I had my followup with my doctor last week. We went over the upcoming plans that we will need to prepare for TTC again in July. Basically, with the LIT procedure being effective, my only real obstacle that I have left is the high TNFa. I need to get that number down below 30. I have already been able to drop it down from 61.5 to 37.1 with supplements which is amazing. My doctor was really impressed - but it's not quite there. So I will keep on the supplements - even adding a few more in the cocktail - and retest everything in 2 weeks to see if there is any more improvement.
If there is improvement - she will likely put me on intralipids to hopefully keep it down. However, she said the most effective thing to do to specifically target TNFa would be the IVIg. Which would suck because it's $2500 a shot. I feel I will have to do this regardless if it comes below 30 or not because inflammation can increase once pregnant and it can't come back up again. Sucks. '
It's all so scary. One little thing can go wrong and boom, it's all over again. I have allowed myself 6 months to mentally prepare myself again. I gave myself a lot of time to get my mind right. While also clearly doing things to hopefully prevent it from happening again. But the thought will forever my engraved in my mind that nothing is guaranteed, and that another miscarriage is still very real and very likely. But it cannot stop me from trying again. I will do everything I can to try and prevent it. But it's just a sad fact I have to face that it just might happen again.
Anyway, one step at a time. Right now, I am trying to eat better, exercise, and just live in the moment as best as I can. We will see where I am at in 2 weeks. From there, I will decide what the best course of action is. Baby steps. Yep. Baby steps to hopefully get baby steps one day. :)
Showing posts with label nk cells. Show all posts
Showing posts with label nk cells. Show all posts
Tuesday, June 7, 2016
Monday, February 29, 2016
Annnd more tests.
Just got back from the Hematologist and he basically agreed with my fertility dr that the high TNF's are the culprit. He took some more tests to look into a few more things and perhaps build a case to my insurance company to cover the IVIg shots to help suppress my immune system. If they can get that covered, that would be our best option. If they cannot, then we are looking into the intralipid/steroid option.
We are still gathering our blood work panel for the Canadian clinic to have for our upcoming trip. I only have two more to do, husband has three. Hopefully we can get all of that done this week. I should have the results for todays labs this week as well. Hopefully things will all start coming together so we can formulate a solid plan. The estimation of when I plan to try again will be April. There just isn't enough time in March to get all of this sorted, so April should be a solid go for us.
What a crazy ride this has been, but to finally be able to see a shed of light at the end of the tunnel is scary, but inspiring.
We are still gathering our blood work panel for the Canadian clinic to have for our upcoming trip. I only have two more to do, husband has three. Hopefully we can get all of that done this week. I should have the results for todays labs this week as well. Hopefully things will all start coming together so we can formulate a solid plan. The estimation of when I plan to try again will be April. There just isn't enough time in March to get all of this sorted, so April should be a solid go for us.
What a crazy ride this has been, but to finally be able to see a shed of light at the end of the tunnel is scary, but inspiring.
Wednesday, February 17, 2016
Some test results (finally)
So here are some results from my autoimmune testing I recently did. I think we may have found the culprit for my losses. Please read below and I will write another post on my thoughts:
Test: CD-3 (Pan T-Cells)
Normal levels: 63-86%
My level: 90.0 (High)
What it means:
These cells are the most important in our immune system. They are low when the immune system is weak (suppressed) and normal when the immune system is healthy. Infertile patients and patients with recurrent pregnancy losses have values in the high normal range. These individuals have immune systems that are strong - even overactive. A strong overactive immune system is associated with a 5% incidence of autoimmune diseases for example, thyroiditis, lupus, rheumatoid arthritis.
Test: CD-8 (T-Cytotoxic-Suppressors)
Normal Levels: 17-35%
My levels: 37.8 (High)
What it means:
These cells are the referees of the Pan T and the T Helper interactions. They coordinate how strongly or how weakly the immune system reacts. In women with miscarriage and or infertility these cells are often on the low side. "They get tired arbitrating the hyperactive Pan T cells and the T Helpers." They are rarely high.
