Use of Prednisone for IVF FET implantation

[karen910]

HI all,
I am going to have FET this cycle. I have done 4 IVFs and SO many IUI, no luck at all. According to my RE there is nothing wrong with my Uterus cavity. While checking on internet I saw so many blogs about Prednisone being used to increase implantation. I was wondering if :

someone has used it,
what was the outcome
What dose
when to start
for how long did you use it
any precautions when you were on it

I'll appreciate all the experiences, opinions advises becoz I am very desperate now...

Thanks

[Ellen038]

Yes, prednisone has a lot of side effects. You can look them all up online. For me the headaches, flushed face and damage it did to my mouth was the worst. I had to take it for 13 weeks and I had taken it with seven other IVFs. Steroids in general aren't good for your body but are sometimes necessary.

[Lulu1173]

Any side effects for taking prednisolone?

[Ellen038]

I would say its too high while ttc.  Your TSH should be between 1-2 while ttc. Generally speaking (not ttc) a TSH of 3 or less is considered normal.  I do not know why opinions vary so much.  Try looking up TSH level while ttc on the net.  Most sites will say the same thing I am saying here.  My RE says in the first tri my TSH has to be 1.5 or less.  Before I started Synthroid my TSH is 2.63 and I had two recent chemicals after IVF, once my level was 1.5 I was successful.  Your TSH will shoot up once your pregnant....then it may really not be within normal range.  I get my checked every 4-6 weeks. I really believe the combination of metholated folate, Synthroid, PGD, prednisone, lovenox ALL have made this pregnancy successful.  I can't recall all the names of the tests I had done that can contribute to recurrent loss.  From what I've heard its a bit harder to get testing in CA.  I think I would press for more testing and I would get that TSH down between 1-2 before doing a transfer.  I don't know enough about the TPA antibodies, Free T4 or Free T3.  My RE said it was only necessary to check the TSH and I know others would disagree with this.  

[karen910]

Ellen,
I have just received TSH , T3 and T4 levels from my clinic and they are :

TSH – 3.41
Free T4 – 20
Free T3 – 3.6
are these not a bit high...but according to my clinic these results are okay. I searched internet and it says 0.5 to 5.0 somewhere and 0,3 to 3.0 at some other sites... I am so confused....
what's your opinion and advice about this

[karen910]

Hi Ellen,
How are you doing. Sorry I had to work 2 days 9am to 9pm so couldn't check on you. I hope you are not bleeding any more and are relaxed and enjoying your pregnancy now. How is Jewel doing....
My clinic emailed me the results for the test that they did and those are:

Thyroglobulin AB – result was <20

ANA – which was negative

Thyroid Peroxidase – we have has suspicions that this may be linked to recurrent losses in patients with normally functioning thyroids, however the treatment is thyroid supplementation which you are already taking…therefore eliminating the concern…

That's a cut paste from their email.
so I guess every thing is okay....and still my embies do not implant...I am lost.
You have any insight on this....
Prayers for you and jewel

[Ellen038]

I hope you get some answers from the labs and maybe some fresh ideas from getting a second opinion :) keep us posted

[karen910]

Thanks Azwoman. I did take Prednisone for my last cycle and had BFN ( though my RE said I had chemical Pregnancy as my HCG was 2.5 on my day of first BETA).
I am going to do another cycle in 1 month and will take prednisone again

[Azwoman]

Good question. My first RE, when I started this journey , did a bunch of bloodwork on me and said I had 'anti-sperm antibodies.' I never got the actual medical term on what it was I had. SO he put me on prednisone for my IUI cycles. I got two pregnancies but miscarried. He attributed these to my egg issue, nothing else. I ended up switching REs who did not believe I had anti-sperm antibodies and he also commented that prednisone is old school and should not be prescribed. But just to ease my mind. He wrote me something else, I can't remember the name but I took it for 5 days. BFN. Now I am trying naturally and I have prednisone in my medicine cabinet and will take it on day 9 or sO and continue. I don't see a problem with it personally but you can't stop taking it cold turkey. Make sure you wean yourself off slowly.

[karen910]

Hi Ellen, I didn't see the bloodwork slip so I don't know which tests he has done. But I'll let you know when I have the results.
His reasoning behind 1 at a time is that there are 17% chances of pregnancy with one and with two there are 25%, and there is not much difference in %age of success (17 vs 25%), he wants to do one at a time. For last cycle too he wanted to do 1, but after yours' and MHV's suggestion to have 2 I asked them for 2 and we did 2 transfer.
I am waiting for the results for my tests and then I'll see what does he recommends.
I am also trying to get an appointment with another RE , I'll discuss things with him too and will see what does he says.

