Simponi and timing of FET

Hadleigh

35 Posts
Reply Simponi and timing of FET Posted on: Jul 25, 2011 at 12:56am
Dr. Braverman,
I was wondering if you have your patients wait a certain amount of time before doing a FET after taking an injection of Simponi? Simponi/IVIG worked to bring my Cytokine levels down from the mid 40's to 26. I was successful in the past when we used Humira/IVIG, but in preparations to try again, the Humira/IVIG didn't work this time. In fact, my levels continued to rise even on the Humira (3 months). I have been cleared to cycle and plan to do our transfer in about 2 weeks. I took my 3rd Simponi injection a day prior to getting my results and getting the green light to cycle (I will have another IVIG on CD6 and 2 days prior to transfer). In your opinion would I have to wait out another cycle before doing the transfer since I took Simponi 1 day prior to CD1? I'm not sure, but I think that I remember you saying that sometimes you continue Simponi even after a positive pregnancy test with some hard cases. So I guess my question really is...can Simponi hinder a FET cycle if it is taken to close to a transfer and could an injection even be taken right before or after an injection? Thanks for taking time to answer my questions and have a great day.
Liz

Dr. Braverman

2016 Posts
Re: Simponi and timing of FET Posted on: Jul 25, 2011 at 6:38pm
no not as long as the TNF levels are not too low. There is a benefit to waiting longer as there is a chain reaction of events once the TNF starts to lower that could take a month or 2. But many get pregnant when trying to cocneive on the same cycle as the injections.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Hadleigh

35 Posts
Reply Re: Simponi and timing of FET Posted on: Jul 26, 2011 at 12:19am
Just curious...at what number would be considered to low? Thanks.

Hadleigh

35 Posts
Reply Re: Simponi and timing of FET Posted on: Jul 26, 2011 at 12:30am
Since this was my 3rd injection (1 month apart) I assume that the chain reaction of events that you spoke of, most likely have taken place with me. For educational purposes, would you mind sharing what the chain reaction of events are and the importance of them? Again, thank you so much for your time. It is very much appreciated.

Hadleigh

35 Posts
Reply Re: Simponi and timing of FET Posted on: Jul 28, 2011 at 2:23am
Dr. Braverman,
Could you check out my last reply. Would love to hear your response. Thanks and have a great day.
Liz

Dr. Braverman

2016 Posts
Re: Simponi and timing of FET Posted on: Jul 28, 2011 at 11:49pm
TNF when elevated activates other TH1 cells(cells that make inflammatory cytokines) and activates other T cells that are part of the adaptive immune system(in our panel the cells with the IL2 receptors), they increase and activate NK cells which form a cycle of inflammation they can activate the complement system as well. . When you take out the engine(TNF) the other cycle gets disrupted then the movement back toward a TH2(anti inflammatory environment) can start to take place.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.