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  1. #1
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    Default Medication timeline on Dr M immune protocol

    Hi Ladies of the RI forum ,

    I went to see Dr M back in Feb 2013 after 6 failed IVF transfers, and he picked up an imbalance in my immune system that requires intralipids with my next FET cycle. He gave me a very vague sketch describing what meds to take and when, so I'm hoping the fellow Dr M patients can help me make sense of it!

    I believe it will be as follows:
    6wks before FET- start doxycycline & dexamethasone
    3wks before FET- stop doxy & dex, start prednisolone 25mg
    2wks before FET- first intralipid infusion, continue pred 25mg
    Day of FET- increase pred to 30mg, start clexane. Continue for TWW.

    I will have to call him to confirm all these details, but wanted to know if the above sounds right based on your experiences.

    Thanks!

  2. The Following 2 Users Say Thank You to SimpsonDesert For This Useful Post:

    hopefulgsn2014  (19-05-2014),MGC Bertie  (24-05-2014)

  3. #2
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    Hi Simpsondesert,

    i haven't commenced Dr M's treatment protocol yet so can't help you unfortunately. Can I suggest that you post this in the NK cell thread, as there are many ladies on this thread that will be able to help. Also, have a read of the previous posts on the thread. Lots of ladies have posted there treatment protocols in previous posts. All the best

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    SimpsonDesert  (25-05-2013)

  5. #3
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    Hi Simpson desert! I am new to this too, actually going to see dr m on Thursday and will hopefully get my protocol then. I will update once I know details but I agree you should post in the nk cells thread. The ladies are lovely and I'm sure will be able to help you

  6. The Following User Says Thank You to timetoshine For This Useful Post:

    SimpsonDesert  (25-05-2013)

  7. #4
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    Thanks Hope & timetoshine. Sorry its taken me so long to get back to the thread. I did look through the NK cell threads, I haven't started posting in there as I technically don't have high uterine NKC's. My issue is Hashimotos disease and some other 'imbalance' that Dr M found in my bloodwork.

    I didn't realise how many immune protocols there were! Even ladies on the same meds are given different starting points & different dosages, so I'll just go back to Dr M to make sure I've got it right.

  8. #5
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    Hey Simpson! Sorry I didn't post over here for you...I reckon it all looks good, like you said he's treating us all for a variety of immune issues so that's why our protocols vary. I had intralipids around your timings, actually I had one on day 4 which was 2 weeks before transfer, one on EPU, so that was 5 days before transfer and then one last Monday after getting a bfp. I was on 25mg pred then bumped up to 35 after bfp. I started clexane on day 4 or 5 this time and stimming on day 4 as I was on menopur for the first time.
    I'm not sure if you have any egg quality issues, but I was reccommended Saizen which is a growth hormone by both Dr M and my fs. We'll never really know what made the difference as there were so many new things in the mix.
    I was also put on an antibiotic amoxilin (sp?), Dr M said that one was fine as my fs gave it to me, though I gather it's similar to doxycycline.
    Anyway, that's some of my protocol. Any questions give me a yell, yours looks like a good starting point.
    I know you have had a hard road as i have read your posts elsewhere, hopefully it won't take much fine tuning and you will get success very soon✨✨🙏🙏

  9. The Following User Says Thank You to lissyloulou For This Useful Post:

    SimpsonDesert  (01-07-2013)

  10. #6
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    Hey SimpsonDesert,

    I thought I'd post my initial protocol on here - it's different to yours but I'll put it up anyway as a comparision (The Gonal F, Orgalutron and Ovidrel are FS prescribed drugs (fresh IVF antagonist cycle) and the Prednisolone, Clexane, Doxycycline and Progesterone are from Dr M).

    I weaned pessaries from approx 12 weeks, reducing by 400mg each week, then stayed on 1 per day for 2 weeks, then stopped. OB wanted me off them completely by 16 weeks.

    I can't remember exactly when I started weaning the prednisolone, but I do know I was completely off it by 27 wks. I dropped down 5 mg a week (plateaued on 15mg/week for 3 weeks, then continued to drop by 5 mg/week. Final week I was only on 2.5mg)

    My diagnosis was very high blood NKCs and slightly elevated uterine NKCs. Dr had also removed 4 polyps from the uterus that would surely have impeded implantation of previous embryos.


