# PLEASE HELP! Prednisone - which days?



## doglover13

Hi all,

We've been TTC for 19 mos. now. I'm wondering if anyone was prescribed prednisone. I've heard it can help the egg implant because it suppresses the immune system. If you were on it, which cycle days did you take it for, and in what dosage?


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## MrsJD

Hi honey 

I was on prenisolone for uterine natural killer cells, however I didn't start this until after my positive test.

I took B6 100mg and wellsprings progesterone cream prior to my :bfp: as this helps implanation.

X


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## doglover13

Thank you so much for the quick reply. I really appreciate it! Mad, mad congratulations on your current pregnancy. Keeping my fingers and toes crossed for you...:hugs:


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## oliveoyl

I've started this cycle on pred, doxycycline and aspirin.
Prednisolone from day 7 of cycle, continuing until either 12 weeks PG or end of 4 cycles.
I am on 20mg daily and we are TTC without any ART at present.
I haven't had uterine biopsy for NK cells but our FS was happy to treat empirically for 4 cycles, then will need biopsy if no luck.
Hope this helps


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## doglover13

Thank you so much. This is EXACTLY what I wanted to know. Thanks again!


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## oliveoyl

You're welcome doglover13 - I hope the steroids do the trick for you and you don't experience any side effects.


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## grneyednurse

Do you have immune issues that have messed with your fertility?


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## doglover13

grneyednurse said:


> Do you have immune issues that have messed with your fertility?

That is a good question. I have sensitivities to several foods, (all soy prods and derivatives, peanut, a few tree nuts, strawberries), and a few drug allergies, (clindomycin, neomycin, benzoyl peroxide). It took a few years to sort it all out. Meanwhile, I was on low-dose prednisone (2 mg/day), to keep the hives at bay. Now, I control reactions through my diet, but I'm wondering if there's a possible underlying inflammatory condition. Any thoughts?


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## oliveoyl

It certainly sounds possible......
I have had immune testing (other than natural killer cell/uterine biopsy) and all normal, but since TTC have had 7 early pg. losses and developed psoriasis, which is an immune condition. Immune causes of infertility/ART failure/miscarriage are only a relatively new field of medicine, but I am hopeful that it is our 'issue', and the steroids will help.


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## doglover13

oliveoyl said:


> It certainly sounds possible......
> I have had immune testing (other than natural killer cell/uterine biopsy) and all normal, but since TTC have had 7 early pg. losses and developed psoriasis, which is an immune condition. Immune causes of infertility/ART failure/miscarriage are only a relatively new field of medicine, but I am hopeful that it is our 'issue', and the steroids will help.

I'm so sorry to hear about your losses. I hope it goes better with the steroids. I just started taking prednisone 3 days ago, 5mg 2x/day, because I think I may have immune/rejection problems as well. When my body reacts to something, it tends to overreact, almost violently. I have also hear that, if you've been with your partner for a long time, it's more likely that you'll develop antibodies to his sperm. IDK if this is true. 

Keeping my fingers crossed for you!


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## grneyednurse

Wow, that really sucks not knowing if this is your problem or not. Have you been tested for immune issues? I wouldn't take that nasty prednisone without knowing though. It has way too many side effects without having a diagnosis. I would think the longer one has been with their hubby if they were to develop antibodies (as with any allergy) it would be true as far as that goes.....can you go to a doctor to be tested for this? I would die not knowing if this were my problem.


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## oliveoyl

Thanks doglover13 - I really hope it helps. My chart is looking amazing, but I'm too scared to test! https://www.fertilityfriend.com/home/202c37 It's certainly worth a go with the steroids and I hope it works for you. Why the dose twice daily - I read to take in the am as if you take it later in the day it can cause insomnia xx

Grneyednurse - yup, it sucks. We have tried all the other less invasive things, so now for the steroids. Although the side effects are potentially nasty, so is a miscarriage every second month for the last year, so for us its the better of the evils, and gives us hope. Also, many women take steroids during pregnancy for conditions like rheumatoid arthritis, and the side effects can generally be managed (I'm a Dr). There is testing available for immune issues. I just worry that there are so many things we don't understand about the immune system, and its role in fertility, and that even having a negative test doesn't rule out immue issues. 

xx


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## doglover13

grneyednurse said:


> Wow, that really sucks not knowing if this is your problem or not. Have you been tested for immune issues? I wouldn't take that nasty prednisone without knowing though. It has way too many side effects without having a diagnosis. I would think the longer one has been with their hubby if they were to develop antibodies (as with any allergy) it would be true as far as that goes.....can you go to a doctor to be tested for this? I would die not knowing if this were my problem.


