Anti nuclear antibodies... Should this be treated?

Jacqui

7 Posts
Reply Posted on: Nov 13, 2013 at 10:46pm
Hi Dr Braverman
All the way from Australia. I need your advice and if you think it's worthwhile I'd love to hear a potential treatment plan if I can organise an appointment with you from Australia?
Myself and my husband have had an extremely tough 2 years. It started with a chemical pregnancy followed by a missed miscarriage of twins at 6.5 weeks after a third iui. The d and c from twins revealed atleast one had a normal female karotype. The other cells in the d and c were mine. I then found out I have balanced translocation and low amh at just 30 years old. Hubby has no problems.
We have endured 5 ivf with PGD cycles this year to finally get our first CGH chromosomally normal embryo blastocyst, it is frozen for embryo transfer in a few months time.
I'm certain I have some auto immune condition going on! I am MTHFR heterozygous and I have positive speckled Ana of 1:320. I am going to have NK cell uterine biopsy before transfer. I also have raynauds. My mum has auto immune disease (raynauds polymiocitis scleroderma).
I dnt have apa or at a antibodies.
I have requested to go on low dose aspirin clexane and prednisone for first 12 weeks with this embryo transfer but my fertility doctor does not think having anti nuclear antibodies woukd prevent implantation or cause miscarriage.
Do you think I require this treatment.
This one embryo might be the only chance I have to have a baby.
What are risks being on blood thinners and steroids in first trimester?
The fact that my twin pregnancy was not chromosomally abnormal makes me believe I have had immune related miscarriage.
What dose of prednisone do you think is an effective dose for immune treatment in first trimester?
Best wishes
Jacqui
Jacqui

Dr. Braverman

1998 Posts
RE: Anti nuclear antibodies... Should this be treated? Posted on: Nov 14, 2013 at 6:13am
you certainly need treatment and I would not place this embryo back without a complete workup . At a minimum you will need clexane and prednisone(and or IVIG) . Please fill out a consult request on our website and we can organize a consult and get all the testing you will need in Australia(but shipped to us here)
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.