    CD1 - Phone clinic. Begin Prednisolone 25 mg.
    CD2 - BT @ 7.30am - levels OK. Begin injecting: 150 Gonal F, 40mg Clexane. 25mg Pred.
    CD3 - Gonal F, Clexane, Pred
    CD4 - Gonal F, Clexane, Pred
    CD5 - Gonal F, Clexane, Pred
    CD6 - Gonal F, Clexane, Pred
    CD7 - Start Orgalutran, continue Gonal F, Clexane, Pred
    CD8 - Gonal F, Clexane, Pred, Orgalutran
    CD9 - BT and U/S @ 9am. Gonal F, Clexane, Pred, Orgalutran + Intralipid Infusion.
    CD10 - Gonal F, Clexane, Pred, Orgalutran
    CD11 - Gonal F, Clexane, Pred, Orgalutran
    CD12 - BT & U/S @ 8.30am. Pred. Stop Gonal F, Clexane, Orgalutran. Trigger with Ovidrel at 7pm.
    CD13 - Pred. Jab free day
    CD14 - EPU @ 9am (13 eggs retrieved!). Begin 400mg Progesterone (P4) Pessary.
    CD15 - Begin 100mg Doxycycline (antibitotic). Pred, Clexane, P4. 11 eggs mature but only 6 fertilised.
    CD16 - Doxycycline, Pred, Clexane, P4
    CD17 - Doxycycline, Pred, Clexane, P4
    CD18 - Doxycycline, Pred, Clexane, P4
    CD19 - Embryo Transfer. 2 hatching blasts transferred. Doxycycline, Pred (increase to 30mg/day), Clexane, P4 (increase to 800mg/day)
    CD20 - 1 day past 5 day transfer (1dp5dt) 1 expanded blastocyst has been frozen. Pred, Doxycycline, Clexane, P4.
    CD21 - 2dp5dt. Doxycycline, Pred, Clexane, P4.
    CD22 - 3dp5dt. Pred Clexane, P4.
    CD23 - 4dp5dt. Pred, Clexane, P4. Spotting in the evening??? Very light.
    CD23 - 5dp5dt. Pred, Clexane, P4. No more spotting, light cramping. FRER @2pm = very faint BFP.
    CD24 - 6dp5dt. Pred, Clexane, P4. FRER @ 7am = BFP, noticeably darker than yesterday!
    CD25 - 7dp5dt. Pred, Clexane, P4.
    CD26 - 8dp5dt. Pred, Clexane, P4.
    CD27 - 9dp5dt. Pred, Clexane, P4. Organised early BT. HCG= 106!!!!!!!!!!!! BFP! P4 = 92
    CD28 - 10dp5dt. Pred (35mg), Clexane, P4 (increase to 3 x 400mg/day). Spotting???!!!
    CD29 - 11dp5dt. Pred, Clexane, P4. Light spotting. Follow up BT. HCG = 303, P4 = 147

    I also had intralipid infusions on cd9, then @ approx 5, 11, 19 and 26 weeks pregnant.
    Last edited by Bella978; 27-06-2013 at 09:44.

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    MGC Bertie  (24-05-2014),SimpsonDesert  (01-07-2013),yjeu  (24-12-2015)

  12. #7
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    Thanks Lissy & Bella, much appreciated! Bella, I love your day-by-day account of getting from CD 1 to BFP

    I checked in with Dr M and my protocol seems waaay different to others:

    6 wks before FET- start dexamethasone . 2 tabs per day x 0.5mg each. Continue for 3 weeks.
    3 wks before FET- stop dexamethasone. Start prednisolone 25mg per day. Continue until ovulation.
    7-10 days before FET- first intralipid infusion.
    5 days before FET- Start doxycycline, continue for 14 days.
    Ovulation day- Start progesterone pessaries. Continue until end of TWW.
    FET day- increase prednisolone to 30mg per day, start clexane, continue both until end of TWW.

    Started dex on Friday, so the long protocol has begun! I will venture over & join everyone in the NK cell thread soon.

    If anyone else wants to add their protocols here for info, please go right ahead
    Last edited by SimpsonDesert; 20-12-2013 at 11:51.

  13. #8
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    I've just stumbled on this thread, and wish I'd found it ages ago. Even though I'm on other NKC threads that are fabulous, this one gives a good run-down of exactly what others medication looks like, without having lots of pages to read through. Thanks.

    I have tried Dr M's immune protocol 4 times now, without any success, and am doing my fifth at the moment. I have high NKCs (56+ and 163+), high ANA (titre 80), elevated DQ Alpha and DQ beta and one or two other minor immune issues that I can't remember off the top of my head at the moment!!

    My immune protocol for the first four times (update 12/9/14) has been:
    - 2 weeks before ET - 10mg aspirin (continuing taking oil, though at Fert First they said not to). As Clexane was increased to 60mg, Dr M said not to do aspirin, even though FS wanted it
    - 2 weeks before ET - 25mg Prednisolone
    - 7-10 days before ET - IVIG infusion (I've had Intrallipids for two cycles with Dr M, and now IVIG for two cycles)
    - from transfer - progesterone pessaries - 1x400 each night (FS said not needed for FETs, by Dr M wanted it)
    - from ET - increase to 30mg Prednisolone
    - 1 week before transfer - Clexane injections 60mg (stop just for day of ET)
    - Pregnyl d3, d6, d9 after ovulation

    My immune protocol for the fifth time (updated 26/9/14) is:
    - 3 weeks before FET - dexamethasone 1 x 0.5g tablet morning and night
    - 7-10 days before FET - Neupogen injections - 1 x daily
    - 10 days before FET - Clexane injections 60mg (stop just for day of ET)
    - 7-10 - days before FET - IVIG infusion
    - from FET - progesterone pessaries 1x400 each night (might do 2x400)
    - Pregnyl d3, d6, d9 after ovulation
    Last edited by MGC Bertie; 26-09-2014 at 14:36.

  14. #9
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    Subbing


    Me 26, DH 30
    TTC 4yrs
    Mild pco
    Mild endo
    Lap done 9/13
    4rounds of clomid with BFN
    5th cycle of clomid chemical pregnancy

    Started IVF jan 2014

    1st IVF Jan 2014: @WFC antagonist cycle started, cancelled day 9 due to over stimulation, 60+ follicles.

    2ND IVF March 2014: Next generation fertility ,Antagonist cycle, chemical pregnancy!!!!!

    *DIAGNOSED WITH HIGH UTERINE NK CELLS

    3rd: 1st FET May2014, started intralipids for the first time due to high NK cells in the uterus

  15. #10
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    Just jumping in here and posting this so i don't lose the thread

    Friends have told us about Dr M and we have our first appointment next Tuesday @ Miranda. that he can help us and this is our last hope.


 

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