How is Jewel doing, are you taking good care of her ....,LOL....Prayers for Jewel

[Ellen038]

MTHFR is not testing on the embryos. Its a blood test for you. it's the inability to absorb regular folate. If you change/add to your folate intake and add B6 and B12 you will be treating yourself as if you do have the mutation and taking that out of the list of things to worry about. Most doctors don't want to test for it and its an expensive blood test. Before I was tested I took those supplements as a precaution.
Did he provide you with the lab slip. Do you know what tests your having? If you do please list them. Why does he want to only transfer one at a time? You had two transferred this time right? I would think transferring two would increase your odds of your Nov FET especially if you've had multiple unsuccessful cycles. It seems strange to only transfer one but that's only my opinion. I also hope you get some answers from this bloodwork and can change some things accordingly to help improve your odds. Doing the same thing doesn't sound like the best idea if it didnt work the first time. I hope he comes up with a better plan with the new testing.

[karen910]

Hi Ellen, Thanks for this detailed and full of information reply.
Congrats for successfully crossing that 10 weeks mark....I am sure you will be okay now. Having so much bleeding must be very scary.....Prayers for you.

For me I am have 2 frozen embryos , and I am going to do do FETs as suggested by my RE. I can't have MTHFR Test on these embryos as they are 5 days blasts.
My RE never mentioned anything about clot....actually I am not satisfied with his response, he didn't suggest anything, didn't give any reasons or factors that can effect implantation or cycle failure.....he just said to do next cycle using one FE at a time. the tests he did were only becoz I insisted. For now I am not sure what has he prescribed.
I am planning to do FET cycle in Nov/2013.....SIGH,

Praying for you and Jewel

[Ellen038]

Hi Karen...I typed a long reply and lost it yesterday, sorry about the delay.

You have used some key words that I've felt and I'm sure others with IF have felt at one time or another....helpless, devastated, everyone is pregnant but me. These are valid and natural feelings to fight thru and its difficult to say the least. We are stronger then we realize and stronger going thru this with people who understand us. I'm glad you came here for support.

I know your feeling pretty awful right now but please know that this is a bit of good news if your RE is saying you had a chemical. This means you implanted!!! This is one step closer to solving the puzzle. I'm glad your RE is sending you for some tests. Can you please name the other tests?  I know you mentioned TSH being checked. This is good because a lot of gps and even some REs don't understand that your TSH needs to be under 2.  Generally 3 and under is considered normal but for ttc it's between 1-2. Before I transferred my TSH was 1.5. I have had it monitored every 4 weeks and am now going out to 6 week follow ups....it's very important because pregnancy is hard on your thyroid. If you have thyroid antibodies they can also cause loss but it can be treated too. I would also look into supplements for MTHFR. Most doctors don't believe it's a real issue but if you go onto MTHFR . com you will find tons of info on what this gene mutation can cause. I had to beg and beg to be tested for this and finally before last cycle I was tested and I have both gene mutations. It can also be a cause for repeated loss. I take metholated folate (there are tons of different kinds and some more effective then others) b6 and b50 as suggested by the website. My RE wasn't really helpful with solutions for this. There is a long list of conditions associated with this and it really opened my eyes to maybe why I have so many health problems. I would do all this with what you did last time and whatever else needed after your results come back. I know it sounds like a lot but I think at this point it would be worth it. Do you take coq10 (ubiliniquol), omega 3 or any other supplements? I wonder if he is testing you for any clotting disorders? It will be interesting to see what he's ordering.

Our health care system is different here in the US. You probably don't want to travel out here for a second opinion. I think you may get some answers with the lab work.

As bad as this feels, you've certainly made some progress with this chemical...hang onto that hope and have faith that your on your way to finding more answers!!

Thank you for being concerned about Jewel. I have had 4 bleeds now. The last one was massive and uncontrollable for a good 5 min or so. I had another scan and one old bleed is gone and I have another one up closer to my uterus. I'm on bed rest till it clears. Tomorrow I will be 11 weeks...the longest pg for me.

When will you have the labs done? When you get the results make sure to get a copy of them so you have the numbers and you can research the results too.  

[karen910]

Ellen, I forgot to mention...I asked for progesterone level when I did my BETA and progesterone was 48. My RE said it's good as it should be 16 or more at this stage...any thoughts on this...