CD56+ CD16+ Natural Killer Cells
Normal Levels: 3-12%
My Levels: 1.0 (Low)
What it means:
Natural Killer cells of this type are produced in the bone marrow and these cells produce a chemotherapy molecule called TNF (Tumor Necrosis Factor). This molecule is involved in eliminating cancer cells that may develop in normal individuals. Tumor Necrosis Factor also causes joint damage in women with rheumatoid arthritis. These Natural Killer cells are often elevated in women with infertility and recurrent miscarriage. The Tumor Necrosis Factor produced by these cells kills the rapidly dividing cells of the embryo and placenta often resulting in IVF or GIFT failure, blighted ovum or a chemical pregnancy where the BhCG elevates slightly and then quickly returns to non-pregnant levels. Normal levels for this cell population are 3-12%. The CD 56 and the CD16 molecules on the surface of these cells are special glue (adhesion) molecules that allow the Natural Killer Cells to attach to cancer, placental and embryonic cells. Once glued to the placental cell, it sprays Tumor Necrosis Factor on the cell and kills it.
TH1/TH2 Intracellular Cytokine Ratios:
Normal Levels:
TNF-a:IL-10 (CD3+CD4+) 13.2-30.6
IFN-G:IL-10 (CD3+CD4+) 5.8-20.5
My levels:
TNF-a:IL-10 (CD3+CD4+) 61.5 (High)
IFN-G:IL-10 (CD3+CD4+) 17.0 (normal)
What it means:
Test: CD-3 (Pan T-Cells)
Normal levels: 63-86%
My level: 90.0 (High)
What it means:
These cells are the most important in our immune system. They are low when the immune system is weak (suppressed) and normal when the immune system is healthy. Infertile patients and patients with recurrent pregnancy losses have values in the high normal range. These individuals have immune systems that are strong - even overactive. A strong overactive immune system is associated with a 5% incidence of autoimmune diseases for example, thyroiditis, lupus, rheumatoid arthritis.
Test: CD-8 (T-Cytotoxic-Suppressors)
Normal Levels: 17-35%
My levels: 37.8 (High)
What it means:
These cells are the referees of the Pan T and the T Helper interactions. They coordinate how strongly or how weakly the immune system reacts. In women with miscarriage and or infertility these cells are often on the low side. "They get tired arbitrating the hyperactive Pan T cells and the T Helpers." They are rarely high.
CD56+ CD16+ Natural Killer Cells
Normal Levels: 3-12%
My Levels: 1.0 (Low)
What it means:
Natural Killer cells of this type are produced in the bone marrow and these cells produce a chemotherapy molecule called TNF (Tumor Necrosis Factor). This molecule is involved in eliminating cancer cells that may develop in normal individuals. Tumor Necrosis Factor also causes joint damage in women with rheumatoid arthritis. These Natural Killer cells are often elevated in women with infertility and recurrent miscarriage. The Tumor Necrosis Factor produced by these cells kills the rapidly dividing cells of the embryo and placenta often resulting in IVF or GIFT failure, blighted ovum or a chemical pregnancy where the BhCG elevates slightly and then quickly returns to non-pregnant levels. Normal levels for this cell population are 3-12%. The CD 56 and the CD16 molecules on the surface of these cells are special glue (adhesion) molecules that allow the Natural Killer Cells to attach to cancer, placental and embryonic cells. Once glued to the placental cell, it sprays Tumor Necrosis Factor on the cell and kills it.
TH1/TH2 Intracellular Cytokine Ratios:
Normal Levels:
TNF-a:IL-10 (CD3+CD4+) 13.2-30.6
IFN-G:IL-10 (CD3+CD4+) 5.8-20.5
My levels:
TNF-a:IL-10 (CD3+CD4+) 61.5 (High)
IFN-G:IL-10 (CD3+CD4+) 17.0 (normal)
What it means:
This is a ratio
between two groups of chemicals in the body. The TH1 cytokines are defensive
and include TNFα and IFNɤ. The TH2 cytokines including IL10 and others
calm down the immune system and promote immune tolerance particularly during
pregnancy so that the mother’s body will allow the embryos to implant and the
pregnancy to be stable.
