IVIG or intralipids

jennydreams

0 Posts
Reply IVIG or intralipids Posted on: Dec 17, 2011 at 9:34am
I have had immune testing at a clinic here in the UK, although I know it may not be quite as comprehensive as yours. They tested in the lab with intralipids and ivig, and after reading posts on here I realise that this does not reflect what may happen in the body. I was told I needed ivig (as the numbers went up, not down when intralipids were used in the lab) but now I am beginning to wonder if I could have intralipids instead as we really can't afford ivig. I would really appreciate your opinion on this, here are some of my results:
50:1 17.9
25:1 15.5
12.5:1 9.4
cd3 94.1
cd19 1.0
cd56 3.2
cd19+cd5+ 1.0
(In the lab with intralipids 50:1 was 25.2 and with ivig it was 8.5)
TNF-a:IL-10(cd3+cd4+) 12.6
IFN-g:IL-10(cd3+cd4+) 6.1

Some of the results seem too low and some seem too high. Do you think intralipids would help?
Thank you so much.

Dr. Braverman

2004 Posts
Re: IVIG or intralipids Posted on: Dec 18, 2011 at 5:00am
ok 2 things here

1. The intralipids "lab" test is worthless ignore it.
2. You dont need IVIG with only a mild elevation in NKa

stay with intralipids its fine here , the only test that matters is how is your NKa one week after the intralipids, not how it responds in the lab. The only lab that counts is the one in your blood stream where the thousands of interactions the NK cells have dictate how they will respond.

You really should have more of a workup done as this one is so superficial it really does not dicate your management, but at the same time ILs will not hurt.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

jennydreams

0 Posts
Reply Re: IVIG or intralipids Posted on: Dec 18, 2011 at 9:01am
Thank you so much. I will try the intralipids.
I would really like to have more testing but we are fast running out of money if I am honest...we have NHS treatment here in the UK, and after this (If i need it) I have the funds for one of our own funded cycles but then we will have to stop.
My NHS doctor does not know that I have had this minimal immune testing done. He offered me Humira free on the nhs as he knows that we are willing to try anything. My TNF results are low/normal...would humira cause more harm than good in this case? I know that these are poor questions without the proper testing and I am sad that money is dictating our treatment path but I am also pleased I have a few options other than continuing to have failed ivf's with our otherwise unexplained infertility.
Thank you again
Jenny x

Dr. Braverman

2004 Posts
Re: IVIG or intralipids Posted on: Dec 19, 2011 at 3:30am
Jenny you are being offered treatment for a diagnosis that has not even been made. Yes Humira in your circumstance will do more harm than good. This is too important to simply try random treatments without some idea of what the problem is. your immune panel does not show enough to even warrant treatment. It might be worthwhile to have an initial consult with me and let me see if I can sort through whats going on and at least give you some reasonable advice on how to proceed.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

jennydreams

0 Posts
Reply Re: IVIG or intralipids Posted on: Dec 19, 2011 at 8:05am
Thank you for your help and advice. I will be turning down the humira as iIwas not happy with it being offered by a doctor who did not know what tests I have had. I think the reason it was offered is because I have never had any implantation, despite excellent quality embryos and 6 years of unexplained infertility. I have also had 2xlaparoscopy at 3 yr intervals, just to check, 2xhysteroscopy to be sure there are no abnormalities and an endometrial biopsy. No one can find anything wrong. I have also had all the "level 1" tests, including thyroid antibodies and a full thrombophilia screen (and others) As you say, intralipids cannot hurt so I will try them for our next frozen cycle. If we are not successful I will look to our next move and will contact you for help.
Thanks again

Dr. Braverman

2004 Posts
Re: IVIG or intralipids Posted on: Dec 20, 2011 at 1:28am
good luck.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Hopingparents

3 Posts
Re: IVIG or intralipids Posted on: Jun 18, 2012 at 1:25am
Hi Dr Braverman

I've been diagnosed with above average number of uterine NK cells based on a uterine biopsy. I've sought opinions on how best to treat this. My fertility specialist uses Intralipid, but a Reproductive Immunologist I consulted uses IVIG. The latter told me it's better to use IVIG as it's stronger.

Would you agree with this?

I'm due to start IVF treatment in about a week and would love to get your opinion.

Thanks

Hopingparents

Dr. Braverman

2004 Posts
Re: IVIG or intralipids Posted on: Jun 18, 2012 at 10:07am
I wouldnt make any recommendation based on only a uterine bx if the blood did not suggest a strong issue, so Im not convinced you need IVIG. IL would be better based on all the facts you have sent me.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Hopingparents

3 Posts
Re: IVIG or intralipids Posted on: Jun 18, 2012 at 4:54pm
Dr Braverman
here are my BT results. Note they were done in Australia, so parameters may be different but I've included indicated nomal range.

normal range
White Cell Count 6.2 4.0-11.0
lymphocytes 1.9 1.0-4.0
CD3 Mature T Cell 85.9%
CD3 Mature T Cell 1.63 0.74-2.70
CD4 Helper T Cell 37.58%
CD4 Helper T Cell 0.71 0.38-1.8
CD8 Suppressor T Cell 44.48%
CD8 Suppressor T Cell 0.85 0.13-0.99
CD19 B Cell 9.82%
CD19 B Cell 0.19 0.05-0.64
CD56 NK Cells 5.56%
CD56 NK Cells 0.11 0.05-0.64
CD4/CD8 Ratio 0.84 1.0-3.8

The only other BT which is worth noting is a heterozygous MTHFR C677T mutation.

I've been prescribed dexamethasone, either intralipid or IVIG and 5mg folate, Ca and Vit D.

My dilemma is whether I should do IVIG or if intralipid. Is IVIG stronger?

Thanks

Dr. Braverman

2004 Posts
Re: IVIG or intralipids Posted on: Jun 18, 2012 at 7:14pm
Im sorry but there is not enough information there to give you an opinion on what is best for your case. yes IVIG is stronger then Intralipids.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.
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