I know prednisone is seriious stuff, but I'm gonna give it a go for the next two weeks, (or until my next period):nope:, and see if it helps. I have to check if there are any minimally invasive tests for immune.antivody issues. I hate the s/e, and am familiar with them, (weight gain, irritability, muscle/joint aches), but it's worth it to me to try it.


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## doglover13

oliveoyl said:


> Thanks doglover13 - I really hope it helps. My chart is looking amazing, but I'm too scared to test! https://www.fertilityfriend.com/home/202c37 It's certainly worth a go with the steroids and I hope it works for you. Why the dose twice daily - I read to take in the am as if you take it later in the day it can cause insomnia xx
> 
> Grneyednurse - yup, it sucks. We have tried all the other less invasive things, so now for the steroids. Although the side effects are potentially nasty, so is a miscarriage every second month for the last year, so for us its the better of the evils, and gives us hope. Also, many women take steroids during pregnancy for conditions like rheumatoid arthritis, and the side effects can generally be managed (I'm a Dr). There is testing available for immune issues. I just worry that there are so many things we don't understand about the immune system, and its role in fertility, and that even having a negative test doesn't rule out immue issues.
> 
> xx

Wow, your chart looks like a textbook pregnancy chart so far! I can see why you're scared to test, though. In the early months, I tested way too early and often. Now, I hold olut until my period is due. I am sick of staring at one naked, lonely line. 
You're a doctor -- how cool. Would you mind telling me what kind of tests there are? Can they test for antibodies to particular sperm? I just have a gut feeling my body is attacking his sperm. I don't know why...I love the guy, that's for sure! LOL! It's just a weird feeling. IDK why I'm splitting the dose. Insomnia, huh? That explains the tossing and turning for the past two nights!


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## grneyednurse

I know oliveoyl, that is why i asked her first if she KNOWS she has an issue, as taking the steroids without knowing the problem could cause more. I am just saying to find out the problem first, then treat. I hope you would agree.


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## oliveoyl

Thanks doglover13 - I caved and just tested...... and got a very feint line on a first response test just now. Here's hoping the steroids do their thing and help our lucky #8 stick this time. I am not sure of your situation, but I have had recurrent miscarriages so had the associated testing. We've had semen analysis, our karyotypes done, tests for autoimmune and clotting disorders, HSG to check tubes and I had an MRI (for other uterus issue probably not associated with early losses). The only testing I haven't had is uterine biopsy, though this is quite easy and is done a few days before your AF, just like a pap smear but I imagine a little more uncomfortable. OF our testing, we found I had a hydrosalpinx in one tube (this can cause MC) so had this removed in June, but have had 2 early losses since. All our other tests have been normal, but an immune mechanism is very likely given the nature of our losses and my development of other immune mediated problems recently. Regarding antisperm antibodies, they can do testing for this. Are you under the care of a fertility specialist?

Regarding the dosing, most people I've talked with about prednisolone take it in the morning to reduce any issues with insomnia. I assume you also know about titrating the dose slowly if you are planning on stopping the pred, or you can get very sick. 

Grneyednurse - I agree that testing is important, but I think it is also important to acknowledge the limitations of testing. If there is one thing that I have learned as a health professional on this rollercoaster of infertility is that it is all well and good to follow the clinical evidence, but as the patient I have found I am more willing to 'give things a go' even if the evidence is not great. This seems to be the case often in fertility medicine as there is so much that is unknown at this time. All that said, the protocol I am on is a protocol that is offered to those who have recurrent unsuccessful ART cycles and is being monitored carefully be an experienced specialist. Thanks for your input on these important issues.


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## doglover13

oliveoyl said:


> Thanks doglover13 - I caved and just tested...... and got a very feint line on a first response test just now. Here's hoping the steroids do their thing and help our lucky #8 stick this time. I am not sure of your situation, but I have had recurrent miscarriages so had the associated testing. We've had semen analysis, our karyotypes done, tests for autoimmune and clotting disorders, HSG to check tubes and I had an MRI (for other uterus issue probably not associated with early losses). The only testing I haven't had is uterine biopsy, though this is quite easy and is done a few days before your AF, just like a pap smear but I imagine a little more uncomfortable. OF our testing, we found I had a hydrosalpinx in one tube (this can cause MC) so had this removed in June, but have had 2 early losses since. All our other tests have been normal, but an immune mechanism is very likely given the nature of our losses and my development of other immune mediated problems recently. Regarding antisperm antibodies, they can do testing for this. Are you under the care of a fertility specialist?
> 
> Regarding the dosing, most people I've talked with about prednisolone take it in the morning to reduce any issues with insomnia. I assume you also know about titrating the dose slowly if you are planning on stopping the pred, or you can get very sick.
> 
> Grneyednurse - I agree that testing is important, but I think it is also important to acknowledge the limitations of testing. If there is one thing that I have learned as a health professional on this rollercoaster of infertility is that it is all well and good to follow the clinical evidence, but as the patient I have found I am more willing to 'give things a go' even if the evidence is not great. This seems to be the case often in fertility medicine as there is so much that is unknown at this time. All that said, the protocol I am on is a protocol that is offered to those who have recurrent unsuccessful ART cycles and is being monitored carefully be an experienced specialist. Thanks for your input on these important issues.