The defensive cytokines are important as well. They defend the
body against bacteria, viruses and cancer changes. Normally during pregnancy,
the ratio shifts towards TH2 to maintain the pregnancy. If the ratio is
deviated significantly toward the defensive cytokines (TH1), the chances of
conceiving become less and the risk of miscarriage becomes high. Th1 cytokine
dominance will make the environment inside the uterus hostile to the embryos
and the pregnancy. This damages the endometrium, and its receptivity.
Additionally, it can also damage the embryos and make their chances of
implantation much lower.
High TNFα can damage the eggs before they are released from the
ovaries. It is imperative to bring the level down and keep it down for a couple
of months before you try for pregnancy. The eggs that develop in the first two
weeks of the cycle would have started to wake up from a long dormant phase over
the previous two to three months, and it is important to wake up in a healthy
environment to avoid the potential damage.
Increased ratio of TNFα is treated with TNFα antagonists e.g.
humira in the form of two injections two weeks apart, and retest 7-10 days
later. If the levels are not low enough, it is advised to have a further course
of two injections. Usually it is supplemented with a second course and a drip
of intralipids to boost the effect. Of course, not everyone will respond to
TNFα antagonists adequately. However, the effect can be boosted with steroids
and intralipids. Additionally, you might need IVIg early in pregnancy if you
still have high TNFα
Monday, February 1, 2016
Start of a new month
Well today I finally got my period. Now that it's here I can start preparing what this month will bring. Hopefully lots of answers and solutions! I guess I am to go in to the doctors on my day 3 to begin some tests. I think my dr. wants to retest my AMH levels, since she said they can always change. My last AMH testing was back in Sept. The numbers were great so I am hoping nothing has changed too drastically. It's always nerve wracking when you get older and you have to go in for these tests. As if aging wasn't hard enough - you have to have constant reminder tests that your eggs are too. oy.
It would be awesome if we could get all of these tests and whatnot done so I can start trying again soon. I hate when days like today happen when I get my period and I know, that was just another egg gone. I feel like my time is just ticking right on by and each month is just another step closer to menopause! haha. Scary to think about. =/
Anyway, I am eager to get to the bottom of everything needless to say. I am emotionally unstable as far as all of this. I am up and down all of the time. I know it's good that I was forced to wait, because I need this time to heal and prepare for the next round. Which I am doing, slowly but surely. But it would be cool if we do these tests and the doctor is like "yep, this is the problem, take this and do that and try again whenever you want!" and then boom, it works and everything is peachy! That's my perfect world. haha! But the reality is, I will have to do these tests, it may provide answers, it may not. And I will more than likely be told to wait until next month so now we are looking at March at the earliest. I just turned 37 in Dec and it is already FLYING by!!
I also am STILLLLLL waiting for the results of the tissue sample. My God it is taking FOR-EV-ER. I called my nurse to see what the hold up was and she is going to call them today to see if she can find out what is taking so long. And hopefully they can just tell her what the results were!! So I don't know if it will be today that I will know anything - but I am confident it will be sometime this week. I will post as soon as I hear something. :)
In other news, my mom came and visited me this weekend which was nice. It's always nice to get some mom time in, especially when you are going through hard times. Nothing like the comfort of your momma. We watched a lot of movies this weekend. The Revenant, The Martian and Everest. All GREAT movies, but if I had to recommend one, The Martian is a MUST SEE!! I loved it!! The Revenant was good, a little long but Leo's acting was great. And Everest was really good too, very sad. Based on a true story which always tugs at the heartstrings a little harder. But The Martian - yeah...phenomenal!!
