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autoimmune issues and IVF

arthritis autoimmune humira

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#1 hopefullyus

hopefullyus
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Posted 13 January 2013 - 07:36 PM

Hi there, 

As per my signature, our primary diagnosis is male factor but we get great fertilization rates.  I was recently diagnosed with early inflammatory arthritis (prob rheumatoid) and need to treat it to prevent long term issues.  I am wondering if there are uterine/immune issues that have led to implantation failure.  

 

Has anyone done IVF while on Humira or salfasalazine and how did it affect success, pregnancy, breastfeeding (as relevant)? Has anyone even done other immunotherapy along with either of these drugs?  

 

Thanks for any input.  


Me: 40

DH: 45

 

Diagnosis: Severe male factor, likely female factor (uterine/immune) and age at this point

 

The short story: 

4 fresh cycles plus one cancelled fresh cycle 

3 FETs plus one cancelled FET

Have a 2 year old son from FET in 2013 when immunotherapy added to protocol with VFC 

Trying for sibling since May 2015

Got pregnant on fresh cycle last year at 39 but ended in miscarriage

Just transferred two blasts Oct 24 from fresh cycle at 40 and was lucky to have two blasts to freeze- this cycle at 40 so far has been way better than my last fresh at 39:)

 

Detailed info re cycles on about me page. 

 

 

 

 


#2 Triscuit

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Posted 13 January 2013 - 08:14 PM

I have autoimmune arthritis and I took humira until a week or two before stimulation.  Implantation issues were never mentioned by my RE, but my rheumatologist said that minimizing inflammation would help my chances for pregnancy.  We conceived our son on our first IVF attempt.  I did not take humira during my pregnancy as I didn't want to expose my baby to any medications (I also had a very good remission from the arthritis if you're concerned about that).  I also chose not to take humira while breastfeeding but I was told that it would have been ok had I chosen to do so.



#3 leigh14

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Posted 13 January 2013 - 08:24 PM

Hi,

 

I don't have any diagnosed arthritis but I did take Humira as part of an immune protocol based on immunological testing I had through my clinic (Markham) and The Alan Beer Centre in California.  My testing revealed that I had high levels of NK cells as well as a high cytokine ratio, indicating some inflammation.  We did this testing because I'd previously had a m/c and my doctor gave us the option of doing immunological testing before doing our cycle.  He felt that controlling the inflammation would help with implantation.  My protocol included taking two shots of Humira 90 days before cycling.  I also had IVIG as part of my cycle. 

 

Although I only had two eggs retrieved, we were successful on our cycle and got our BFP!

 

I am not sure of the safety of taking Humira during your cycle but I do know that it can definitely help to reduce inflammation leading up to the cycle which, in turn, can help your chances.

 

Best of luck.

 

Leigh


Me: 40
Dx: DH: Vasectomy; need IVF/ICSI ME: D.O.R. and many immunological issues. (Initially presented as "normal" but issues were only discovered after IVF attempt #2 and #3 after testing at new clinic)
IVF attempt #1 Nov.2009, Age 37: Long "Lupron" protocol
Dec.2009: Cycle cancelled due to oversuppression
IVF attempt #2, Age 38: April 2010: 3 eggs retrieved, 2 mature, 2 fertilized, ET of 2 embryos BFN
IVF atempt #3 at new clinic: November 2010, Age 38: 5 eggs retrieved, 4 mature, 4 fertilized, ET of 2 blastocysts BFP
Strong beta numbers but babies not measuring on track but one heartbeat is present. Followup u/s reveals no HB's :( Had D&C--so sad.
Moved to new clinic closer to home + more of a focus on testing for potential immunological factors:
Further testing reveals three mutations related to inherited thrombophilia (2 MTHFR mutations and PA1-1 mutation), positive ANA, elevated NK cells and cytokines and low levels of leukocyte antibodies (LADS), Recommended Immunological treatment: Humira, LIT, IVig and blood thinners if PG
IVF Protocol: Low stim for me/ TESE needed for DH; took Humira in late August and early September; taking DHEA plus Co-Enzyme Q10, vitamins for DH just for good measure! September--two trips to Mexico for LIT treatment, treatments 3 weeks apart
Initial re-testing through Alan Beer Centre after some of the immune treatments reveals only cytokines were lowered, NKs still high and LAD numbers still low. Another LIT in Mexico is recommended. We decide to begin cycle on doctor's recommendation of just doing IVIG.
IVF#4, Age 39 : November 2011: Worst AFC EVER--a whopping 4! Three follicles responded, two eggs were retrieved. Three day transfer of two Grade 1 8 cell embryos: "Fahita" & "Burrito" Stick, stick, stick little ones!
BFP! Beta of 569
Viability u/s at 6 w 2d shows TWO babies measuring on track with heartbeats of 121. Looks like babies might be sharing the same amniotic sac.
Second u/s at 7w 2 d shows ONE baby with hb of 150, measuring 7 w 3 days. No sign of twin. Vanishing twin syndrome?
Third u/s at 8 w 2d shows ONE baby with hb of 170, measuring 8 w 3 days. Looks like a little jellybean!
12 week u/s at 12 w 2 days and baby is measuring 12 w 5 days with a heart beat of 150. Baby mooned us and waved at us with one hand....looked like a "royal" wave to me!
13 week doctor's appointment, HB=155 on doppler
14 week u/s to check cervix, HB=148
16 week u/s to check cervix, HB=138, baby had hiccups!
20 week u/s--everything looks good! HB=130, looks like we're having a GIRL!
IPS results very good!
39 weeks: Our baby girl arrived!!! She is healthy and beautiful! We are so happy! :)