Congrats!, I'm crossing my toes, the dog's paws, etc. for you! 
To answer your Q's, I was under the care of an RE, and took a break from the meds to let my body normalize, but now I'm going to go back. I haven't been pregnant yet, as far as I know. There was one cycle where I'm pretty sure I conceived, but we lost it very early. I think I will request a test for antisperm antibodies. Thanks for the heads-up; I didn't know the test existed. I know about titrating the prednisone, because I was on it for a food allergy before. Today, I switched to taking all 10mg in the a.m., so hopefully it'll alleviate the sleep issues. I feel so hormonal this month, like period is about to come, but it's not due for another week. Then again, I felt this way for the first time last month, and wasn't pregnant, so I guess it doesn't mean anything. :shrug:
Are you taking prednisone and progesterone now?


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## honeyz

Hi I would like to know if anyone has had suspected immune issues and taken just the steroids either predisalone dexmethasone or any other steriod but not taken any other immune therapy or drugs and got a bfp. I would especially be interested in anyone who has never had a bfp and has had long term trying to concieve unexplained issues.

Also I would like to know pplz experiences of taking the steroids which side effects they got at what dose and did all the side effects completley dissapear after stopping the steroid or hav some side effects remained permanantely?

thank you for takin ur time to reply ur experiences would be greatly appreciated


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## Smiler13

Hi ladies,

Am interested in this thread as I have experienced four early pregnancy losses in the last year and am having dilemmas about tests and treatments. 

Oliveoyl, I agree, these are important issues and fertility testing and treatments for recurrent m/c are a minefield. Thank you for your informative posts - is reassurring that all this is difficult even for qualified medical professionals! I hope that this time works out for you.

I have seen two RMC specialists who are dubious about immunological issues / prednisolone, say there isn't the evidence, there are side-effects for the baby etc. etc. 

It makes it so difficult that drs have different opinions and approaches. As a non-scientist and not being able to read any relevant scientific studies, articles etc. I'm not sure how far I personally want to go in terms of "empirical" / more controversial approaches. It is something I'm carefully considering and am interested in others' experiences and viewpoints.

To make it even more complex, my husband has slightly different views and is an optimist, isn't keen on the more controversial tests and treatments, whereas I think I'm more "give it a go".

I have been trying to find somewhere doing the uterine biopsy (privately, I'm not eligible for the NHS trial in Liverpool) for NKCs, but not managed to find anywhere yet. 

Mrs JD (she has a pregnancy journal) is taking prednisolone after RMC and is 17 weeks along - am sure would be happy to share her perspective, will get in touch with her if I can work out private messaging / forwarding links etc.!


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## oliveoyl

Hey girls, this month was not meant to be - lovely BFP yesterday but then AF started - bring on 2010!

Doglover - Sounds like a visit back to your FS would be a good idea. How's your sleep now? I hope you don't mind me asking but how long have you been TTC? My FS said that there was no evidence that progesterone supplementation reduces risk of miscarriage as the cause of low progesterone is a non-viable pregnancy, but I haven't read the literature myself. Fingers crossed for you that you get your xmas BFP.

Honeyz - welcome. I have just done my first 'natural' cycle with 20mg prednisolone in the morning (+100mg aspirin + doxycycline days 2-12) for suspected immune issues . I got a BFP this month, but another chemical preg (our issue). In terms of side effects I haven't experienced any really. There are many potential side effects, some serious, but these can usually be managed and need to be weighed against the potential benefits. It is my understanding that most side effects will resolve when ceased, but issues such as bone density and skin changes may be permanent. Worth a good long chat with your doctor. 

Smiler - sorry you have had four pg losses in the last year, it just sucks doesn't it. I hope you get your sticky one soon. As for this area of fertility - it is a minefield, and really in its infancy with regards to good quality research. I am currently reading Dr Beers book on immune issues ("Is your body baby friendly?") which discusses the evidence. 20+ years ago leading FS thought IVF wouldn't work, so there is always hope. Regarding steroids many women take them during pregnancy without major issues, but it is a personal decision. I figure that without trying this treatment, we may never get the chance to have children, and it is a risk I am willing to take. Our next option is IVF/ICSI to look at whether embryo quality is our issue, but I figure the drugs used in this treatment are not without their own risks (and the financial and emotional costs) so would like to try less invasive methods first. Although it is difficult if your parther feels otherwise. It is encouraging as you point out that there are trials for this therapy currently underway - good luck trying to get on one. I have been in contact with Mrs JD and her story keeps me going.