Ok that's enough of my movie reviews! (Sometimes you have to go a little off topic to get your mind off of things!!) ;)
It would be awesome if we could get all of these tests and whatnot done so I can start trying again soon. I hate when days like today happen when I get my period and I know, that was just another egg gone. I feel like my time is just ticking right on by and each month is just another step closer to menopause! haha. Scary to think about. =/
Anyway, I am eager to get to the bottom of everything needless to say. I am emotionally unstable as far as all of this. I am up and down all of the time. I know it's good that I was forced to wait, because I need this time to heal and prepare for the next round. Which I am doing, slowly but surely. But it would be cool if we do these tests and the doctor is like "yep, this is the problem, take this and do that and try again whenever you want!" and then boom, it works and everything is peachy! That's my perfect world. haha! But the reality is, I will have to do these tests, it may provide answers, it may not. And I will more than likely be told to wait until next month so now we are looking at March at the earliest. I just turned 37 in Dec and it is already FLYING by!!
I also am STILLLLLL waiting for the results of the tissue sample. My God it is taking FOR-EV-ER. I called my nurse to see what the hold up was and she is going to call them today to see if she can find out what is taking so long. And hopefully they can just tell her what the results were!! So I don't know if it will be today that I will know anything - but I am confident it will be sometime this week. I will post as soon as I hear something. :)
In other news, my mom came and visited me this weekend which was nice. It's always nice to get some mom time in, especially when you are going through hard times. Nothing like the comfort of your momma. We watched a lot of movies this weekend. The Revenant, The Martian and Everest. All GREAT movies, but if I had to recommend one, The Martian is a MUST SEE!! I loved it!! The Revenant was good, a little long but Leo's acting was great. And Everest was really good too, very sad. Based on a true story which always tugs at the heartstrings a little harder. But The Martian - yeah...phenomenal!!
Ok that's enough of my movie reviews! (Sometimes you have to go a little off topic to get your mind off of things!!) ;)
Wednesday, January 6, 2016
More Tests
I went to the doctor yesterday to discuss what my options were from here. When I walked into her office, she gave me a sad look and said she was sorry. Then from there, she got right down to business and I kind of felt the way she was speaking to me, it was if she is really taking me seriously now. Not to say she didn't before, but this time she was very direct. I think her, being a fertility specialist, letting her patient suffer another miscarriage really got to her. She is supposed to be there to help, and it happened now under her care. I don't think that sat well with her.
So she told me that she re-reviewed my entire file (which was starting to look more like the size of an encyclopedia) and felt she was 90% sure of the cause of all of this. She stated that NK Cells were never tested on me, because she felt that my blood clotting disorders were big enough that with the treatment of Lovenox, that, that would be the cure. She apologized for being wrong, and stated clearly that this is a lot bigger and more serious than that.
NK Cells, aka "Natural Killer Cells" are cells that help fight off infections and cancer type cells in your body. Everyone has them and they typically are a great thing. However, they can formulate in an excessive amount in some women, which in turn, if she gets pregnant, they recognize the embryo as a foreign object and instantly start attacking it. My doctor feels that I could potentially have an increased about of these cells and that is what is happening to me, and would explain why most of my miscarriages happen so early on. My body rejects it before they even realize that this is actually a good thing! Just add it to the list of things that are wrong with me. Well, potentially anyway.
Her being 90% sure is comforting, because there is a cure for this. I will be boosted up with steroids and other hormones to help suppress my immune system so these cells don't go on attack. However, if these results come back normal, and I don't have this issue, then we will most likely have to chalk everything up to simply bad eggs. Which is crazy since I have a great AMH level and my FSH level was great too! I'm only 37, so to have bad egg, after bad egg is a little nuts to fathom. There has to be ONE good egg in there for heavens sake!! I don't drink, smoke, do drugs, eat relatively good. I mean, cmon!!
Also - I saved the gestational sac from my miscarriage when I passed it, and gave it to them to send off for testing. That too will let us know if this was chromosomal or not. If they can hopefully use it and it's a good sample to test on. I will know those results in a couple of weeks.
