Vi som snart är gravida efter utredning i Aten!

Om du blir gravid, så sluta inte med progesterontillskott föränn i v.14 när moderkakan tar över produktionen av progesteron.

Det finns också receptfria Progesteronkrämer att köpa i Sverige,
här hittar du 2 olika exempel på det:

halsopaketet.se/products/progesteronkram-progesterall

www.moodmama.com/matriarch-100

Utomlands finns också Progesteronsprutor som heter Prontogest, Gestone och Prolutex att köpa.

Om inte extra progesteron gör någon skillnad, så kolla upp vad du har i Prolaktinvärde. Det kan du göra t ex genom Blodkollen.se Vissa kvinnor får blödningstrassel och mellanblödningar om de har höga nivåer av Prolaktin. Det är ett hormon som bara ska vara högt när man ammar, inte annars. För att sänka det behövs tabletter som heter Pravidel eller Norprolac (receptbelagt i Sverige).

Jag kan också tipsa dig om ivfSerums Mensblodtest som man gör hemifrån och skickar till labbet i Aten samt hysto som man gör via Serum. Jag har gjort båda.

Jag brukade få bruna spottings 3 dagar innan mensen började förut, men nu efter hyston i november så fick jag bara röd spotting en dag och sen drog mensen igång rejält som den ska. Så det kan vara ett tips.

Här kan du läsa mer:
www.ivfserum.com/infection-screening/

www.ivfserum.com/hysteroscopy-with-implantation-cuts/

Jag har tyvärr ingen aning, inga baciller hittades vid mitt mensblodtest, så jag har aldrig tagit antibiotika inför eller vid graviditet, men jag hoppas någon annan här i tråden kan svara dig om antibiotikan.

Om man gjort utredning hos Dr Gorgy och fått rekommendationen Ivig, så kan man endera resa till London och få droppet satta där på hans klinik, annars kan Marie på Fertilitetplus sätta Ivig också.

När det gäller Neupogen så är det sprutor som endera tas som sprutor i magen eller som underlivssköjning (man sprutar in Neupogen i livmodern) några gånger innan insättning. Marie på Fertilitetplus kan hjälpa till om man behöver få Neupogen insprutat i underlivet har jag läst här i Atentråden tidigare.

När det gäller priser på Neupogen och ivig (Privigen) så kolla på www.fass.se och för Maries priser får man kontakta Fertilitetplus och fråga.

Zwillinge86 & blomman18- Det är möjligt att även andra kliniker kan hjälpa till med ivigdroppsättning och Neupogenadministration. Kolla med tex Sophiahemmet och Christinakliniken.

finee- Var har du läst om ratio mellan tnfalfa och ifn?

När jag tog prover hos Dr D för några år sen var min ratio större än hälften, men hos Dr Gorgy hade det nu förbättrats, så nu är det hälften. Jag har normalt tnfalfa.

Fråga Gorgys klinik, men jag tror det är endast underlivssköljningen man gör inför insättning. Jag tror man kan ta Neupogensprutor i magen oavsett hur man blev gravid. På samma sätt som Fragminsprutor.

Det stämmer säkert om ration, att det är bra om den är hälften. Jag höll på att läsa i Beerboken och jag tänkte bara om du hade läst det där ? Eller på Fertilitetsguiden.com kanske ?

blomman 18- However, SERUM seem to use an 'in-cycle' protcol for most ladies who test positive for chlamydia, rather than trying to erradicate chlamydia before IVF (starting 12 days before your period is due - and using barrier contraception):

day 1 (12 days before period). 1g azithromycin
day 2-24 (until about day 12 of stimms/cycle). 100mg doxycycline morning and evening
day 25.  (day 11-13 of stimms/cycle) 1g azithromycin

then from bfp 5 days on and 5 days off clarithromycin (or 500mg azithromycin) until about 8 weeks of pregnancy

After the positive pregnancy test, Serum seem to prefer to recommend clarithromycin, erythromycin or azithromycin rather than doxycycline, although up until then, doxycycline may be the preferred option for ladies with immune issues because it has some proven NK suppression activity.

For ladies who test positive for mycoplasma as well as chlamydia, serum seem to substitute erythromycin instead of doxycycline.

Källa:
www.fertilityfriends.co.uk/forum/index.php

Kanske du läste det i här i Agathes EAQ?