[karen910]

Hi Ellen,
Sorry for replying after so many days...I was not home and I didn't have easy access to internet.
Thanks for your such kind words and hugs....that brought tears to my eyes and I feel like have a very close buddy now and I can share all my feelings and fears ( and may be happiness some day ) with you....Thanks for being so caring and loving......HUgs
I am VERY concerned about what's going on at your end....I can totally understand what you are going through and how helpless you must be feeling as I am going through similar situation where it seems that every one else is pregnant or have children except me.....
I hope and pray that every thing ends up in a normal pregnancy for you so that you can relax and enjoy your pregnancy rather than being nervous and on your toes all the time.

I went for Beta on Tuesday and of course BFN, But my HCG was 2.5 and my RE said it's not becoz of  HCG injection that I had ( last dose of which was a week ago). He said that was a chemical pregnancy...so I am REALLY sad and devastated now. I did BETA  againnext day (wednesday) and HCG was 1.9. My nurse told me to stop progesterone which I did yesterday and I had my periods this morning....I don't know what to say. Even my RE does not have any answers..he said he does not know the reason and when I asked about any tests that we should be doing before we do next FET cycle he said he couldn;t think of any investigations or test he could do for me. But since I insisted he said he would do some thyroids and couple of other autoimmune test, which according to him he only does for women who loose pregnancy repeatedly.
I don't know what to do where else to look for answers....
I don't know where do you live or who your RE is But I live in London Ontario, Canada....and my clinic is SOFT clinic and DR Martin is my RE.

keep me posted on your condition....and all my prayers are for your healthy pregnancy now ( even the prayers I had to do for myself are for you now...)

[Ellen038]

My RE can see a couple pockets of blood that we couldn't see on the first scan last week.  I will either bleed or if I get lucky I will reabsorb those bleeds.  I guess its still serious right now because I am not allowed to do anything still.  

The first loss we don't know what happened, the second one almost 10 weeks was because of trI 18 and that is why we do PGD every time now.  I would never be able to take care of a baby with special needs with my disability and I think it would be tough these days on the poor child having to deal with society these days, lets face it a lot of people are cruel out there.

There is also such a thing as over suppressing with the prednisone my nurse mentioned once with me.  I have been thinking about you and cant come up at the moment with anything else.  I really don't know much in the terms of implantation failure.  What I have mentioned are all things that my RE has discussed with me in consultation.  I don't know what state you are in or if you are up to traveling but I believe my clinic gives phone consults free of charge.  Don't hold me to that but if you want the info I will message you with it.  I would think you could get the same by a clinic in your area too.  It wouldn't hurt to get an outside opinion about what is going on and maybe a fresh approach.  I was thinking if your RE thinks PGD would be a good option it will give you insight as to how many of your embryos are normal.  I know I had more abnormal ones then normal for someone 40 yrs old and I am 38.  That was really a wake up call for me.  What looks good to the embryologist's naked eye is not always as it seems.  

Please don't apologize for the typos, I know you are feeling devastated right now and I am really sorry.  I wish there was something I could do or say to make you feel better.  I think once you have your consultation and have a new plan of action it will help you focus on the next cycle.  Please feel free to vent your feelings and get it all out.  
Hugs to you!

[karen910]

pl ignore my typos for above post.....I am very depressed and sad...so I didn't even read what I typed last night .
Ellen I took Prednisone 5 mg twice daily so that's 10 mg/ day

[karen910]

Thanks MHV for you king words. Yes I'll try again with my frozen embies but I think I will do next FET in Dec 2013.....

Ellen...How do you know that you going to bleed more and what is causing all this bleeding?
You have also mentioned that you kept loosing pregnancies so what was the reason, I should say you have gone through SO much and here I am thinking I am the only one who been trying for so many years and so my IUIs, IVFs.

For me I also can't think of any reason why my embies didn't implant. I took 5 mg prednisone so that's 10mg /day. I took Azithromycin before transfer to clear any infection , I did Pineapple, I took aspirin 81 mg I had biopsy, my lining was  9.3......SIGH....still BFN
So if anything else comes to your mind that I should do for next cycle.....let me know
Hopefully you won't have any bleeding any more and you will have a healthy, happy pregnancy for rest of the weeks...Prayers for you and Jewel

[Ellen038]

Yes, I'm on bedrest and the bleeding is better but I'm to expect more large bleeds....at least I know where it's coming from. I am supposed to see a specialist soon.