So now, the gameplan. The NEW gameplan. I have to wait 1 cycle and have a regular period. I cannot get pregnant during this time so I have to be super careful with the husband. After my regular period comes at the end of this cycle, I will then go in for the full immunity panel. They will test everything and anything that has to do with my immune system. From there, really depends on the results. If my levels come back elevated, then we will proceed with the steroid cocktail. I will still have to do lovenox injections, only I will start them on cycle day 6 along with baby aspirin.
IF
these results come back negative, and my immunity is fine, then we will have to start looking into IVF. That way they can take a few eggs, study them to make sure they are viable before injecting the lab created embryo back in me. I really do not want to go down this route - since it's super expensive....but if I have no other choice, then so be it. It's what we will do. But I am praying that my answer will fall with the NK Cells and that we can cure this and move on naturally.
In the meantime, I am just going to take this little break I have from the baby making nonsense and get my mind, body and soul back on track. I really could use the break, even though I want to just go-go-go all of the time. Now I am being forced to wait...so might as well take advantage of it.
I played powerball for the 500 Mil jackpot. I figure, my odds that all of this going on with me is 1 in every 100 women. So why can't I be 1 in 292 million for the lucky numbers?! haha! ;)
So she told me that she re-reviewed my entire file (which was starting to look more like the size of an encyclopedia) and felt she was 90% sure of the cause of all of this. She stated that NK Cells were never tested on me, because she felt that my blood clotting disorders were big enough that with the treatment of Lovenox, that, that would be the cure. She apologized for being wrong, and stated clearly that this is a lot bigger and more serious than that.
NK Cells, aka "Natural Killer Cells" are cells that help fight off infections and cancer type cells in your body. Everyone has them and they typically are a great thing. However, they can formulate in an excessive amount in some women, which in turn, if she gets pregnant, they recognize the embryo as a foreign object and instantly start attacking it. My doctor feels that I could potentially have an increased about of these cells and that is what is happening to me, and would explain why most of my miscarriages happen so early on. My body rejects it before they even realize that this is actually a good thing! Just add it to the list of things that are wrong with me. Well, potentially anyway.
Her being 90% sure is comforting, because there is a cure for this. I will be boosted up with steroids and other hormones to help suppress my immune system so these cells don't go on attack. However, if these results come back normal, and I don't have this issue, then we will most likely have to chalk everything up to simply bad eggs. Which is crazy since I have a great AMH level and my FSH level was great too! I'm only 37, so to have bad egg, after bad egg is a little nuts to fathom. There has to be ONE good egg in there for heavens sake!! I don't drink, smoke, do drugs, eat relatively good. I mean, cmon!!
Also - I saved the gestational sac from my miscarriage when I passed it, and gave it to them to send off for testing. That too will let us know if this was chromosomal or not. If they can hopefully use it and it's a good sample to test on. I will know those results in a couple of weeks.
So now, the gameplan. The NEW gameplan. I have to wait 1 cycle and have a regular period. I cannot get pregnant during this time so I have to be super careful with the husband. After my regular period comes at the end of this cycle, I will then go in for the full immunity panel. They will test everything and anything that has to do with my immune system. From there, really depends on the results. If my levels come back elevated, then we will proceed with the steroid cocktail. I will still have to do lovenox injections, only I will start them on cycle day 6 along with baby aspirin.
IF
these results come back negative, and my immunity is fine, then we will have to start looking into IVF. That way they can take a few eggs, study them to make sure they are viable before injecting the lab created embryo back in me. I really do not want to go down this route - since it's super expensive....but if I have no other choice, then so be it. It's what we will do. But I am praying that my answer will fall with the NK Cells and that we can cure this and move on naturally.
In the meantime, I am just going to take this little break I have from the baby making nonsense and get my mind, body and soul back on track. I really could use the break, even though I want to just go-go-go all of the time. Now I am being forced to wait...so might as well take advantage of it.
I played powerball for the 500 Mil jackpot. I figure, my odds that all of this going on with me is 1 in every 100 women. So why can't I be 1 in 292 million for the lucky numbers?! haha! ;)
Subscribe to:
Posts (Atom)