Thinking of you all at this tough time of year xx


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## honeyz

thnx oliveoyl ur reply has helped me tons.
Im soo sorry bout ur af tht witch doesnt giv up. I hope and send u lots of luck 4 next month. :thumbup:
I jst wanted to ask u could the bone density change in a short space of time like taking predisialone for only a few weeks? one could workout and strenghen ur bones back right?
Also did ur psoriasis improve on the steriods? and after u stopped taking them did ur skin flare up even worse than before? as I have heard this is what happens.
baby dust ur way!


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## oliveoyl

Hey Honez, happy to help where i can.
Yup - I wish the witch would give me a break too - 9 months or so would do.
Probably not our month next cycle as only have one tube (to add to the confusion :wacko:)
Bone density would be a longer term effect, related to the dose and duration of treatment, as well as initial density. I am not too fussed as 20mg is a relatively low dose, and only 4 months treatment at this point - this side effect is usually more of an issue with longer higher dose therapy. I figure also PG vitamins are supplemented with Calcium and Vit D too.

My psoriasis has improved, but I am expecting a flare up following steroid cessation. I guess I'll deal with that when I need. Not too fussed about the psoriasis at this point - just want my sticky BFP.

Baby dust back at you xx


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## honeyz

:hugs:
thnx
Jst cos u hav one tube doesnt mean next month cant b ur month. I ovulate from the same side a few months then the other mayb a few then mayb one of each it varies u never knw 
loads luck xxxx


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## oliveoyl

Good point honeyz - although I've just had two months in a row on the right side - here's hoping for a third in a row!
xx


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## doglover13

Hey, just checking in. Olive Oyl, thanks for all the advice. Well, period reared her ugly head again. Onto month 20 TTC.:wacko: Titrating off prednisone now, and increasing DHEA dosage from 25mg to 100mg per naturopath. No other meds, but hey, I'd stand on the roof in a Mary Poppins hat if I thought it'd help us conceive! I'd make DH do it, too!:haha: I have an appointment with a new RE on Jan 4, one who comes highly recommended by a friend of mine. Anyway, where's everyone else at, at the moment?


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## oliveoyl

Hey doglover13, sorry about AF arriving, she's a nasty witch! Bugger about #20- I hope its a luck number for you - I'm up to #23.
Good luck titrating the steroids - I dropped back from CD1-7 with 5mg drop every 3 days and noticed my psoriasis flared badly - now back up to 20mg and all looking better.
He he, thanks for the smile at the thought of you and your DH dressed like mary poppins.
Good luck with your FS on Jan 4 - I'd love to hear how you go.

AFM - I'm waiting to o at the moment. Thinking about getting a second opinion from another FS after getting all my records from the current one. I can feel the pressure to go down the IVF/ICSI line from our current FS but I want to make sure we've tried everything else first - especially as ART price will almost double here in Australia tomorrow!
xx


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## honeyz

Hiya oliveoyl doglover and everyone else
Any updates how u all doing with the treatments?
Wishing you all luck in 2010 :thumbup:


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## oliveoyl

Heya honeyz,

Not much to add here. Another cycle and another TWW - 10DPO and another super feint line on dodgy internet test, so who knows. Continuing with antibotics, steroids and aspirin. Did some reading about Dr Beer "is your body baby friendly" - very helpful and found specialist here in Australia (another state) who does phone consults so have plan B, and have also requested full copy of records from fertility specialist so I can check what has and has not been tested.

Enough of me, how are you all going??
Hoping 2010 is the year for all of us
xxx


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## honeyz

Hiya oliveoyl it must be really hard getting a postive line and then a negative i hope the steroids do their bit and u get a sticky little bean. Nofin new here iv got an appointment with the consultant at the end of the month to discuss whether he will allow me to take steriods for my ivf cycle in march. I really wish he can come up with something new and not jst keep tellin me its unexplained, im a bit fed up of that after 13 years of trying. 
Anyway iv read that what u focus on most is what you end up with in live so here's to positive thinking :thumbup:


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## oliveoyl

Hey Honeyz,
Just a quick response, sorry.
I'd be pushing for more testing/ivf protocol with pred and other things.
Read Dr Beers book, or at least mention it to your FS - it was eye opening and gave me hope that there is an explanation for our "unexplained"
If we end up doing IVF I'll be pushing for steroids, aspirin, doxycycline, LMWH and intralipid protocol.
Thinking of you xxx


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