4.6   Cytokine ratio (TH1:TH2) test

4.6.1   What is the cytokine ratio test? 
This is a blood test done by various labs in the US including RFU Chicago. It is a measure of the ratio of chemical messengers to each other. TH1 cytokines are associated with the cellular parts of the immune system.  TH2 with antibody (humoral)  immune activation TH2.  RFU measures the cytokines TNFa and IFNg compared to IL10 inside CD3+CD4+ white cells (cells which make a lot of cytokines) in the blood.  Higher ratios have been shown to be associated with a lower chance of live birth and are common in many inflammatory conditions (e.g., Crohns, IBS, arthritis, asthma), in cases where there is a DQalpha match and/or elevated NK activity.  They may also be elevated under chronic stress or when you have an infection.  Beer described the TH1 cytokines as promoting aggression against the body and pregnancy and TH2 cytokines as promoting tolerance against foreign cells (so simplistically he saw high TNFa:IL10 or IFNg:IL10 as unfavourable for fertility and describing a situation which was high in inflammation and usually associated with increased NK cell activity).   However, in some autoantibody driven conditions like asthma, dermatitis and rhinitis TH2 cytokines like IL4 and IL13 may be very dominant compared to IFNg (TH1) which can also be described as an inflammatory state, but low TH1:TH2.   More recently, there has been a tendency to classify TNFalpha as a TH17 rather than TH1 (although its always classified as pro-inflammatory).

In the RFU and Millenova test, the cytokines are measured in intracellularly (in the cytoplasm of CD4 white cells in the blood).  In some of the RIC tests and tests elsewhere, the cytokines are measured in free serum.  Intracellular tests require fresh, live white cells  (which need to be couriered to the laboratory within 48 hours of blood draw) whereas serum tests can use samples of serum that are centrifuged and preserved so they can be used on samples that are older and have been posted.  The different methods of testing at different labs does mean that the normal ranges for tests differ greatly between different labs.

4.6.2   Please explain my cytokine ratio test results?
In the RFU tests there will usually be two ratios: TNFalpha to Interleukin 10; and Interferon gamma to Interleukin 10

e.g.,     TNF-a:IL10 (CD3+CD4+)        38.3
   IFN-g:IL10 (CD3+CD4+)   10.9

The TNFalpha ratio is usually seen as more important for fertility and at RFU Chicago anything over 30.6 is elevated. Values over 40 are fairly high. Values over 50 are very high. For tests run at other laboratories, the normal range may be very different.   Some labs have started measuring another cytokine, IL17.  High IL17 seems to be associated with diminished immunoregulation and may also be proinflammatory.

4.6.3   How is the cytokine ratio test different to a TNFa measurement test?
Apparently, TNFa is very difficult to measure accurately, but measuring the ratio of one cytokine to another is supposed to be more accurate.  Most immune fertility doctors therefore prefer to use the ratio test rather than the absolute TNFa measurement.

4.6.4   What are the sample requirements for the cytokine ratio test at RFU Chicago?
30-40mls of blood collected in green top (lithium heparin additive) tubes ? mixed well before posting (tubes rolled end over end about 10 times).  Not refrigerated.  Must be received by RFU within 48 hours of blood being drawn during working hours.  You can have the blood drawn at TDL (on Wimpole St, two doors from Dr Gorgy) or you can arrange to get a post pack from Dr Gorgy/TDL and have the blood drawn at your GP (or local hospital) on Monday/Tuesday afternoon and then post it back to TDL special delivery before 9am so that they add it to their fedex pick up on Tuesday/Wednesday in time to get it to Chicago within 48 hours.

4.6.5   How long does it take to get the results of the cytokine ratio test back?
About three days after it is received in Chicago.  Dr Gorgy?s patients will need to phone the clinic to ask for a copy of the results (by fax/post).

4.6.6   What are the treatment options for high TNFa ratio?
ARGC and Dr Gorgy prefer to use Humira (plus steroids and IVIg and/or intralipids), particularly if the ratio is very high.  Dr Sher doesn?t advocate Humira ? only steroids and intralipids.  In my personal opinion, if elevated TNFa is associated with elevated NK activity, then it seems logical that it may well respond to intralipids as suppressing NK activity seems likely to reduce any associated TNFa.  However, if TNFa is elevated in the absence of elevated NKa, it is not obvious how intralipids would help, whereas Humira is specifically targeted at blocking TNFa. However, success rates at clinics that don't use humira are often very good, so for some ladies the combination of steroids plus intralipids without Humira clearly does work. Other options like resveratrol, fish body oil or pre-treatment with low dose steroids also seem to work.
www.fertilityfriends.co.uk/forum/index.php

Maila Dr D igen och skriv Urgent som subject om du inte fått svar på måndag heller. Så hoppas jag du får svar från honom snart hur du ska göra.