blasts = wash 5 days before FET)
  • gibasgirl likes this

Me: 33 DH: 31
TTC 4+ years
Asthmatic - Bricanyl & Symbicort daily
Hydrosalpinges --> Bilateral Tubal removal


IVF#1 - September 2011 - Short protocol - Cancelled/Ectopic pregnancy; Tubal removal (October)
IVF#2 - March/April 2012 - Modified Microdose Flare Protocol - BFN - 3 frozen blasts
FET#1 - July 2012 - Cancelled; zero survive thaw
IVF#3 - October/November 2012 - Modified Microdose Flare Protocol - BFN - 3 frozen blasts
Hysteroscopy and Biopsy February 2013 - All results normal

FET#2 - BFP - March/April 2013 - EDD December 25, 2013

2 frosties waiting

January 1 - Our beautiful baby boy arrived after an emergency induction.  Completely in love! <3






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