Lilypie Maternity tickers

#4 hopefullyus

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Posted 13 January 2013 - 08:31 PM

Thanks Triscuit.  That is great and hopeful info.  As the inflammatory arthritis was just diagnosed, I think that the Rheumatologist wants to ensure that I am on meds in order to ensure aggressive treatment during early window of disease.  She did mention I could come off during pregnancy if I wanted and was remitted but warned re high risk of postnatal flare.  Humira is a favourable option for me if I can get it covered given its effectiveness (vs sulfasalazine) and because it has been used to the help with implantation with repeat failed IVFs!  I made a quick decision to take methotrexate and put things off for awhile (or try surrogacy), but am now thinking of switching to Humira and then trying 4ish months down the road once MTX out of my system.  Congratulations on your successful IVF and perfect baby boy.  Best of luck with your second attempt. I hope that it happens first time for you guys again.  


Me: 40

DH: 45

 

Diagnosis: Severe male factor, likely female factor (uterine/immune) and age at this point

 

The short story: 

4 fresh cycles plus one cancelled fresh cycle 

3 FETs plus one cancelled FET

Have a 2 year old son from FET in 2013 when immunotherapy added to protocol with VFC 

Trying for sibling since May 2015

Got pregnant on fresh cycle last year at 39 but ended in miscarriage

Just transferred two blasts Oct 24 from fresh cycle at 40 and was lucky to have two blasts to freeze- this cycle at 40 so far has been way better than my last fresh at 39:)

 

Detailed info re cycles on about me page. 

 

 

 

 


#5 hopefullyus

hopefullyus
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Posted 13 January 2013 - 08:41 PM

Leigh, 

 

Congratulations to you too!!!  It took me awhile to get through your signature and wow - you really went through a lot to get your baby girl.  I'm sorry you had to go through so many IVFs before finding out the problem.  You must have been an amazing advocate for you and your husband getting all of this immune treatment in Canada.  How amazing!  Thank you so much for the information.  My research shows that Humira is a Category B drug re pregnancy and so its a tough call, but sounds like it sure might help with implantation:):):):)


  • leigh14 and Trina like this

Me: 40

DH: 45

 

Diagnosis: Severe male factor, likely female factor (uterine/immune) and age at this point

 

The short story: 

4 fresh cycles plus one cancelled fresh cycle 

3 FETs plus one cancelled FET

Have a 2 year old son from FET in 2013 when immunotherapy added to protocol with VFC 

Trying for sibling since May 2015

Got pregnant on fresh cycle last year at 39 but ended in miscarriage

Just transferred two blasts Oct 24 from fresh cycle at 40 and was lucky to have two blasts to freeze- this cycle at 40 so far has been way better than my last fresh at 39:)

 

Detailed info re cycles on about me page. 

 

 

 

 


#6 Triscuit

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Posted 15 January 2013 - 12:10 PM

hopefullyus - Thanks for the well wishes. 

Just a pointer on the MTX - go off it as soon as possible.   My rheumatologist recommended more like 6-8 months since its not fully out of your system 3-4 months, the levels are just low.  And btw, humira is awesome.  The injections hurt, but there's no side effects and it works quickly.  The progress program helps with payments if your insurance isn't sufficient.  And regarding post-natal flare: it happened for me when my son was 5 weeks old but it was no worse than the pain I was in before meds.  My dr. and I decided to have no meds in my system during pregnancy and breast feeding and then just treat a flare if I needed to (which I didn't, just used tylenol).  Good luck!!!



#7 hopefullyus

hopefullyus
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Posted 18 January 2013 - 01:39 AM

Thanks Triscuit.  I'd love to get on Humira but its tricky to get it covered.  I'm going off MTX and starting sulfasalazine but hope to add or replace with Humira.  I'll check out the progress program.  


Me: 40

DH: 45

 

Diagnosis: Severe male factor, likely female factor (uterine/immune) and age at this point

 

The short story: 

4 fresh cycles plus one cancelled fresh cycle 

3 FETs plus one cancelled FET

Have a 2 year old son from FET in 2013 when immunotherapy added to protocol with VFC 

Trying for sibling since May 2015

Got pregnant on fresh cycle last year at 39 but ended in miscarriage

Just transferred two blasts Oct 24 from fresh cycle at 40 and was lucky to have two blasts to freeze- this cycle at 40 so far has been way better than my last fresh at 39:)

 

Detailed info re cycles on about me page. 

 

 

 

 






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