I'm not sure what makes fibroids grow but with polyps estrogen makes them multiply like crazy. NK cells and APA are things that can cause your body to reject the embryos. Prednisone is the fix for this I was told. Maybe 5mg wasn't enough if you have high levels in your body??? There are thyroid antibodies too that can cause trouble. Between 1-2 is good for your TSH. I know there is probably so many more factors to take into consideration to getting to the bottom of things. I am not familiar with all of them relating to implantation honestly. After my first failed ivf and FET I have implanted every time afterwards. It was a matter of figuring out what was causing me to loose my pregnancies. There have been several reasons so it wasn't easy to figure everything out. Each IVF brought us a step closer. I know it's crazy money we are talking about here. I have had 14 gyn surgeries on top of 9 IVFs (3 canceled right before egg recovery) all cash.  I will try and think of anything else relating to implantation. Right now I can't think of anyone who can really help give you anymore info.  I think after discussing things with your RE you may have some changes put in place to help your FET be successful.  Please keep us posted and let us know what happens ok. I really hope you get some answers soon!

[mhv]

I am sorry things appear not to have worked this time.  I am really glad to hear you are going to try again.  I can tell you that 95% of the women on this site, that don't give up, end up having babies.  I know how frustrating this whole process is, after being in it for many years myself. I wish you luck with your FET.  I pray it brings your baby(ies).  Sending my thoughts.  

[karen910]

How are you doing Ellen...and how is jewel...are you still on bed rest? how about bleeding ,has it stopped

For me I had Hystroscopy done in Oct 2012 which according to my RE was clear. I do have 2 fibroids 0.6cm and 0.4 cmm and he is not concerned about them. I asked for Hystroscopy again before this transfer and I was on the table for that and a biopsy but my RE said it's no use doing hystroscopy if I had it in Oct 2012 and was clear becoz things do not change so quickly and he didn't do it. He just did Biopsy. And I been never tested for any immune issues though I took prednisone 5 mg twice daily on my own for this cycle. I do take Thyroid pills and my level was 2 before transfer..
For antibodies...which when they look for ,do you have any idea? and what are the meds for it.
I'll go for my Beta tomorrow,  I had to work all weekend and today so couldn't go to have it done. But I am off tomorrow hence will go to have official BFN
I still have 2 frozen embies.....but now I am not sure I want to waste them...and you are right I have to have detailed discussion with my RE and look for another one if needed.
Thanks for all your help.....and TONS  and TONS of prayers for you and jewels.
Pl stay in touch...you are my inspiration and Mentor.

[Ellen038]

Thank you for the prayers and checking up on me earlier. I'm feeling better about things now.

I am really not sure about how testing works with the hcg you were taking. I want to say that maybe it's cleared your system and it's still early to get a positive but I'm really not sure. You are the first person that I have heard of with this protocol. If it is in fact a neg outcome I would really wonder why implantation didn't occur. Without going thru the above posts I would say hysteroscopy may be warranted to see if there are polyps or fibroids stopping implantation, immune testing or at least meds to take care of immune issues if there are any potentially (prednisone, Lovenox is what I was prescribed) checking your thyroid levels and antibodies. These things come to mind off the top of my head as things to really look into. PGD to make sure that the embryos are chromosomally before transferring so you can eliminate that factor as well. If your RE isn't interested in doing any new things to help things I would think about getting another opinion. I hope some of this info helps.

[karen910]

So I did HPT this morning. Today is my 14dpt of  5 days embryo and I got NEGATIVE...not even a faint line.
I am lost again...I did my best (as always) and still nothing....I don't understand why nothing is working for me....

[karen910]

Ellen ..this blog is to support each other, share our feelings, our fears and get inspirations. Sometimes I write or express my fears here which i don't have the courage or heart to talk to even my husband about.
You are pregnant and God willing you going to have a cute little bundle in your arms soon, you need to be happy and positive now. Look at me I am not even sure I am pregnant but I gave my 2000% and am hoping for a miracle. I know how it feels to have BFN every time..it breaks the heart but that's life for us so we have to face it.
LOTS of prayers and sticky sticky baby dust

[Ellen038]

You are so right! We have to keep on trying even when we think we can't go on any longer.  Its not only stressful in the moment but it changes who you are permanently I feel.  I am not the happy person I used to be. I hope that part of me comes back one day. I know I should be happy now but its just so hard to let yourself feel happy for fear of what has happened in the past.  I really hope that you get good news concerning your beta.  I know you have done all you can and the rest is up to the man upstairs.  Hope and faith is what we have to hang onto and surround ourselves with everything positive to help offset the fear. Sorry about the rambling.