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.
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19-05-2013 13:20 #1
Medication timeline on Dr M immune protocol
21-05-2013 07:09 #2
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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21-05-2013 07:20 #3Senior Member
- Join Date
- Mar 2013
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
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30-05-2013 11:26 #4
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.
31-05-2013 16:09 #5
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✨✨🙏🙏
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14-06-2013 08:11 #6
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.
01-07-2013 13:53 #7
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 12:51.
24-05-2014 23:04 #8Senior Member
- Join Date
- Oct 2012
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.
15-06-2014 21:58 #9
Me 26, DH 30
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
15-07-2014 16:19 #10
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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